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Sections
Cover Page and Inside Cover
Table of Contents
Introduction/Plain Language/Advisory
PSHB 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(f)(a). FEP Medicare Prescription Drug Plan
5(g). Dental Benefits
5(h). Wellness and Other Special Features
5(i). Services, Drugs, and Supplies Provided Overseas
Non-PSHB Benefits Available to Plan Members
Section 6
Section 7
Section 8
Section 8(a)
Section 9
Section 10
Index
Summary of Benefits – Standard Option
Summary of Benefits – Basic Option
2026 Rate Information
Entire brochure in page-number order
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Blue Cross Blue Shield Association logo
 
 

Blue Cross and Blue Shield Service Benefit Plan Brochure - 2026

PSHB Standard and Basic Options - Local Plans and BCBSA Internal Use

 

Section 5(b). Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals

Section 5(b). Overview
Surgical Procedures
Reconstructive Surgery
Oral and Maxillofacial Surgery
Organ/Tissue Transplants
Anesthesia
 

Blue Cross and Blue Shield Service Benefit Plan
Confidential - Local Plan and BCBSA use only