Medical Policies and Utilization Management Guidelines
Medical Policies
The policies contained in the FEP Medical Policy Manual are developed to assist in administering contractual benefits and do not constitute medical advice. They are not intended to replace or substitute for the independent medical judgment of a practitioner or other health care professional in the treatment of an individual member. The Blue Cross and Blue Shield Association does not intend by the FEP Medical Policy Manual, or by any particular medical policy, to recommend, advocate, encourage or discourage any particular medical technologies. Medical decisions relative to medical technologies are to be made strictly by members/patients in consultation with their health care providers. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that the Blue Cross and Blue Shield Service Benefit Plan covers (or pays for) this service or supply for a particular member.
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Coronavirus Update
FEP will waive copays for all telehealth services provided by Teladoc® during this time for all members. The most convenient way to get care is by requesting a visit on the Teladoc app or online. If you’re new to Teladoc’s services, you can set up your account ahead of time. Learn more here.
Register to get care when you need it most
Teladoc lets you connect with board-certified doctors anytime, anywhere. Watch this video to see the ways it can help you get care and then register.
All current Service Benefit Plan members are eligible for telehealth services. Members under 18 must be registered by an adult on the contract. Start by answering a brief medical history questionnaire, similar to the questions asked during a traditional doctor visit.
You may also call Teladoc at 1-855-636-1579
In an emergency, always call 911 or go to your local emergency services immediately. Register Now
General Health
Telehealth services offer convenient access to board-certified doctors 24 hours a day, seven days a week. Get treatment for minor injuries, illnesses and non-emergency health issues such as:
- Cold and flu symptoms
- Sore throat
- Bronchitis and respiratory infections
- Allergies
General health services are available in all 50 states, Washington, D.C., Puerto Rico, the U.S. Virgin Islands, and Guam.
Behavioral Health
Telehealth services can also be a stress-free and cost-effective way to get support for your mental and emotional well-being. Adults (age 18+) and adolescents (ages 13-17) can speak to a licensed behavioral health specialist from wherever you’re most comfortable. Appointments are available seven days a week, from 7 a.m. to 9 p.m. local time, and must be scheduled at least 72 hours in advance. Get support for:
- Stress and anxiety
- Depression
- Substance use disorder
- Grief and family difficulties
Behavioral health services are available in all 50 states and Washington, D.C.
Dermatology
You can get treatment for skin, nail and hair issues from a licensed dermatologist. These issues can often take weeks or months to get an appointment for or to diagnose. But with telehealth, you’ll receive treatment options within days. Get treatment for:
- Acne and rosacea
- Psoriasis and eczema
- Skin infections and rashes
- Moles and warts
Dermatology services are available in all 50 states and Washington, D.C.
Nutritional Counseling
You can also meet with a registered dietician to evaluate your nutritional needs and develop personalized diet meal plans and more. Appointments are available seven days a week, from 7 a.m. to 9 p.m. local time. Get resources such as:
- Personalized diet plans
- Actionable meal plans
- Shopping guides
- Customized nutritional manuals
Nutritional counseling is available in all 50 states and Washington, D.C. These are limited to individual sessions; we do not provide benefits for group counseling.
FEP Blue Focus
First two visits free, then $10 copay per visit
Basic Option
First two visits free, then $15 copay per visit
Standard Option
First two visits free, then $10 copay per visit
Nutritional counseling sessions are covered in full for all members.
Now access quality care 24/7 when you’re overseas
For members living overseas, the Teladoc® Global Care App makes it easier than ever for you to get the care you need.
Learn More