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Sections
Cover Page and Inside Cover
Table of Contents
Introduction/Plain Language/Advisory
FEHB Facts
Section 1
Section 2
Section 3
Section 4
Section 5
5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals
5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services
5(d). Emergency Services/Accidents
5(e). Mental Health and Substance Use Disorder Benefits
5(f). Prescription Drug Benefits
5(g). Dental Benefits
5(h). Wellness and Other Special Features
5(i). Services, Drugs, and Supplies Provided Overseas
Non-FEHB Benefits Available to Plan Members
Section 6
Section 7
Section 8
Section 9
Section 10
Index
Summary of Benefits – Standard Option
Summary of Benefits – Basic Option
2027 Rate Information
 
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FEHB FEP Blue Standard and FEP Blue Basic Options

 

 

2027 Blue Cross and Blue Shield Service Benefit Plan
FEP Blue Standard and FEP Blue Basic
Section 4. Your Costs for Covered Services
Your costs for other care

Overseas care. Services provided outside the United States, Puerto Rico, and the U.S. Virgin Islands are considered overseas care. Under Standard and Basic Options, we pay overseas claims at Preferred benefit levels. Therefore, the Basic Option requirement to use Preferred providers in order to receive benefits does not apply. See Section 5(i) for specific information about our overseas benefits.

Dental care. Under Standard Option, we pay scheduled amounts for covered dental services and you pay balances as described in Section 5(g). Under Basic Option, you pay $35 for any covered evaluation and we pay the balance for covered services. Basic Option members must use Preferred dentists in order to receive benefits. See Section 5(g) for a listing of covered dental services and additional payment information.

Inpatient facility care. Under Standard and Basic Options, you pay the coinsurance or copayment amounts listed in Section 5(c). Under Standard Option, you must meet your deductible before we begin providing benefits for certain facility-billed services. Under Basic Option, you must use Preferred facilities in order to receive benefits. See Section 3 under What you must do to get covered care.
 

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