2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Index
Page 161

Medicaid - 143 
Medical emergency - 20, 94, 96-97
Medical foods - 58-59, 108-119,155
Medical supplies - 58-59, 79-85, 89-92
Medically necessary - 21, 26, 134-135, 144-145, 155 
Medicare - 1, 21, 69-70, 88-89, 127, 142-151 Medications and supplies - 108-119
Member facilities - 13-14, 18-19, 155-157 
Mental health/substance use disorder - -47-49, 87-88, 98-102, 154 
MRIs - 40-42, 81-85, 152 
Multiple procedures - 63-65
MyBlue Customer eService - 127-128
National Doctor & Hospital Finder - 128
Neurological testing - 40-42, 81-85
Never Events - 6-8, 155
Newborn care - 26, 39-40, 45-49
No Surprises Act (NSA) - 32
Non-member facilities - 13-14, 155-157
Non-participating providers - 13-14, 24, 32
Non-preferred providers - 29-33
Nurse - 18-19, 59-60, 89-92, 125, 128
Nutritional counseling - 42-47, 126, 129
Observation care - 155 
Obstetrical care - 47-49
Occupational therapy - 53-54, 89-92
Office visits - 37, 39-40, 99-100, 158, 163 
Online Health Coach (OHC) - 125
Oral surgery - 68-69
Organ/tissue transplants - 22-24, 69-76
Orthopedic devices - 56-57, 81-85
Osteopathic manipulative treatment - 60 
Osteoporosis screening - 158
Ostomy and catheter supplies - 58-59
Out-of-pocket expenses - 32-33, 37, 157-158
Outpatient facility services - 81-85
Outpatient professional services - 39-40
Overpayments - 34
Overseas Assistance Center - 130
Overseas services, drugs, supplies and claims - 130-132
Oxygen - 57-59
Pap tests - 42-47
Participating providers - 39-61, 63-75, 77, 94-97, 99-100, 124
Patient Safety and Quality Monitoring (PSQM) Program - 104-107
Personal Health Record - 125
PET scans - 42, 81-85, 152
Pharmacotherapy - 39-40, 52-53
Physical examination - 81-85,134-135 
Physical therapy - 39-40, 53-54, 89-92
Physician - 17, 21, 146, 149-150, 154,162-165
Plan allowance - 155-157
PPO - 13-14, 158
Pre-admission testing - 79-81 
Precertification - 21, 24-26, 154, 157-158 
Preferred providers - 1314, 20, 29-32
Pregnancy (see: Maternity care)
Pregnancy Care Incentive Program - 127
Prescription drugs - 108-119Preventive carePrimary care provider - 17, 37, 39-40, 45-47, 50-56, 61, 89-92 
Prior approval - 21-25, 52-53, 62-70, 78-79, 89-92, 103-119, 137-138,152, 154, 158
Professional providers - 17
Prostate cancer tests - 42-45
Prosthetic devices - 56-57, 63-68, 78-85
Psychotherapy - 99-102 
Pulmonary rehabilitation - 52-53, 81-85
Radiation therapy - 52-53, 81-85
Reconsiderations - 27, 139-141
Renal dialysis - 18-19, 52-53, 81-85
Replacement coverage - 12
Reproductive services - 50, 152Residential Treatment Center (RTC) - 18-19, 21, 24-25, 87-88, 100-101, 128, 153
Retail Pharmacy Program - 37, 103-119, 131-132, 136-138, 158, 163, 165
Rights and responsibilities - 13-14
Room and board - 21, 26, 39-40, 79-81, 87-89, 100-101 
Screening services - 158
Second surgical opinion - 39-40
Self-injectable drugs - 108-119, 158-159
Skilled nursing facility (SNF) care - 18-19, 153
Smoking cessation - 61, 108-119, 125
Social worker - 128
Specialty Drug Pharmacy Program - 103-104, 108-119, 131-132, 137-138
Specialty drugs - 108-119, 158-159
Speech therapy - 53-54, 81-85, 89-92 
Speech-Generating Devices - 57-58
Stem Cell Transplants - 69-75
Sterilization procedures - 49, 63-65
Subrogation - 143-144, 159
Substance use disorder - 98-102, 163-164
Surgery - 24, 54-55, 62-77, 86-87, 153Syringes - 108-119
Telehealth - 159Temporary Continuation of Coverage (TCC) - 11-12
Tobacco cessation - 61, 108-119, 125
Transplants - 18-19, 21-24, 52-53, 69-76
Travel benefit - 75-76, 125
Treatment therapies - 52-53
TRICARE - 142-143 
Ultrasounds - 40-42, 81-85
Urgent care center - 95-97
Urgent care claims - 25-26, 159
VA facilities - 150
Vision services - 54-55, 144
Waivers - 29
Weight control - 125, 134-135
Wheelchairs - 57-58, 88-89, 92-93
Wigs - 56-57
X-rays - 40-42, 144-145

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