2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 2. Changes for 2023
Changes to both our Standard and Basic Options
Section 2. Changes for 2023
Changes to both our Standard and Basic Options
Changes to both our Standard and Basic Options
- We now cover preventive low-dose CT screenings for lung cancer for members aged 50 to 80. Previously, preventive benefits did not start until age 55.
- We now require prior approval for certain high-cost drugs obtained outside of a pharmacy setting. Previously, prior approval was not required. (See page 22.)
- We now require prior approval for proton beam therapy. Previously, prior approval was not required. (See page 22.)
- We now require prior approval for stereotactic radiosurgery and stereotactic body radiation therapy. Previously, prior approval was not required. (See page 22.)
- We now cover one year of sperm and egg storage for those individuals facing iatrogenic infertility. Previously, there was no benefit for this service. (See pages 22, 50 and 154.)
- We now cover computed tomography (CT) colonography under the adult preventive benefit for colorectal cancer tests. Previously, this was not covered under the preventive benefit. (See page 42.)
- We will make changes as soon as possible and provide you with preventive benefits for the USPSTF A and B, ACIP, HRSA, and Bright Futures recommendations as they occur throughout the year. Previously, these updates were made annually. (See pages 43 and 45.)
- We now provide 8 visits per calendar year to treat depression associated with pregnancy with no member cost-share when a Preferred provider is used. Previously, we provided coverage for only 4 visits per calendar year. (See page 47.)
- We now provide individuals who are pregnant with a free blood pressure monitor when ordered through our vendor. (See page 48.)
- We now cover medical foods for the treatment of inborn errors of amino acid metabolism regardless of age. Previously, we limited this to individuals under the age of 22. (See page 109.)
- We now provide benefits for medically necessary bariatric surgery beginning at the age of 16. Previously, this benefit was limited to individuals aged 18 and older. (See page 64.)
- We no longer limit the number of non-full sibling donor screening tests for transplants. Previously, we limited non-full sibling donor test screenings to three. (See page 75.)
- We now cover the generic naloxone nasal spray with zero cost-share for the first purchase of up to a 90-day supply per calendar year. Previously, we covered the Narcan nasal spray under this benefit. (See page 113.)
- We now provide coverage for weight loss medications to treat obesity when obtained through one of our pharmacy drug programs. Previously, these drugs were not covered for the treatment of obesity.
- We now cover over-the-counter (OTC) condoms for all members with zero member cost-share when you have a prescription from your physician and they are purchased in a Preferred retail pharmacy. Previously, benefits were available only for female condoms. (See page 110.)