FEHB Standard and Basic Options
2026 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Index
Page 161
Index
Page 161
Medications and supplies - 102-106, 110-113
Member facilities - 13-14, 155-156
Mental health/substance use disorder - 92-96, 128
MRIs - 40-41, 77-81
Multiple procedures - 63-64
MyBlue Customer eService - 126
National Doctor & Hospital Finder - 13-14, 126
Neurological testing - 40-41, 77-81
Never Events - 6-8, 154
Newborn care - 26-27, 47-48
No Surprises Act (NSA) - 32
Non-member facilities - 13-14, 155-156
Non-participating providers - 13-14, 156-157
Non-preferred providers - 29-32
Nurse - 59, 124
Nutritional counseling - 42-46, 158
Observation care - 154
Obstetrical care - 47-48
Occupational therapy - 53-54, 84-86
Office visits - 39-40, 93-94
Oral surgery - 65-66
Organ/tissue transplants - 66-67, 71-72
Orthopedic devices - 56-57, 77-81
Osteopathic manipulative treatment - 59-60
Osteoporosis screening - 157
Ostomy and catheter supplies - 58-59
Out-of-pocket expenses - 29-33
Outpatient facility services - 81-82
Outpatient professional services - 39-40
Overpayments - 34
Overseas Assistance Center - 129
Overseas services, drugs, supplies and claims - 129-131
Oxygen - 57-59
Pap tests - 42-46
Participating providers - 13-14, 29-32, 155-156
Patient Safety and Quality Monitoring (PSQM) Program - 98-101
Personal Health Record - 124
PET scans - 40-41, 77-81
Pharmacotherapy - 39-40, 52-53
Physical examination - 42-46, 77-81
Physical therapy - 53-54, 84-86
Physician - 153, 157
Plan allowance - 155-156
PPO - 13-14
Pre-admission testing - 75-77
Precertification - 22
Preferred providers - 13-14, 29-32
Pregnancy (see: Maternity care)
Pregnancy Care Incentive Program - 125-126
Prescription drugs
Prior approval - 22-25, 157
Professional providers - 18
Prostate cancer tests - 42-44
Prosthetic devices - 56-57, 77-81
Psychotherapy - 93-95
Pulmonary rehabilitation - 52-53, 77-81
Radiation therapy - 22-25, 52-53, 77-81
Reconsiderations - 27, 138-140
Renal dialysis - 52-53, 77-81
Replacement coverage - 11-12
Reproductive services - 50-51
Retail Pharmacy Program - 97 -98, 102-106, 130-131, 136-137
Rights and responsibilities - 13-14
Room and board - 75-77, 82-83, 94-95
Screening services - 157
Second surgical opinion - 39-40
Self-injectable drugs - 38, 62, 74, 77-81
Skilled nursing facility (SNF) care - 18-20
Smoking cessation - 60-61, 113-118, 124
Social worker - 126-127
Specialty Drug Pharmacy Program - 97-98, 102-106, 130-131, 136-137
Specialty drugs - 98-110, 136-137, 158
Speech therapy - 53-54, 77-81, 84-86
Speech-Generating Devices - 57-58
Stem Cell Transplants - 67-70
Sterilization procedures - 49-50
Subrogation - 142-143, 158
Substance use disorder - 18-20, 92-96, 128
Surgery
Telehealth
Tobacco cessation - 60-61, 113-118, 124
Transplants - 22-25, 63-64, 66-72
Travel benefit - 71-72, 124
Treatment therapies - 52-53
TRICARE - 141-142
Ultrasounds - 40-41, 77-81
Urgent care center - 89-91
Urgent care claims - 158-159
VA facilities - 34, 149
Vision services - 54-55, 144
Waivers - 29
Weight control - 42-46, 124, 128
Wheelchairs - 57-58
Wigs - 56-57
X-rays - 20-21, 40-41, 77-81
Member facilities - 13-14, 155-156
Mental health/substance use disorder - 92-96, 128
MRIs - 40-41, 77-81
Multiple procedures - 63-64
MyBlue Customer eService - 126
National Doctor & Hospital Finder - 13-14, 126
Neurological testing - 40-41, 77-81
Never Events - 6-8, 154
Newborn care - 26-27, 47-48
No Surprises Act (NSA) - 32
Non-member facilities - 13-14, 155-156
Non-participating providers - 13-14, 156-157
Non-preferred providers - 29-32
Nurse - 59, 124
Nutritional counseling - 42-46, 158
Observation care - 154
Obstetrical care - 47-48
Occupational therapy - 53-54, 84-86
Office visits - 39-40, 93-94
Oral surgery - 65-66
Organ/tissue transplants - 66-67, 71-72
Orthopedic devices - 56-57, 77-81
Osteopathic manipulative treatment - 59-60
Osteoporosis screening - 157
Ostomy and catheter supplies - 58-59
Out-of-pocket expenses - 29-33
Outpatient facility services - 81-82
Outpatient professional services - 39-40
Overpayments - 34
Overseas Assistance Center - 129
Overseas services, drugs, supplies and claims - 129-131
Oxygen - 57-59
Pap tests - 42-46
Participating providers - 13-14, 29-32, 155-156
Patient Safety and Quality Monitoring (PSQM) Program - 98-101
Personal Health Record - 124
PET scans - 40-41, 77-81
Pharmacotherapy - 39-40, 52-53
Physical examination - 42-46, 77-81
Physical therapy - 53-54, 84-86
Physician - 153, 157
Plan allowance - 155-156
PPO - 13-14
Pre-admission testing - 75-77
Precertification - 22
Preferred providers - 13-14, 29-32
Pregnancy (see: Maternity care)
Pregnancy Care Incentive Program - 125-126
Prescription drugs
Brand-name drugs - 98-110
Drugs from other sources - 118-119
Generic drugs - 98-101, 107-110
Mail Service Prescription Drug Program - 97-106, 110-113, 130-131, 136-137
Preferred retail pharmacies - 102-106, 113-118, 136-137
Retail Pharmacy Program - 97-98, 101-106, 136-137
Self-injectable drugs - 38, 62, 74, 77-81
Specialty Drug Pharmacy Program - 97-106, 136-137
Specialty drugs - 98-110, 136-137, 158
Preventive carePrimary care provider - 18Drugs from other sources - 118-119
Generic drugs - 98-101, 107-110
Mail Service Prescription Drug Program - 97-106, 110-113, 130-131, 136-137
Preferred retail pharmacies - 102-106, 113-118, 136-137
Retail Pharmacy Program - 97-98, 101-106, 136-137
Self-injectable drugs - 38, 62, 74, 77-81
Specialty Drug Pharmacy Program - 97-106, 136-137
Specialty drugs - 98-110, 136-137, 158
Prior approval - 22-25, 157
Professional providers - 18
Prostate cancer tests - 42-44
Prosthetic devices - 56-57, 77-81
Psychotherapy - 93-95
Pulmonary rehabilitation - 52-53, 77-81
Radiation therapy - 22-25, 52-53, 77-81
Reconsiderations - 27, 138-140
Renal dialysis - 52-53, 77-81
Replacement coverage - 11-12
Reproductive services - 50-51
Assisted reproductive technology (ART) - 151
Residential Treatment Center (RTC) - 22, 82-83, 94-95Retail Pharmacy Program - 97 -98, 102-106, 130-131, 136-137
Rights and responsibilities - 13-14
Room and board - 75-77, 82-83, 94-95
Screening services - 157
Second surgical opinion - 39-40
Self-injectable drugs - 38, 62, 74, 77-81
Skilled nursing facility (SNF) care - 18-20
Smoking cessation - 60-61, 113-118, 124
Social worker - 126-127
Specialty Drug Pharmacy Program - 97-98, 102-106, 130-131, 136-137
Specialty drugs - 98-110, 136-137, 158
Speech therapy - 53-54, 77-81, 84-86
Speech-Generating Devices - 57-58
Stem Cell Transplants - 67-70
Sterilization procedures - 49-50
Subrogation - 142-143, 158
Substance use disorder - 18-20, 92-96, 128
Surgery
Assistant surgeon - 20-21, 38, 62
Eye: cataract, amblyopia, strabismus - 54-55, 63-64
Multiple procedures - 63-64
Oral and maxillofacial - 65-66
Outpatient - 155
Reconstructive - 64-65
Sterilization, reversal of voluntary - 49-50, 63-64
Surgical implants - 56-57, 77-81
Surgical treatment of severe obesity - 42-46
Transplants - 63-64, 66-72
Syringes - 102-106, 110-113Eye: cataract, amblyopia, strabismus - 54-55, 63-64
Multiple procedures - 63-64
Oral and maxillofacial - 65-66
Outpatient - 155
Reconstructive - 64-65
Sterilization, reversal of voluntary - 49-50, 63-64
Surgical implants - 56-57, 77-81
Surgical treatment of severe obesity - 42-46
Transplants - 63-64, 66-72
Telehealth
Dermatology - 39-40, 158
Mental health/substance use disorder - 18-20, 92-96, 128
Minor acute conditions - 18, 39-40, 154, 158
Nutritional counseling - 18, 39-40, 42-46, 158
Temporary Continuation of Coverage (TCC) - 12Mental health/substance use disorder - 18-20, 92-96, 128
Minor acute conditions - 18, 39-40, 154, 158
Nutritional counseling - 18, 39-40, 42-46, 158
Tobacco cessation - 60-61, 113-118, 124
Transplants - 22-25, 63-64, 66-72
Travel benefit - 71-72, 124
Treatment therapies - 52-53
TRICARE - 141-142
Ultrasounds - 40-41, 77-81
Urgent care center - 89-91
Urgent care claims - 158-159
VA facilities - 34, 149
Vision services - 54-55, 144
Waivers - 29
Weight control - 42-46, 124, 128
Wheelchairs - 57-58
Wigs - 56-57
X-rays - 20-21, 40-41, 77-81