2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 3. How You Get Care
Where you get covered care
Section 3. How You Get Care
Where you get covered care
Where you get covered care
Under Standard Option, you can get care from any “covered professional provider” or “covered facility provider.” How much we pay – and you pay – depends on the type of covered provider you use. If you use our Preferred, Participating, or Member providers, you will pay less.
Under Basic Option, you must use those “covered professional providers” or “covered facility providers” that are Preferred providers for Basic Option in order to receive benefits. Please refer to page 20 for the exceptions to this requirement. Refer to page 13 for more information about Preferred providers.
Under both Standard and Basic Option, you can also get care for the treatment of minor acute conditions (see page 155 for definition), dermatology care (see page 39), counseling for behavioral health and substance use disorder (see page 99), and nutritional counseling (see pages 42 and 46), using teleconsultation services delivered via phone by calling 855-636-1579, TTY: 711, or via secure online video/messaging at www.fepblue.org/telehealth.
The term “primary care provider” includes family practitioners, general practitioners, medical internists, pediatricians, obstetricians/gynecologists, and physician assistants. Physician assistants working for a specialist may also be considered specialists.
Under Standard Option, you can get care from any “covered professional provider” or “covered facility provider.” How much we pay – and you pay – depends on the type of covered provider you use. If you use our Preferred, Participating, or Member providers, you will pay less.
Under Basic Option, you must use those “covered professional providers” or “covered facility providers” that are Preferred providers for Basic Option in order to receive benefits. Please refer to page 20 for the exceptions to this requirement. Refer to page 13 for more information about Preferred providers.
Under both Standard and Basic Option, you can also get care for the treatment of minor acute conditions (see page 155 for definition), dermatology care (see page 39), counseling for behavioral health and substance use disorder (see page 99), and nutritional counseling (see pages 42 and 46), using teleconsultation services delivered via phone by calling 855-636-1579, TTY: 711, or via secure online video/messaging at www.fepblue.org/telehealth.
The term “primary care provider” includes family practitioners, general practitioners, medical internists, pediatricians, obstetricians/gynecologists, and physician assistants. Physician assistants working for a specialist may also be considered specialists.