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The Governmentwide Service Benefit Plan (also referred to as the Federal Employee Program or FEP), is administered by the Blue Cross and Blue Shield Association on behalf of Blue Cross and Blue Shield Plans nationwide, and is open to everyone eligible to enroll under the FEHB Program.
Depending on the type of care you require, you may need pre-approval (in the form of a prior authorization, precertification or both). We review the service or treatment to ensure it is medically necessary. If you do not obtain pre-approval, there may be a reduction or denial of your benefit.
Imaging (CT /PET scans, MRIs) 30% coinsurance Not covered Prior approval is required. There is a $100 penalty if prior approval is not obtained. More information about prescription drug coverage is available at fepblue.org/formulary Tier 1 (Preferred generic drugs) $5/prescription (30-day supply).
Prior authorization means that your doctor must get approval from Blue Shield before prescribing specific medications or performing a particular medical service or operation. Without this prior approval, Blue Shield may not pay for your medication or medical procedure, and you will have to pay out of pocket.
FEP Blue Focus offers quality health care coverage from in-network providers, plus budget-friendly benefits. With Basic Option, you can enjoy no deductible with care from in-network providers.
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FEP Blue Focus offers quality health care coverage from in-network providers, plus budget-friendly benefits. With Basic Option, you can enjoy no deductible with care from in-network providers.
The answer to whether or not Blue Cross Blue Shield covers stem cell therapy depends on several factors, including the particular plan you have and where you live. Generally speaking, most plans do not specifically list stem cell therapy as an item they will cover, but it may be considered on a case-by-case basis.
You can also call 1-800-624-5060 for more information, claim forms and customer service assistance. The claim form provides detailed instructions for submission of the form and should be mailed to: Service Benefit Plan Retail Pharmacy Program, P.O. Box 52057, Phoenix, AZ 85072-2057.

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