FEP Blue Focus
the limit is $8,500 for self only or $17,000 for self plus one or family when you use Preferred Providers
What is Catastrophic Amount limit?
Evaluations, Prophys (cleanings), fluoride per calendar year, Palliative treatment, intra oral complete series
What is the Dental Benefit?
Crutches are a part of this benefit
What is Durable Medical Equipment (DME)?
Personal comfort items, such as guest meals and beds, telephone, television, beauty and barber services
What is not covered?
Excision of tumors and cyst of the jaws, cheeks, lips, tongue, roof and floor of mouth when pathological examination is necessary
What is a type of Oral and Maxillofacial Surgery?
$500 individual $1000 self plus one or family coverage
What is deductible?
Routine foot care when you are under active treatment for a metabolic or peripheral vascular disease, such as diabetes
What is Foot Care benefit?
Bone density test copay with PPO providers?
What is a $100 copay?
Inpatient facility copay for PPO providers Basic
What is $175 copay per day, up to $875 maximum per admission
Shoes (including diabetic shoes), over- the- counter orthotics, arch supports, heel pads and heel cups
What is not covered under Orthopedic and Prosthetic Devices?
Limit of 10 visits per person per calendar year
Provocative food testing
What is not covered for Allergy Care?
Copay for Maternity Care Facility PPO Provider
What is $175 copay per admission
Inpatient Facility Non-Member Copay Standard Option
What is Patient is responsible for $450 copay per admission for unlimited days?
Colonoscopy benefits with PPO provider all options
What is covered at 100% of plan allowance?
After 10th visit: Patient is responsible for 30% of plan allowance, after deductible of $500 ind/$1000 self plus one or family
What is Office visit benefit?
Vasectomy- Benefits are provided at 100% of the plan allowance, for all eligible services (no deductible)
What is Family Planning PPO Benefit?
This is a federal law that provides you with protections against "surprise billing" and "balance billing" under circumstances.
What is the No Surprises Act?
Inpatient PPO Benefit FEP Blue Focus
What is Patient is responsible for 30% of plan allowance after deductible of $500/$1,000 self plus one or family?
Hearing aid for adult benefits Standard
What is Hearing aids for adults age 22 and over, limited to $2500 every 5 calendar years?
Benefits are limited to 25 visits per person, per calendar year for ______, _______, or ______, or a combination of all three
What is Physical, occupational, or speech therapy?
$350 individual/ $700 family
What is the calendar year deductible?
Urgent Care Non- PPO benefits
What are no benefits available?
Inpatient Hospice Benefit Standard Option PPO provider
What is plan provides benefits at 100% of plan allowance (no deductible)?
What is not a benefit on FEP Blue Focus?