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Cover Page and Inside Cover
Table of Contents
Introduction/Plain Language/Advisory
FEHB Facts
Section 1
Section 2
Section 3
Section 4
Section 5
5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals
5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services
5(d). Emergency Services/Accidents
5(e). Mental Health and Substance Use Disorder Benefits
5(f). Prescription Drug Benefits
5(g). Dental Benefits
5(h). Wellness and Other Special Features
5(i). Services, Drugs, and Supplies Provided Overseas
Non-FEHB Benefits Available to Plan Members
Section 6
Section 7
Section 8
Section 9
Section 10
Index
Summary of Benefits – FEP Blue Focus
2025 Rate Information
Entire brochure in page-number order
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Blue Cross Blue Shield Federal Employee Program logo
 
 

 

2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 3. How You Get Care

What you must do to get covered care:
If you are hospitalized when your enrollment begins

 

  • If you are hospitalized when your enrollment begins
We pay for covered services from the effective date of your enrollment. However, if you are in the hospital when your enrollment in our Plan begins, call us immediately. If you have not yet received your ID card, you can contact your Local Plan at the phone number listed in your local phone directory. If you already have your new ID card, call us at the phone number on the back of your ID card. If you are new to the FEHB Program, we will reimburse you for your covered services while you are in the hospital beginning on the effective date of your coverage.

However, if you changed from another FEHB plan to us, your former plan will pay for the hospital stay until:
  • you are discharged, not merely moved to an alternative care center;
  • the day your benefits from your former plan run out; or
  • the 92nd day after you become a member of this Plan, whichever happens first

These provisions apply only to the benefits of the hospitalized person. If your plan terminates participation in the FEHB in whole or in part, or if OPM orders an enrollment change, this continuation of coverage provision does not apply. In such cases, the hospitalized family member’s benefits under the new plan begin on the effective date of enrollment.
 

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