2027 Blue Cross and Blue Shield Service Benefit Plan
FEP Blue Standard and FEP Blue Basic
Section 5. Benefits
Section 5. Benefits
See Section 2 for how our benefits changed this year and towards the end of the brochure for a benefits summary of each option. Make sure that you review the benefits that are available under the option in which you are enrolled.

Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals - 37
Diagnostic and Treatment Services - 38
Lab, X-ray and Other Diagnostic Tests - 39
Preventive Care, Adult - 41
Preventive Care, Child - 44
Maternity Care - 46
Family Planning - 49
Reproductive Services - 50
Allergy Care - 51
Treatment Therapies - 52
Physical Therapy, Occupational Therapy, Speech Therapy, and Cognitive Rehabilitation Therapy - 54
Hearing Services - 54
Vision Services (Testing, Treatment, and Supplies) - 55
Foot Care - 56
Orthopedic and Prosthetic Devices - 56
Durable Medical Equipment (DME) - 57
Medical Supplies - 59
Home Health Services - 59
Manipulative Treatment - 60
Alternative Treatments - 60
Educational Classes and Programs - 61
Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals - 63
Surgical Procedures - 64
Reconstructive Surgery - 65
Oral and Maxillofacial Surgery - 66
Organ and Tissue Transplants - 67
Anesthesia - 73
Section 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services - 75
Inpatient Hospital - 76
Outpatient Hospital or Ambulatory Surgical Center - 78
Blue Distinction® Specialty Care - 82
Residential Treatment Center - 83
Extended Care Benefits/Skilled Nursing Care Facility Benefits - 84
Hospice Care - 85
Ambulance - 87
Section 5(d). Emergency Services/Accidents - 89
Accidental Injury - 90
Medical Emergency - 91
Ambulance - 92
Section 5(e). Mental Health and Substance Use Disorder Benefits - 93
Professional Services - 94
Inpatient Hospital or Other Covered Facility - 95
Residential Treatment Center - 95
Outpatient Hospital or Other Covered Facility - 96
Not Covered (Inpatient or Outpatient) - 96
Section 5(f). Prescription Drug Benefits - 98
Covered Medication and Supplies - 115
Section 5(g). Dental Benefits - 122
Accidental Injury Benefit - 122
Dental Benefits - 123
Section 5(h). Wellness and Other Special Features - 126
Health Tools - 126
Services for the Deaf and Hearing Impaired - 126
Web Accessibility for the Visually Impaired - 126
Travel Benefit/Services Overseas - 126
Healthy Families - 126
Diabetes Management Program - 126
Blue Health Assessment - 127
Pregnancy Care Incentive Program - 128
Annual Incentive Limitation - 128
Reimbursement Account for Basic Option Members Enrolled in Medicare Part A and Part B - 128
MyBlue® Customer eService - 128
National Doctor & Hospital Finder - 128
Care Management Programs - 129
Flexible Benefits Option - 129
Telehealth Services - 130
The fepblue Mobile Application - 130
Weight Loss Management Program - 130
Section 5(i). Services, Drugs, and Supplies Provided Overseas - 131
Non-FEHB Benefits Available to Plan Members - 134