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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
2026 Rate Information
 
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PSHB Standard and Basic Options

 
 

 

2026 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 5.  Benefits
Page 36

 

Not Covered (Inpatient or Outpatient) - 98
Section 5(f). Prescription Drug Benefits - 100
Covered Medications and Supplies - 105
Section 5(f)(a). FEP Medicare Prescription Drug Plan - 110
Covered Medications and Supplies - 114
Section 5(g). Dental Benefits - 125
Accidental Injury Benefit - 125
Dental Benefits - 126
Section 5(h). Wellness and Other Special Features - 129
Health Tools - 129
Services for the Deaf and Hearing Impaired - 129
Web Accessibility for the Visually Impaired - 129
Travel Benefit/Services Overseas - 129
Healthy Families - 129
Diabetes Management Program - 129
Blue Health Assessment - 129
Hypertension Management Program - 130
Pregnancy Care Incentive Program - 130
Annual Incentive Limitation - 131
Reimbursement Account for Basic Option Members Enrolled in Medicare Part A and Part B - 131
MyBlue® Customer eService - 131
National Doctor & Hospital Finder - 131
Care Management Programs - 131
Flexible Benefits Option - 132
Telehealth Services - 133
The fepblue Mobile Application - 133
Weight Loss Management Program - 133
Section 5(i). Services, Drugs, and Supplies Provided Overseas - 134
Non-PSHB Benefits Available to Plan Members - 137
 

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