Changes to our Federal Employee Program (FEP) for 2022
December 31, 2021
This article is for all providers caring for our members
Beginning January 1, 2022, we will make changes to our Federal Employee Program Standard Option, Basic Option, and FEP Blue Focus plans. Because of these changes, it is important to always check your patient’s Blue Cross ID card and to verify their eligibility and benefits.
We now cover:
- Electrocardiograms (EKGs) as a medical benefit only. Previously, one EKG per calendar year was covered under the preventive care adult benefit with no member cost-share. Applies
to Standard Option and FEP Blue Focus plans.
- Group counseling on prevention and reducing health risks, and group nutritional counseling under the preventive benefit. Previously, only individual counseling was covered. Applies to all FEP plans.
- Nipple reconstruction after a mastectomy for female to male gender reassignment surgery. Previously, there was no benefit for this procedure. Applies to all FEP plans.
- Tubeless insulin delivery systems under the Tier 2 and Tier 3 pharmacy benefit. Previously, all types of insulin delivery systems were covered only under the durable medical equipment benefit. Applies to all FEP plans.
For FEP Blue Focus only, we now offer a breast pump and milk storage bags under our maternity benefit, for members who are pregnant or nursing when ordered through our fulfillment vendor. Previously, these items were covered when ordered through CVS Caremark.
- Prior authorization is no longer required for surgery needed to correct accidental injuries to the jaw, cheeks, lips, tongue, roof, and floor of mouth. This applies to care provided within 72 hours of the accidental injury. Previously, authorization was required for all surgeries listed above regardless of when the care was performed. Applies to Standard Option and Basic Option.
- We now offer kidney transplants as part of the Blue Distinction Centers for Transplants® Program. Kidney transplants will now require prior authorization. Previously, kidney transplants did not require prior approval. Applies to Standard Option and Basic Option.
We no longer offer pancreas transplants under the Blue Distinction Centers for Transplants® Program.
Replacement member identification cards
All current Service Benefit Plan contract holders will receive replacement member ID cards in the mail in the first few months of 2022. These cards will include a few benefit details and updated contact information.
Federal transparency initiatives
We’re continuing to review guidance from the federal government on the Consolidated Appropriations Act (CAA) and other federal transparency initiatives. We’ll notify you of any impacts or changes as we learn of them.
For more details on FEP benefit changes, download plan brochures at fepblue.org/plan-brochures.