FEP Blue Focus
PPO: Patient is responsible for $10 copay (no deductible)
What is office visit benefit?
limited to a combined total of 12 visits per person, per calendar year.
What is Chiropractic?
benefits are limited to a combined total of 20 visits per person, per calendar year.
What is Chiropractic?
Patient is responsible for $25 copay to a primary care provider or $35 copay to a specialist, (no deductible). All other covered services are subject to $350 individual/ $700 family calendar year deductible. Patient is responsible for 15% of plan allowance, after deductible.
what are standard option office visit benefits?
Benefits provided at 100% of plan allowance.
what are basic option inpatient treatment therapies?
Two hours per day limited to 10 visits per year
What is home Nursing?
Evaluations (2 periodic oral evaluations per calendar year), 2 prophylaxis (cleanings) per calendar year, 2 topical applications of flouride per calendar year, palliative treatment, and intraoral complete series.
What are dental benefits?
Patient responsible for $175 copay, per day, up to a $875 maximum per admission. Benefits are provided at 100% of plan allowance for unlimited days
What is inpatient admission?
Nothing. Benefits for all eligible cancer diagnostic testing and screening procedures are provided at 100% of plan allowance.
what are BRAC benefits?
Inpatient services are necessary to control pain and/or manage the Member's symptoms;
Death is imminent; or
Inpatient services are necessary to provide an interval of relief (respite) to the caregiver
What is inpatient hospice care standard option?
Covered at 100% of the allowed
What is Family Planning?
5000/10000 max out of pocket with preferred providers
What is Catastrophic?
Patient is responsible for 30% of plan allowance, for all eligible items and supplies.
What is DME?
Benefits are limited to 10 visits per calendar year.
what are basic option acupuncture benefits?
Patient is responsible for 30% of plan allowance, after deductible of $500 individual /$1,000 Self Plus One or Family
what are FEP Blue Focus inpatient treatment therapies benefits
Patient is responsible for 30% of plan allowance, for all eligible items and supplies, after deductible of $500 individual /$1,000 Self Plus One or Family
What is DME?
Contraceptive counseling
Diaphragms and contraceptive rings
Injectable contraceptives
Intrauterine devices (IUDs)
What is Family Planning?
Patient is responsible for a $150 copay per day per facility
What is BASIC OUTPATIENT FACILITY DIAGNOSTIC TESTING & LABS?
Patient is responsible for $30 copay per evaluation, and we pay any balances in full.
what is basic option dental benefits?
Patient is responsible for $350 copay per admission. Plan provides benefits at 100% of allowed amount. (no deductible)
What is inpatient mental health and substance use disorder benefits?
Benefits are limited to 25 visits per person, per calendar year
What is Physical, Occupational and Speech Therapy?
benefits are limited to one per calendar year and to members age 22 and over
What is Preventative Care Adult?
adults age 22 and over, limited to $2500 every 5 calendar years
What are hearing aids?
Patient is responsible for 30% of plan allowance, after deductible of $500 individual /$1,000 Self Plus One or Family
What is FEP Blue Focus inpatient professional benefits?
Benefits are provided at 100% of plan allowance for all eligible services
What are Basic option inpatient professional benefits?