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Document Outline

Pages 1--56 from Keystone Blue


Page 1 2


This Plan has commendable accreditation
from the NCQA. See the 2002 Guide for
more information on accreditation.

KeystoneBlue http:// www. highmark. com 2002
A Health Maintenance Organization

Serving: The Pittsburgh, Altoona and Erie, Pennsylvania areas
Enrollment in this Plan is limited; You must live or work in our Geographic service area to enroll. See page 7 for requirements.

Enrollment codes for this Plan:
EF1 Self Only
EF2 Self and Family

RI 73-484

For changes
in benefits
see page 8.
1
1 Page 2 3

Table of Contents
Introduction ................................................................................................................................................................... 4
Plain Language................................................................................................................................................................ 4
Inspector General Advisory ............................................................................................................................................ 5
Section 1. Facts about this HMO plan........................................................................................................................... 6
How we pay providers.................................................................................................................................. 6
Who provides my health care ....................................................................................................................... 6
Your Rights ................................................................................................................................................... 6
Service Area.................................................................................................................................................. 7
Section 2. How we change for 2002.............................................................................................................................. 8
Program-wide changes.................................................................................................................................. 8
Changes to this Plan...................................................................................................................................... 8
Section 3. How you get care.......................................................................................................................................... 9
Identification cards........................................................................................................................................ 9
Where you get covered care ......................................................................................................................... 9
Plan providers......................................................................................................................................... 9
Plan facilities .......................................................................................................................................... 9
What you must do to get covered care ......................................................................................................... 9

Primary care............................................................................................................................................ 9
Specialty care.......................................................................................................................................... 9
Hospital care......................................................................................................................................... 10
Circumstances beyond our control.............................................................................................................. 11
Services requiring our prior approval ......................................................................................................... 11
Section 4. Your costs for covered services .................................................................................................................. 12
Copayments .......................................................................................................................................... 12
Deductible............................................................................................................................................. 12
Coinsurance .......................................................................................................................................... 12
Your catastrophic protection out-of-pocket maximum............................................................................... 12
Section 5. Benefits ....................................................................................................................................................... 13
Overview..................................................................................................................................................... 13
(a) Medical services and supplies provided by physicians and other health care professionals............. 14
(b) Surgical and anesthesia services provided by physicians and other health care professionals ......... 24
(c) Services provided by a hospital or other facility, and ambulance services ....................................... 28
(d) Emergency services/ accidents ............................................................................................................ 31
(e) Mental health and substance abuse benefits....................................................................................... 33

2002 KeystoneBlue 2 Table of Contents 2
2 Page 3 4

(f) Prescription drug benefits................................................................................................................... 35
(g) Special features................................................................................................................................... 38
Flexible benefits option ................................................................................................................... 38
Reciprocity benefit/ travel ................................................................................................................ 38
(h) Dental benefits.................................................................................................................................... 39
(i) Non-FEHB benefits available to Plan members ................................................................................ 40
Section 6. General exclusions things we don't cover ........................................................................................... 41
Section 7. Filing a claim for covered services ......................................................................................................... 42
Section 8. The disputed claims process.................................................................................................................... 43
Section 9. Coordinating benefits with other coverage ............................................................................................. 45
When you have
Other health coverage....................................................................................................................... 45
Original Medicare............................................................................................................................. 45
Medicare managed care plan ............................................................................................................ 47
TRICARE/ Workers' Compensation/ Medicaid........................................................................................ 48
Other Government agencies.................................................................................................................... 48
When others are responsible for injuries................................................................................................. 48
Section 10. Definitions of terms we use in this brochure.......................................................................................... 49
Section 11. FEHB facts .............................................................................................................................................. 50
Coverage information.............................................................................................................................. 50
No pre-existing condition limitation................................................................................................. 50
Where you get information about enrolling in the FEHB Program................................................. 50
Types of coverage available for you and your family...................................................................... 50
When benefits and premiums start ................................................................................................... 51
Your medical and claims records are confidential............................................................................ 51
When you retire ................................................................................................................................ 51
When you lose benefits ........................................................................................................................... 51

When FEHB coverage ends.............................................................................................................. 51
Spouse equity coverage .................................................................................................................... 51
Temporary Continuation of Coverage (TCC)................................................................................... 51
Converting to individual coverage ................................................................................................... 52
Getting a Certificate of Group Health Plan Coverage...................................................................... 52
Long term care insurance is coming later in 2002 ....................................................................................................... 53
Index.............................................................................................................................................................................. 54
Summary of benefits .................................................................................................................................................... 55
Rates................................................................................................................................................................ Back cover

2002 KeystoneBlue 3 Table of Contents 3
3 Page 4 5

Introduction
Keystone Health Plan West, Inc., d. b. a. KeystoneBlue
Fifth Avenue Place
120 Fifth Avenue
Pittsburgh, PA 15222

This brochure describes the benefits of KeystoneBlue under its contract (CS2340) with the Office of Personnel
Management (OPM), as authorized by the Federal Employees Health Benefits (FEHB) law. This brochure is the
official statement of benefits. No oral statement can modify or otherwise affect the benefits, limitations, and exclusions
of this brochure.

If you are enrolled in this Plan you are entitled to the benefits described in this brochure. If you are enrolled for Self
and Family coverage, each eligible family member is also entitled to these benefits. You do not have a right to benefits
that were available before January 1, 2002, unless those benefits are also shown in this brochure.

OPM negotiates benefits and premiums with each plan annually. Benefit changes are effective January 1, 2002, and
changes are summarized on page 8. Rates are shown at the end of this brochure.

Plain Language
Teams of Government and health plans' staff worked on all FEHB brochures to make them responsive, accessible, and
understandable to the public. For instance,

Except for necessary technical terms, we use common words. For instance, "you" means the enrollee or family member; "we" means KeystoneBlue.

We limit acronyms to ones you know. FEHB is the Federal Employees Health Benefits Program. OPM is the Office of Personnel Management. If we use others, we tell you what they mean first.
Our brochure and other FEHB plans' brochures have the same format and similar descriptions to help you compare plans.
If you have comments or suggestions about how to improve the structure of this brochure, let OPM know. Visit OPM's
"Rate Us" feedback area at www. opm. gov/ insure or e-mail OPM at fehbwebcomments@ opm. gov. You may also write
to OPM at the Office of Personnel Management, Office of Insurance Planning and Evaluation Division, 1900 E Street,
NW, Washington, DC 20415.

2002 KeystoneBlue 4 Introduction/ Plain Language/ Advisory 4
4 Page 5 6
Inspector General Advisory
Stop health care fraud!
Fraud increases the cost of health care for everyone. If you suspect that a physician, pharmacy, or hospital has charged you for services you did not
receive, billed you twice for the same service, or misrepresented any
information, do the following:

Call the provider and ask for an explanation. There may be an error.
If the provider does not resolve the matter, call us at 1-800/ 421-0959 and explain the situation.

If we do not resolve the issue, call or write: THE HEALTH CARE FRAUD HOTLINE
202/ 418-3300
The United States Office of Personnel Management
Office of the Inspector General Fraud Hotline
1900 E Street, NW, Room 6400
Washington, DC 20415

Penalties for Fraud Anyone who falsifies a claim to obtain FEHB Program benefits can be prosecuted for fraud. Also, the Inspector General may investigate anyone
who uses an identification card if the person tries to obtain services for a
person who is not an eligible family member, or is no longer enrolled in the
Plan and tries to obtain benefits. Your agency may also take administrative
action against you.

2002 KeystoneBlue 5 Introduction/ Plain Language/ Advisory 5
5 Page 6 7

Section 1. Facts about this HMO plan
This Plan is a health maintenance organization (HMO). We require you to see specific physicians, hospitals, and other
providers that contract with us. These Plan providers coordinate your health care services.

HMOs emphasize preventive care such as routine office visits, physical exams, well-baby care, and immunizations, in
addition to treatment for illness and injury. Our providers follow generally accepted medical practice when prescribing
any course of treatment.

When you receive services from Plan providers, you will not have to submit claim forms or pay bills. You only pay the
copayments, and coinsurance described in this brochure. When you receive emergency services from non-Plan
providers, you may have to submit claim forms.

You should join an HMO because you prefer the plan's benefits, not because a particular provider is available.
You cannot change plans because a provider leaves our Plan. We cannot guarantee that any one physician,
hospital, or other provider will be available and/ or remain under contract with us.

How we pay providers
We contract with individual physicians, medical groups, and hospitals to provide the benefits in this brochure.
These Plan providers accept a negotiated payment from us, and you will only be responsible for your copayments
or coinsurance.

Who provides my health care?
KeystoneBlue is an Individual Practice Prepayment (IPP) model HMO, offering you a choice of more than 2,600
primary care doctors. Federal employees, annuitants, and their dependents enrolled in this Plan will need to select a
personal doctor from a list of our participating primary care doctors. A primary care doctor is a doctor who has been
specially trained in the areas of Family Practice, General Practice, Internal Medicine, or Pediatrics.

Your Rights
OPM requires that all FEHB Plans provide certain information to their FEHB members. You may get information about
us, our networks, providers, and facilities. OPM's FEHB website (www. opm. gov/ insure) lists the specific types of
information that we must make available to you.

If you want more information about us call 1-800/ 421-0959, or write to KeystoneBlue, 1800 Center Street,
P. O. Box 890037, Camp Hill, PA 17089-0037, or visit our website at www. highmark. com.

2002 KeystoneBlue 6 Section 1 6
6 Page 7 8
Service Area
To enroll in our Plan, you must live or work in our Service Area. This is where our providers practice. Our service area
is Western Pennsylvania which includes the following areas:

Greater Pittsburgh: The Pennsylvania counties of Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Lawrence,
Washington and Westmoreland.

Erie: The Pennsylvania counties of Clarion, Crawford, Erie, Forest, McKean, Mercer and Venango.
Altoona: The Pennsylvania counties of Bedford, Blair, Cambria, Cameron, Clearfield, Elk, Huntingdon, Indiana,
Jefferson, Potter, Somerset and Warren.

Ordinarily, you must get your care from providers who contract with us. If you receive care outside our service area,
we will pay only for emergency care benefits. We will not pay for any other health care services out of our service area
unless the services have prior plan approval.

If you or a covered family member move outside of our service area, you can enroll in another plan. If your dependents
live out of the area (for example, if your child goes to college in another state), you should consider enrolling in a fee-for-
service plan or an HMO that has agreements with affiliates in other areas. If you or a family member move, you do
not have to wait until Open Season to change plans. Contact your employing or retirement office.

2002 KeystoneBlue 7 Section 1 7
7 Page 8 9
Section 2. How we change for 2002
Do not rely on these change descriptions; this page is not an official statement of benefits. For that, go to Section 5
Benefits. Also, we edited and clarified language throughout the brochure; any language change not shown here is a
clarification that does not change benefits.

Program-wide changes
We changed the address for sending disputed claims to OPM. (Section 8)
Changes to this Plan

Your share of the non-Postal premium will increase by 71.9% for Self Only or 56.5% for Self and Family
We now cover certain intestinal transplants; islet cell autotransplantation; and multivisceral transplantation, which includes the small bowel with or without the liver and one or more of the following: stomach, duodenum, jejunum,

ileum, pancreas, and colon. (Section 5( b))
We changed speech therapy benefits by removing the requirement that services must be required to restore functional speech. (Section 5( a))

We no longer limit total blood cholesterol tests to certain age groups. (Section 5( a))

2002 KeystoneBlue 8 Section 2 8
8 Page 9 10
Section 3. How you get care
Identification cards
We will send you an identification (ID) card when you enroll. You should carry your ID card with you at all times. You must show it whenever you
receive services from a Plan provider, or fill a prescription at a Plan
pharmacy. Until you receive your ID card, use your copy of the Health
Benefits Election Form, SF-2809, your health benefits enrollment
confirmation (for annuitants), or your Employee Express confirmation letter.

If you do not receive your ID card within 30 days after the effective date of
your enrollment, or if you need replacement cards, call us at 1-800/ 421-0959.

Where you get covered care You get care from "Plan providers" and "Plan facilities." You will only pay copayments or coinsurance and you will not have to file claims.

Plan providers Plan providers are physicians and other health care professionals in our service area that we contract with to provide covered services to our
members. We credential Plan providers according to national standards.
We list Plan providers in the provider directory, which we update
periodically. The list is also on our website.

Plan facilities Plan facilities are hospitals and other facilities in our service area that we contract with to provide covered services to our members. We list these in
the provider directory, which we update periodically. The list is also on
our website.

What you must do It depends on the type of care you need. First, you and each family to get covered care member must choose a primary care physician. This decision is important
since your primary care physician provides or arranges for most of your
health care. You can choose a primary care physician from our provider
directory or from our website.

Primary care Your primary care physician can be a family practitioner, internist, pediatrician, general practitioner, etc. Your primary care physician will
provide most of your health care, or give you a referral to see a specialist.
If you want to change primary care physicians or if your primary care
physician leaves the Plan, call us. We will help you select a new one.

Specialty care Your primary care physician will refer you to a specialist for needed care. For most types of specialty care, the referred specialist can provide
necessary follow-up care for up to 60 days, if needed, without an
additional referral from your primary care physician. Any continued
treatment beyond this 60-day period needs to be authorized by your
primary care physician. However, women may see a network
gynecologist or network nurse midwife for obstetrical or gynecological
care without a referral.

2002 KeystoneBlue 9 Section 3 9
9 Page 10 11
Here are other things you should know about specialty care:
If you need to see a specialist frequently because of a chronic, complex, or serious medical condition, your primary care physician
will develop a treatment plan that allows you to see your specialist for
a certain number of visits without additional referrals. Your primary
care physician will use our criteria when creating your treatment plan
(the physician may have to get an authorization or approval
beforehand).

If you are seeing a specialist when you enroll in our Plan, talk to your primary care physician. Your primary care physician will decide what
treatment you need. If he or she decides to refer you to a specialist, ask
if you can see your current specialist. If your current specialist does
not participate with us, you must receive treatment from a specialist
who does. Generally, we will not pay for you to see a specialist who
does not participate with our Plan.

If you are seeing a specialist and your specialist leaves the Plan, call your primary care physician, who will arrange for you to see another
specialist. You may receive services from your current specialist until
we can make arrangements for you to see someone else.

If you have a chronic or disabling condition and lose access to your specialist because we:

terminate our contract with your specialist for other than cause; or
drop out of the Federal Employees Health Benefits (FEHB)
Program and you enroll in another FEHB Plan; or

reduce our service area and you enroll in another FEHB Plan,
you may be able to continue seeing your specialist for up to 90 days
after you receive notice of the change. Contact us or, if we drop out of
the Program, contact your new plan.

If you are in the second or third trimester of pregnancy and you lose
access to your specialist based on the above circumstances, you can
continue to see your specialist until the end of your postpartum care, even
if it is beyond the 90 days.

Hospital care Your Plan primary care physician or specialist will make necessary hospital arrangements and supervise your care. This includes admission to
a skilled nursing or other type of facility.
If you are in the hospital when your enrollment in our Plan begins, call our
customer service department immediately at 1-800/ 421-0959. If you are
new to the FEHB Program, we will arrange for you to receive care.

2002 KeystoneBlue 10 Section 3 10
10 Page 11 12
If you changed from another FEHB plan to us, your former plan will pay
for the hospital stay until:

You are discharged, not merely moved to an alternative care center; or

The day your benefits from your former plan run out; or
The 92 nd day after you become a member of this Plan, whichever happens first.

These provisions apply only to the benefits of the hospitalized person.
Circumstances beyond Under certain extraordinary circumstances, such as natural disasters, we our control may have to delay your services or we may be unable to provide them. In
that case, we will make all reasonable efforts to provide you with the
necessary care.

Services requiring our Your primary care physician has authority to refer you for most services. prior approval For certain services, however, your physician must obtain approval from
us. Before giving approval, we consider if the service is covered,
medically necessary, and follows generally accepted medical practice.
Care received outside of our network, except for emergency care, is not
covered. Elective care received outside our network is not covered.

We call this review and approval process Prior Plan Approval. Your
physician must obtain Prior Plan Approval for the following services:
Assisted fertilization procedures; Cardiac Rehabilitation; Durable medical
equipment (DME), Orthopedic and Prosthetic devices, and Respiratory
equipment and supplies; Enteral formulae; Home health aides; Physical,
speech, and occupational therapy; growth hormone therapy (GHT); and
Hysterectomy, Appendectomy, and back surgeries, etc.

2002 KeystoneBlue 11 Section 3 11
11 Page 12 13
Section 4. Your costs for covered services
You must share the cost of some services. You are responsible for:
Copayments A copayment is a fixed amount of money you pay to the provider, facility, pharmacy, etc., when you receive services.

Example: When you see your primary care physician you pay a
copayment of $10 per office visit. When you go in the hospital, you
pay $100 per admission, limited to three inpatient hospital copayments
per individual, and up to five inpatient hospital copayments per family,
per calendar year.

Deductible We do not have a deductible.
Note: If you change plans during open season, you do not have to start a
new deductible under your old plan between January 1 and the effective
date of your new plan. If you change plans at another time during the
year, you must begin a new deductible under your new plan.

Coinsurance Coinsurance is the percentage of our negotiated fee that you must pay for your care.
Example: In our Plan, you pay up to $200 or 50% of the cost, whichever
is less, for infertility services.

Your catastrophic protection We do not have an out-of-pocket maximum, except for a $300 per out-of-pocket maximum individual and $500 per family inpatient hospital copayment limit.
for coinsurance and copayments

2002 KeystoneBlue 12 Section 4 12
12 Page 13 14

Section 5. Benefits OVERVIEW (See page 8 for how our benefits changed this year and page 55 for a benefits summary.)
NOTE: This benefits section is divided into subsections. Please read the important things you should keep in mind at
the beginning of each subsection. Also read the General Exclusions in Section 6; they apply to the benefits in the
following subsections. To obtain claims forms, claims filing advice, or more information about our benefits, contact us
at 1-800/ 421-0959 or at our website at www. highmark. com.

(a) Medical services and supplies provided by physicians and other health care professionals................................ 14
Diagnostic and treatment services Speech therapy Lab, X-ray, and other diagnostic tests Hearing services (testing, treatment, and supplies)

Preventive care, adult Vision services (testing, treatment, and supplies) Preventive care, children Foot care
Maternity care Orthopedic and prosthetic devices Family planning Durable medical equipment (DME)
Infertility services Home health services Allergy care Chiropractic
Treatment therapies Alternative treatments Physical and occupational therapies Educational classes and programs

(b) Surgical and anesthesia services provided by physicians and other health care professionals ............................ 24
Surgical procedures Oral and maxillofacial surgery Reconstructive surgery Organ/ tissue transplants

Anesthesia
(c) Services provided by a hospital or other facility, and ambulance services........................................................... 28
Inpatient hospital Extended care benefits/ skilled nursing care Outpatient hospital or ambulatory facility benefits

surgical center Hospice care Ambulance

(d) Emergency services/ accidents ............................................................................................................................... 31
Medical emergency Ambulance

(e) Mental health and substance abuse benefits.......................................................................................................... 33
(f) Prescription drug benefits ...................................................................................................................................... 35
(g) Special features ...................................................................................................................................................... 38
Flexible benefits option Reciprocity benefit/ travel

(h) Dental benefits ....................................................................................................................................................... 39
(i) Non-FEHB benefits available to Plan members.................................................................................................... 40
Summary of benefits ..................................................................................................................................................... 55

2002 KeystoneBlue 13 Section 5 13
13 Page 14 15
Section 5 (a). Medical services and supplies provided by physicians and
other health care professionals

Here are some important things to keep in mind about these benefits:
Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure and are payable only when we determine they are medically necessary.

Plan physicians must provide or arrange your care.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other

coverage, including with Medicare.

Diagnostic and treatment services
Professional services of physicians $10 per office visit
In physician's office
Office medical consultation
Second surgical opinion

Professional services of physicians Nothing
In an urgent care center
During a hospital stay
In a skilled nursing facility

At home $10 per visit
Not covered: Charges for missed appointments. All charges.

2002 KeystoneBlue 14 Section 5( a)

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Benefit Description You pay 14
14 Page 15 16
Lab, X-ray and other diagnostic tests You pay
Tests, such as: Nothing when authorized by a Plan
Blood tests Non-routine mammograms primary care physician or specialist.
Urinalysis Cat Scans/ MRI
Non-routine pap tests Ultrasound
Pathology Electrocardiogram and EEG
X-rays

Preventive care, adult
Routine screenings, such as: $10 per office visit; no separate
Routine physical exams copayment for routine screenings.
Total Blood Cholesterol once every three years
Colorectal Cancer Screening, including
Fecal occult blood test
Sigmoidoscopy, screening every five years starting at age 50
Prostate Specific Antigen (PSA test) one annually for men age 40 and older

Routine pap test Nothing
Routine mammogram covered for women age 35 and older, Nothing
as follows:

From age 35 through 39, one during this five year period
From age 40 and over, one every calendar year
Screening regardless of age when prescribed by your primary care physician or obstetrician/ gynecologist.

Not covered: Physical exams required for obtaining or continuing All charges.
employment or insurance, attending schools or camp, or immunizations
for foreign travel, licensing, premarital or sports.

2002 KeystoneBlue 15 Section 5( a) 15
15 Page 16 17
Preventive care, adult (continued) You pay
Routine immunizations, limited to: $10 per office visit; no separate
Tetanus-diphtheria (Td) booster once every 10 years, ages 19 and copayment for routine immunizations. over (except as provided for under Childhood immunizations)

Influenza vaccine
annually, age 50 and over
annually, for person at high risk, between ages 18 and 64
Pneumococcal vaccine
annually, age 65 and over
annually, for person at high risk, between ages 18 and 64

Preventive care, children
Childhood immunizations recommended by the American Academy $10 per office visit; no separate of Pediatrics copayment for routine immunizations.

Well-child care charges for routine examinations, immunizations and care (up to age 22)
Examinations, such as:
Eye exams through age 17 when performed by primary care physician to determine the need for vision correction.

Ear exams through age 17 when performed by primary care physician to determine the need for hearing correction.
Examinations done on the day of immunizations (up to age 22)
Maternity care
Complete maternity (obstetrical) care, such as:
Prenatal care
Delivery
Postnatal care
Note: Here are some things to keep in mind:

You may remain in the hospital up to 48 hours after a regular delivery and 96 hours after a cesarean delivery. We will extend
your inpatient stay if medically necessary.
We cover routine nursery care of the newborn child during the covered portion of the mother's maternity stay. We will

cover other care of an infant who requires non-routine treatment
only if we cover the infant under a Self and Family enrollment.

Nothing. Copayments are waived
for maternity care.

$10 per office visit; no separate
copayment for preventive care
screenings.

2002 KeystoneBlue 16 Section 5( a) 16
16 Page 17 18
Maternity care (continued) You pay
Coverage is provided for one (1) maternity home health care visit, within 48 hours of discharge when the discharge occurs prior to 48
hours of inpatient care following a normal vaginal delivery, or 96
hours of inpatient care following a cesarean delivery.

We pay hospitalization and surgeon services (delivery) the same as for illness and injury. See Hospital benefits (Section 5c) and

Surgery benefits (Section 5b).
Not covered: Routine sonograms to determine fetal age, size or sex. All charges.

Family planning
A broad range of voluntary family planning services, limited to:
Voluntary sterilization
Surgically implanted contraceptives (such as Norplant)
Injectable contraceptive drugs (such as Depo provera)
Intrauterine devices (IUDs)
Diaphragms
Note: We cover oral contraceptives under the prescription drug benefit.

Not covered: reversal of voluntary surgical sterilization, genetic counseling. All charges.

Infertility services
Diagnosis and treatment of infertility, such as:
Artificial insemination:
intravaginal insemination (IVI)
intracervical insemination (ICI)
intrauterine insemination (IUI)
Fertility drugs
Cost of donor sperm
Note: We cover injectable fertility drugs under medical benefits and oral fertility drugs under the prescription drug benefit.

Not covered: All charges.
Assisted reproductive technology (ART) procedures, such as:
in vitro fertilization
embryo transfer, gamete GIFT and zygote ZIFT
Zygote transfer
Medical services and supplies related to excluded ART procedures
Cost of donor egg

Up to $200 or 50% of the cost,
whichever is less. These services,
including fertility drugs, require
prior authorization by the Plan.

$10 per office visit; no separate
copayment for listed services.

Nothing. Copayments are waived
for maternity care.

2002 KeystoneBlue 17 Section 5( a) 17
17 Page 18 19
Allergy care You pay
Testing and treatment
Allergy injection
Allergy serum

Not covered: Provocative food testing, and sublingual allergy desensitization. All charges.

Treatment therapies
Chemotherapy and radiation therapy
Note: High dose chemotherapy in association with autologous bone
marrow transplants is limited to those transplants listed under
Organ/ Tissue Transplants on pages 26-27.

Respiratory and inhalation therapy
Dialysis Hemodialysis and peritoneal dialysis
Intravenous (IV)/ Infusion Therapy Home IV and antibiotic therapy

Enteral formulae administered on an outpatient basis either orally or through a tube
Growth hormone therapy (GHT)
Note: Growth hormones are covered under the prescription drug
benefit. We will only cover Enteral formulae and GHT when we
preauthorize treatment.

Not covered: All charges.
Hair growth stimulants
Hair replacements and hair replacement surgery
Weight reduction programs, except when medically necessary for morbid obesity

Physical and occupational therapies
60 days per condition for the services of each of the following: Nothing
qualified physical therapists;
occupational therapists.
Note: We only cover therapy to restore bodily function when there has
been a total or partial loss of bodily function due to illness or injury.

Cardiac rehabilitation following a heart transplant, bypass surgery or a myocardial infarction is covered at a Plan facility for up to 12 weeks

Not covered: All charges.
long-term rehabilitative therapy
exercise programs

$10 per office visit to specialist; no
separate copayment for treatment
therapies.

$10 per office visit; no separate
copayment for testing, injections
or serum.

2002 KeystoneBlue 18 Section 5( a) 18
18 Page 19 20
Speech therapy You pay
60 days per condition for the services of qualified speech therapists. Nothing

Hearing services (testing, treatment, and supplies)
Diagnostic hearing test when medically necessary
Hearing testing for children through age 17 (see Preventive care, children)

Not covered: All charges.
all other hearing testing
hearing aids, testing and examinations for them

Vision services (testing, treatment, and supplies)
One pair of eyeglasses or contact lenses to correct an impairment $10 per office visit directly caused by accidental ocular injury or intraocular surgery
(such as for cataracts)
Note: See Preventive care, children for eye exams for children

The following benefits are provided through OptiChoice, our
Preferred Vision Care Program. The OptiChoice In-Network Annual
Vision Benefits Program offers affordability and paid-in-full vision
benefits on standard, eligible services. It also offers a quality net-work
of statewide and national vision care providers who agree to
accept program allowances as payment in full, in accordance with
the OptiChoice benefit design. Members are required to select
an optometrist, ophthalmologist, or optical supplier from the
Preferred Provider Network. You can get information by calling
1-800/ 541-2039. Payment for services is limited to in-network
only and services are eligible once a year.
It also provides
discounts on additional examinations, frames, lenses, contacts,
optical accessories, and supplies. There is no pre-authorization or
deductible required. OptiChoice Preferred Providers submit claims
for members and receive direct reimbursement, completely
removing members from the paperwork process.

Following is a summary of benefits and out-of-pocket expenses.

Eye Examination and Refractive Service Nothing
Contact Lens Prescription Fitting

Vision services (testing, treatment, and supplies) continued on next page.

$10 per office visit; no separate
copayment for hearing screenings

2002 KeystoneBlue 19 Section 5( a) 19
19 Page 20 21
Vision services (testing, treatment, and supplies) (continued) You pay
Post Refractive Services
Frames All charges in excess of $60

Post Refractive Services
Single Vision Lenses (Standard) Nothing
Bifocal Vision Lenses (Standard)
Trifocal Vision Lenses (Standard)
Aphakic Vision Lenses (Standard)

Post Refractive Services:
Single Vision Lenses (Non-standard)
Bifocal Vision Lenses (Non-standard)
Trifocal Vision Lenses (Non-standard)
Aphakic/ Lenticular Vision Lenses (Non-standard)

Post Refractive Services:
Hard Contact Lenses (Standard) Nothing
Soft Contact Lenses (Standard)

Post Refractive Services: All charges in excess of $75.
Specialty Contact Lenses (Standard)

Post Refractive Services:
Vision Care Options (tints, contact lens solutions, etc.)

Post Refractive Services:
Additional Post-Refractive Services

Not covered: All charges.
Eye exercises and orthoptics
Radial keratotomy

All charges in excess of the
Program's Allowance.

The cost of the items less a 10%
discount.

90% of the difference between the
normal charge and the non-standard
charge for the same type of standard
lenses.

2002 KeystoneBlue 20 Section 5( a) 20
20 Page 21 22
Foot care You pay
Routine foot care when you are under active treatment for a metabolic $10 per office visit
or peripheral vascular disease, such as diabetes.

See Orthopedic and prosthetic devices for information on podiatric
shoe inserts.

Not covered: All charges.
Cutting, trimming or removal of corns, calluses, or the free edge of toenails, and similar routine treatment of conditions of the foot,

except as stated above
Treatment of weak, strained or flat feet or bunions or spurs; and of any instability, imbalance or subluxation of the foot (unless the

treatment is by open cutting surgery)

Orthopedic and prosthetic devices
Artificial limbs and eyes; lenses following cataract removal; $10 per office visit stump hose

Externally worn breast prostheses and surgical bras, including necessary replacements, following a mastectomy
Internal prosthetic devices, such as artificial joints, pacemakers, cochlear implants, and surgically implanted breast implant
following mastectomy. Note: We pay internal prosthetic
devices as hospital benefits; see Section 5( c) for
payment information.

Corrective orthopedic appliances for non-dental treatment of temporomandibular joint (TMJ) pain dysfunction syndrome.

Braces
Shoes permanently attached to a brace
Custom molded foot orthotics

Not covered: All charges.
Arch supports
Heel pads and heel cups
Lumbosacral supports
Corsets, trusses and other supportive devices

2002 KeystoneBlue 21 Section 5( a) 21
21 Page 22 23
Durable medical equipment (DME) You pay
Rental or purchase, at our option, including repair and adjustment, of Nothing
durable medical equipment prescribed by your Plan physician, such as
oxygen and dialysis equipment. Under this benefit, we also cover:

Standard hospital beds;
Standard wheelchairs;
Crutches;
Walkers;
Blood glucose monitors;
Insulin pumps, and
Motorized wheel chairs if authorized and medically necessary
Note: Call us at 1-800/ 421-0959 as soon as your Plan physician prescribes
this equipment. We will arrange with a health care provider to rent or sell
you durable medical equipment at discounted rates and will tell you more
about this service when you call.

Not covered: All charges.
Motorized wheelchairs that are not authorized and not medically necessary
Electric hospital beds

Home health services
Home health care ordered by your primary care physician and Nothing provided by a registered nurse (R. N.), licensed practical nurse
(L. P. N.), licensed vocational nurse (L. V. N.), or home health aide.
Services include oxygen therapy, intravenous therapy and medications.

Not covered: All charges.
Nursing care requested by, or for the convenience of, the patient or the patient's family;

Home care primarily for personal assistance that does not include a medical component and is not diagnostic, therapeutic, or rehabilitative;
Homemaker services, and
Food or home delivered meals

Chiropractic
Limited to spinal manipulation Nothing

2002 KeystoneBlue 22 Section 5( a) 22
22 Page 23 24
Alternative treatments You pay
Acupuncture by a doctor of medicine or osteopathy for: anesthesia, $10 per office visit
pain relief.

Not covered: All charges.
naturopathic services
hypnotherapy
biofeedback

Educational classes and programs
Coverage includes, but is not limited to: Nothing
Diabetes self-management
Congestive heart failure self-management
Chronic obstructive pulmonary disease (COPD) self-management
Smoking cessation class (see Section 5( i))

2002 KeystoneBlue 23 Section 5( a) 23
23 Page 24 25
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Section 5 (b). Surgical and anesthesia services provided by physicians and other
health care professionals

Here are some important things to keep in mind about these benefits:
Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure and are payable only when we determine they are medically necessary.

Plan physicians must provide or arrange your care.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other cover-age,

including with Medicare.
The amounts listed below are for the charges billed by a physician or other health care professional for your surgical care. Any costs associated with the facility charge

(i. e. hospital, surgical center, etc.) are covered in Section 5 (c).
YOUR PHYSICIAN MUST GET PRECERTIFICATION FOR ALL INPATIENT PROCEDURES AND SOME OUTPATIENT SURGICAL PROCEDURES. Please

refer to the precertification information shown in Section 3.

Surgical procedures
A comprehensive range of services, such as: Nothing
Operative procedures
Treatment of fractures, including casting
Normal pre-and post-operative care by the surgeon
Correction of amblyopia and strabismus
Endoscopy procedures
Biopsy procedures
Removal of tumors and cysts
Correction of congenital anomalies (see reconstructive surgery)
Surgical treatment of morbid obesity a condition in which an individual weighs 100 pounds or 100% over his or her

normal weight according to current underwriting standards;
eligible members must be age 18 or over

Insertion of internal prosthetic devices. See 5( a) Orthopedic and prosthetic devices for device coverage information.

Voluntary sterilization
Treatment of burns
Note: Generally, we pay for internal prostheses (devices) according to
where the procedure is done. For example, we pay Hospital benefits
for a pacemaker and Surgery benefits for insertion of the pacemaker.

Surgical procedures continued on next page.

2002 KeystoneBlue 24 Section 5( b)

Benefit Description You pay 24
24 Page 25 26
Surgical procedures (continued) You pay
Not covered: All charges.
Reversal of voluntary sterilization
Routine treatment of conditions of the foot; see Foot care.
Correction of myopia or hyperopia by means of corneal microsurgery such as keratomileusis, keratophakia and

radial keratotomy

Reconstructive surgery
Surgery to correct a functional defect Nothing
Surgery to correct a condition caused by injury or illness if:
the condition produced a major effect on the member's
appearance and

the condition can reasonably be expected to be corrected by
such surgery

Surgery to correct a condition that existed at or from birth and is a significant deviation from the common form or norm. Examples of

congenital anomalies are: protruding ear deformities; cleft lip; cleft
palate; birth marks; webbed fingers; and webbed toes.

All stages of breast reconstruction surgery following a mastectomy, such as:
surgery to produce a symmetrical appearance on the other breast;
treatment of any physical complications, such as lymphedemas;
breast prostheses and surgical bras and replacements
(see Prosthetic devices)

Note: If you need a mastectomy, you may choose to have this procedure
performed on an inpatient basis and remain in the hospital up to 48 hours
after the procedure. Member is eligible for 1 (one) home health care visit,
as determined by the member's physician and received within 48 hours
after discharge. The discharge must occur within 48 hours after the
admission for a mastectomy.

Not covered: All charges.
Cosmetic surgery any surgical procedure (or any portion of a procedure) performed primarily to improve physical appearance through change in

bodily form, except repair of accidental injury
Surgeries related to sex transformation

2002 KeystoneBlue 25 Section 5( b) 25
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Oral and maxillofacial surgery You pay
Oral surgical procedures, limited to: Nothing
Reduction of fractures of the jaws or facial bones;
Surgical correction of cleft lip, cleft palate or severe functional malocclusion;

Removal of stones from salivary ducts;
Excision of leukoplakia or malignancies;
Excision of cysts and incision of abscesses when done as independent procedures;

Procedures adjacent to the oral cavity or sinuses (such as excision of tumors and cysts);
Extractions of impacted third molars when partially or totally covered by bone;
Extraction of teeth in preparation for radiation therapy, and
Other surgical procedures that do not involve the teeth or their supporting structures.

Not covered: All charges.
Oral implants and transplants
Procedures that involve the teeth or their supporting structures (such as the periodontal membrane, gingiva, and alveolar bone)

Dental care involving temporomandibular joint (TMJ) pain dysfunction syndrome

Organ/ tissue transplants
Limited to: Nothing
Cornea
Heart
Heart/ lung
Kidney
Kidney/ Pancreas
Liver
Lung: Single-Double
Pancreas
Skin and tissue
Small bowel
Small bowel/ liver
Multivisceral which includes the small bowel with or without the liver and one or more of the following: stomach, duodenum, jejunum, ileum,

pancreas and colon.
Islet cell autotransplantation
Allogeneic (donor) bone marrow transplants

Organ/ tissue transplants continued on next page.

2002 KeystoneBlue 26 Section 5( b) 26
26 Page 27 28
Organ/ tissue transplants (continued) You pay
Autologous bone marrow transplants (autologous stem cell and Nothing
peripheral stem cell support) for the following conditions: acute
lymphocytic or non-lymphocytic leukemia; advanced Hodgkin's
lymphoma; advanced non-Hodgkin's lymphoma; advanced
neuroblastoma; breast cancer; multiple myeloma; epithelial
ovarian cancer; and testicular, mediastinal, retroperitoneal and
ovarian germ cell tumors

Intestinal transplants (small intestine) and the small intestine with the
liver or small intestine with multiple organs such as the liver, stomach,
and pancreas.

Limited Benefits Treatment for breast cancer, multiple myeloma, and
epithelial ovarian cancer may be provided in an NCI-or NIH-approved
clinical trial at a Plan-designated center of excellence and if approved
by the Plan's medical director in accordance with the Plan's protocols.

Note: We cover related medical and hospital expenses of the donor when
we cover the recipient.

Not covered: All charges.
Donor screening tests and donor search expenses, except those performed for the actual donor

Implants of artificial organs
Transplants not listed as covered

Anesthesia
Professional services provided in Nothing
Hospital (inpatient)
Hospital outpatient department
Skilled nursing facility
Ambulatory surgical center
Office

2002 KeystoneBlue 27 Section 5( b) 27
27 Page 28 29
Section 5 (c). Services provided by a hospital or other facility, and
ambulance services

Here are some important things to remember about these benefits:
Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure and are payable only when we determine they are medically necessary.

Plan physicians must provide or arrange your care and you must be hospitalized in a Plan facility.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other
coverage, including with Medicare.
The amounts listed below are for the charges billed by the facility (i. e., hospital or surgical center) or ambulance service for your surgery or care. Any costs associated with the

professional charge (i. e., physicians, etc.) are covered in Sections 5( a) or (b).

Inpatient hospital
Room and board, such as
ward, semiprivate, or intensive care accommodations;
general nursing care; and
meals and special diets.

NOTE: If you want a private room when it is not medically necessary,
you pay the additional charge above the semiprivate room rate.

Other hospital services and supplies, such as:
Operating, recovery, maternity, and other treatment rooms
Prescribed drugs and medicines
Diagnostic laboratory tests and X-rays
Administration of blood and blood products
Blood or blood plasma, if not donated or replaced
Dressings, splints, casts, and sterile tray services
Medical supplies and equipment, including oxygen
Anesthetics, including nurse anesthetist services
Take-home items
Medical supplies, appliances, medical equipment, and any covered items billed by a hospital for use at home.

Inpatient hospital continued on next page.

$100 copay per admission up to a
maximum of $300 per individual
and $500 per family per calendar
year.

2002 KeystoneBlue 28 Section 5( c)

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Inpatient hospital (continued) You pay
Not covered: All charges.
Custodial care
Non-covered facilities, such as nursing homes, schools
Personal comfort items, such as telephone, television, barber services, guest meals and beds

Private nursing care
Storage of blood, except when done in preparation for a scheduled surgical procedure.

Outpatient hospital or ambulatory surgical center
Operating, recovery, and other treatment rooms Nothing
Prescribed drugs and medicines
Diagnostic laboratory tests, X-rays, and pathology services
Administration of blood, blood plasma, and other biologicals
Blood and blood plasma, if not donated or replaced
Pre-surgical testing
Dressings, casts, and sterile tray services
Medical supplies, including oxygen
Anesthetics and anesthesia service
NOTE: We cover hospital services and supplies related to dental
procedures when necessitated by a non-dental physical impairment.
We do not cover the dental procedures.

Not covered: All charges.
Storage of blood, except when done in preparation for a scheduled surgical procedure

2002 KeystoneBlue 29 Section 5( c) 29
29 Page 30 31
Extended care benefits/ skilled nursing care facility benefits You pay
Skilled nursing facility (SNF): Nothing
The Plan provides a comprehensive range of benefits for up to 100 days
per calendar year when full-time skilled nursing care is necessary and
confinement in a skilled nursing facility is medically appropriate as
determined by a Plan doctor. All necessary services are covered
including:

Bed, board and general nursing care
Drugs, biologicals, supplies, and equipment ordinarily provided or arranged by the skilled nursing facility when prescribed by a

Plan doctor.
Not covered: custodial care All charges.
Hospice care

Supportive and palliative care for a terminally ill member is covered in Nothing
the home or hospice facility. Services include inpatient and outpatient care,
and family counseling; these services are provided under the direction
of a Plan doctor who certifies that the patient is in the terminal stages
of illness, with a life expectancy of approximately six months or less.

Not covered: Independent nursing, homemaker services All charges.
Ambulance

Local professional ambulance service when medically appropriate Nothing and ordered or authorized by a Plan doctor.

2002 KeystoneBlue 30 Section 5( c) 30
30 Page 31 32
Section 5 (d). Emergency services/ accidents
Here are some important things to keep in mind about these benefits:
Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure.

Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other cover-age,
including with Medicare.

What is a medical emergency?
A medical emergency is the sudden and unexpected onset of a condition or injury that you believe endangers your
life, including a pregnant woman or her unborn child, or could result in serious injury or disability, and requires
immediate medical or surgical care. Some problems are emergencies because, if not treated promptly, they might
become more serious; examples include deep cuts and broken bones. Others are emergencies because they are
potentially life-threatening, such as heart attacks, strokes, poisonings, gunshot wounds, or sudden inability to
breathe. There are many other acute conditions that we may determine are medical emergencies what they all
have in common is the need for quick action.

What to do in case of emergency:
Emergencies within our service area:
In the event that you or a covered dependent requires emergency care, all charges for such covered services will be paid. No prior authorization is required for emergency care.

Either the member or a family member should, if possible, notify the Primary Care Physician within 48 hours of
the emergency care or as soon as reasonably possible to facilitate follow-up care.

If you need to be hospitalized, the Plan must be notified within 48 hours or on the first working day following your
admission, unless it was not reasonably possible to notify the Plan within that time. If you are hospitalized in non-Plan
facilities and Plan doctors believe care can be better provided in a Plan hospital, you will be transferred when
medically feasible with any ambulance charges covered in full.

Benefits are available for care from non-Plan providers in a medical emergency only if delay in reaching a Plan
provider would result in death, disability or significant jeopardy to your condition.

To be covered by this Plan, any follow-up care recommended by non-Plan providers must be approved by the Plan
or provided by Plan providers.

Emergencies outside our service area: Benefits are available for any medically necessary health service that is immediately required because of injury or unforeseen illness.

If you need to be hospitalized, the Plan must be notified within 48 hours or on the first working day following your
admission, unless it was not reasonably possible to notify the Plan within that time. If a Plan doctor believes care
can be better provided in a Plan hospital, you will be transferred when medically feasible with any ambulance
charges covered in full.

To be covered by this Plan, any follow-up care recommended by non-Plan providers must be approved by the Plan
or provided by Plan providers.

Emergency benefits begin on the next page

2002 KeystoneBlue 31 Section 5( d)

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Emergency within our service area
Emergency care at a doctor's office $10 per office visit
Emergency care at an urgent center
Emergency care as an outpatient or inpatient at a hospital, including doctors' services.

Not covered: Elective care or non-emergency care All charges.
Emergency outside our service area
Emergency care at a doctor's office $10 per office visit
Emergency care at an urgent center
Emergency care as an outpatient or inpatient at a hospital, including doctors' services

Not covered: All charges.
Elective care or non-emergency care
Emergency care provided outside the service area if the need for care could have been foreseen before leaving the service area

Medical and hospital costs resulting from a normal full-term delivery of a baby outside the service area

Ambulance
Professional ambulance service, including air ambulance, when Nothing
medically appropriate.

See 5( c) for non-emergency service.

$50 per visit (waived if admitted,
but the inpatient copay applies).

$50 per visit (waived if admitted,
but the inpatient copay applies).

2002 KeystoneBlue 32 Section 5( d)

Benefit Description You pay 32
32 Page 33 34
Section 5 (e). Mental health and substance abuse benefits
When you get our approval for services and follow a treatment plan we approve, cost-sharing
and limitations for Plan mental health and substance abuse benefits will be no
greater than for similar benefits for other illnesses and conditions.

Here are some important things to keep in mind about these benefits:
All benefits are subject to the definitions, limitations, and exclusions in this brochure.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other

coverage, including with Medicare.
YOU MUST GET PREAUTHORIZATION OF THESE SERVICES. See the instructions after the benefits description below.

Mental health and substance abuse benefits
All diagnostic and treatment services recommended by a
Plan provider and contained in a treatment plan that we
approve. The treatment plan may include services, drugs,
and supplies described elsewhere in this brochure.

Note: Plan benefits are payable only when we determine
the care is clinically appropriate to treat your condition
and only when you receive the care as part of a treatment
plan that we approve.

Professional services, individual or group $10 per office visit therapy by providers such as psychiatrists,
psychologists, or clinical social workers
Medication management

Mental health and substance abuse benefits continued on next page.

Your cost sharing responsibilities are no
greater than for other illnesses or
conditions.

2002 KeystoneBlue 33 Section 5( e)

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Mental health and substance abuse benefits (continued) You pay
Diagnostic tests

Services provided by a hospital or other facility
Services in approved alternative care settings such as partial hospitalization and substance abuse residential treatment facilities

Not covered: Services we have not approved All charges.
Note: OPM will base its review of disputes about treatment plans on the
treatment plan's clinical appropriateness. OPM will generally not order us to
pay or provide one clinically appropriate treatment plan in favor of another.

Preauthorization To be eligible to receive these benefits you must obtain a treatment plan and follow the network authorization process:
You must obtain approval from our mental health administrators prior to
treatment for any mental health or substance abuse condition. Please call
1-800/ 258-9808, for preauthorization.

Limitation We may limit your benefits if you do not obtain a treatment plan.

$100 copay per admission up to a
maximum of $300 per individual and
$500 per family per calendar year

$10 per specialist office visit; no sep-arate
copayment for diagnostic tests.

2002 KeystoneBlue 34 Section 5( e) 34
34 Page 35 36
Section 5 (f). Prescription drug benefits
Here are some important things to keep in mind about these benefits:
We cover prescribed drugs and medications, as described in the chart beginning on the next page.

All benefits are subject to the definitions, limitations and exclusions in this brochure and are payable only when we determine they are medically necessary.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other
coverage, including with Medicare.

There are important features you should be aware of. These include:
Who can write your prescription. A Plan or referral doctor or licensed dentist must write the prescription.
Where you can obtain them. You must fill the prescription at a Plan pharmacy or by mail for a maintenance medication.

We use a formulary. The formulary is an extensive list of Food & Drug Administration (FDA) approved prescription drugs selected for their quality, safety and effectiveness. It includes products in every major
therapeutic category. The formulary was developed by Highmark Pharmacy and Therapeutics Committee made up
of clinical pharmacists and physicians. Your program includes coverage for both formulary and non-formulary
drugs at the specific copay listed on page 36.

We have an open formulary. If your physician believes a name brand product is necessary or there is no generic available, your physician may prescribe a name brand drug from a formulary list. This list of name brand drugs is a

preferred list of drugs that we selected to meet patient needs at a lower cost. To order a prescription drug brochure,
call 1-800/ 421-0959.

These are the dispensing limitations:
Prescription drugs prescribed by a Plan or referral doctor or licensed dentist and filled at a Plan pharmacy will be
dispensed for up to a maximum 34-day supply. Generic drugs may be dispensed when substitution is permissible.

When generic drugs are available and the prescribing doctor requires the use of a name brand drug, you will pay a
higher copayment per prescription or refill.

When generic drugs are available and the prescribing doctor does not require the use of a name brand drug, but
you request the name brand drug, you will pay a higher copayment per prescription or refill, plus the price
difference between the generic and name brand drug.

A mail order program is available to provide up to a 90-day supply of maintenance drugs. For more information on
mail order prescription drugs call 1-800/ 903-6228.

If you attempt to refill a prescription too soon, it will be denied; however, your pharmacist will be given the
eligible date for refill and will pass that information on to you. If your supply has run out because your
doctor increased your dosage, your doctor must write a new prescription to cover the increased amounts.

Continued on next page.

2002 KeystoneBlue 35 Section 5( f)

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Important features you should be aware of (continued):
Why use generic drugs? Generic drugs are lower-priced drugs that are the therapeutic equivalent to more expensive name brand drugs. They must contain the same active ingredients and must be equivalent in strength

and dosage to the original name brand product. Generics cost less than the equivalent name brand product. The
U. S. Food and Drug Administration sets quality standards for generic drugs to ensure that these drugs meet the
same standards of quality and strength as name brand drugs.

You can save money by using generic drugs. However, you and your physician have the option to request a name brand if a generic option is available. Using the most cost-effective medication saves money.

A generic equivalent will be dispensed if it is available, unless your physician specifically requires a name brand. If you receive a name brand drug when a Federally-approved generic drug is available, and your physician has not
specified Dispense as Written for the name brand drug, you have to pay the difference in cost between the name
brand drug and the generic

When you have to file a claim. Mail your completed form and receipts to: Paid Prescriptions, LLC, P. O. Box 1258, Lees Summit, MO 64063-8258. Please complete a separate form for each covered person. You can obtain a claim

form by calling Member Service at 1-800/ 421-0959.

Covered medications and supplies
We cover the following medications and supplies prescribed by a Plan
or referral physician, or licensed dentist, and obtained from a Plan
pharmacy or through our mail order program:

Drugs and medicines that by Federal law of the United States require a physician's prescription for their purchase, except those listed as

Not covered.
All FDA approved contraceptive drugs. (Up to a three-cycle supply of oral contraceptive drugs may be obtained for a single copayment charge

through the mail order program)
Insulin
Insulin syringes, needles, and/ or disposable diabetic testing materials; supplies will be included under the same copayment as the insulin

Disposable needles and syringes needed to inject covered prescribed medication
Prenatal vitamins
Fluoride vitamins
Fertility drugs (require prior authorization by the Plan)
Drugs for sexual dysfunction are subject to dosage limits set by the Plan. Contact the Plan for details.

Intravenous fluids and medications for home use and some covered injectable drugs are covered under home health services at no charge
Growth Hormone Therapy requires prior authorization by the Plan
FDA approved drugs to assist with smoking cessation

Prescription drug benefits continued on next page.

Retail pharmacy for up to a
34-day supply:

$8 copay for generic drugs
$14 copay for physician required
use of name brand drugs

Mail order pharmacy for up to a
90-day supply for maintenance
medications for a single copay:

$8 copay for generic drugs
$14 copay for physician required
use of name brand drugs

Note: If there is no generic
equivalent available, you will still
have to pay the $14 name brand
copayment.

If generic drug is available but you
request a name brand drug you pay
the $14 name brand copay plus the
difference between the generic and
name brand drug.

2002 KeystoneBlue 36 Section 5( f)

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Covered medications and supplies (continued) You pay
Not covered: All charges.
Drugs and supplies for cosmetic purposes
Vitamins, and nutritional supplements that can be purchased without a prescription, except for enteral formulae (See above and

Section 5( a) Treatment therapies)
Nonprescription medicines and over-the-counter drugs
Weight loss drugs, except when medically necessary in the treatment of Morbid Obesity

Drugs obtained at a non-Plan pharmacy except out-of-area emergencies
Medical supplies such as dressings and antiseptics
Drugs to enhance athletic performance

2002 KeystoneBlue 37 Section 5( f) 37
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Section 5 (g). Special Features
Under the flexible benefits option, we determine the most effective way to
provide services.

We may identify medically appropriate alternatives to traditional care and coordinate other benefits as a less costly alternative benefit.

Alternative benefits are subject to our ongoing review.
By approving an alternative benefit, we cannot guarantee you will get it in the future.

The decision to offer an alternative benefit is solely ours, and we may withdraw it at any time and resume regular contract benefits.
Our decision to offer or withdraw alternative benefits is not subject to OPM review under the disputed claims process.

Obtaining care while away from home:
If you are away from home, you can obtain urgent and follow-up care
through the Blue Cross Blue Shield Association's BlueCard program. The
BlueCard program, gives you access to the largest network of providers in
the United States. The benefits are the same as if you were receiving care
at home.

If you have an unexpected illness or injury that cannot wait to be treated
until you return home, you can arrange urgent care by calling the
BlueCard Provider Finder number at 1-800/ 810-BLUE; it is available 24
hours a day. You will be given the names of three local Blue Cross Blue
Shield participating physicians you can call to schedule an appointment
that is convenient for you. You can also find a provider online at
www. bcbs. com. You do not need to contact your primary care physician
for the urgent visit. However, if the out-of-area physician you seek care
from recommends any additional visits or refers you to another physician
or facility for other services, you must coordinate this subsequent care
with your primary care physician before receiving services.

On-going routine services (follow-up care) that you require when you are
away from home must be coordinated with your primary care physician
prior to leaving. You can arrange follow-up care through the same process
as urgent care and make your appointment at a time and place that is
convenient for you.

You can also obtain services outside the U. S. by contacting BlueCard Worldwide.
Call Member Service at 1-800/ 421-0959 for information or logon to
www. bcbs. com to access the BlueCard Worldwide data base.

Reciprocity benefit/ travel
Flexible benefits option

2002 KeystoneBlue 38 Section 5( g)

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Section 5 (g). Special Features
Note: The procedure for emergency services has not changed. When you
need emergency services, you should seek care immediately and
coordinate any needed follow-up care with your primary care physician.
You do not need to call your primary care physician or the BlueCard
telephone number before seeking emergency care.

Your reciprocity benefit also includes a guest membership feature. This
feature is for members who will be living outside western Pennsylvania
for an extended period of time (for example, a child away at school or
when business takes you temporarily to another location.) Through this
program, you can apply for a guest membership in another area of the
country that has a Blue Cross and Blue Shield HMO plan. The guest
membership is designed to serve members who plan to be out of the
KeystoneBlue area for 90 to 180 days. The temporary residence can be for
either work-related or personal reasons. Your dependents covered by
KeystoneBlue can also apply for an unlimited length of time, as long as
the application is renewed yearly. As a guest member of another "Blue"
HMO plan, you or your dependents would choose a primary care doctor at
that plan and have the benefits offered by that HMO. For care coordinated
by that plan's primary care physician, you would be responsible only for
any applicable copayments or deductibles for that HMO. You need to
apply for a guest membership at least 30 days before you would like the
guest membership to become effective.

Section 5 (h). Dental benefits
Here are some important things to keep in mind about these benefits:
Please remember that all benefits are subject to the definitions, limitations, and exclusions in this brochure and are payable only when we determine they are medically necessary.

We cover hospitalization for dental procedures only when a nondental physical impairment exists which makes hospitalization necessary to safeguard the health of the patient; we do not cover the dental procedure unless it is
described below.
Be sure to read Section 4, Your costs for covered services, for valuable information about how cost sharing works. Also read Section 9 about coordinating benefits with other coverage, including with Medicare.

Accidental injury benefit You pay
We cover restorative services and supplies necessary to promptly repair Nothing
(but not replace) sound natural teeth. The need for these services must
result from an accidental injury.

Dental benefits
We have no other dental benefits.

Reciprocity benefit/ travel
(continued)

2002 KeystoneBlue 39 Section 5( g) and Section 5( h) 39
39 Page 40 41
Section 5 (i). Non-FEHB benefits available to Plan members
The benefits on this page are not part of the FEHB contract or premium, and you cannot file an
FEHB disputed claim about them.
Fees you pay for these services do not count toward FEHB
deductibles or out-of-pocket maximums.

KeystoneBlue also offers members these Distinct Health Enhancement Opportunities:
Dental coverage All KeystoneBlue members may take advantage of special discounts through our Healthy Lifestyle

Program. By simply presenting your Plan ID card at participating Healthy Lifestyle providers you
will receive a 10% to 30% discount off the cost of most dental services. Some dental providers also
offer KeystoneBlue members free or discounted initial exams, x-rays, and cleanings.

Healthy Lifestyle Programs All KeystoneBlue members may take advantage of discounts available at more than 500 area

establishments which promote "healthy lifestyle" choices. By simply presenting your KeystoneBlue
membership card at the time of purchase at participating establishments, you may take advantage of
discounts on health club memberships, sporting goods, fitness equipment, and nutritional items.

Also, KeystoneBlue members may take advantage of free lifestyle improvement classes on such
topics as nutrition and weight loss, smoking cessation, stress management, and prepared childbirth.
These classes are offered at least three times a year at various locations in the Western Pennsylvania
area.

Blues On Call SM 1-888/ BLUE-428 Blues On Call provides all KeystoneBlue members with 24-hour access 7 days a week to health

information and personalized support for health decisions. The program helps you get more involved
in your care by providing a reliable source for current medical information. Blues On Call promotes
the philosophy of Shared Decision Making by helping you share with your physicians in the task of
choosing treatment options that take into account your values and preferences. Blues On Call also
supports physicians by encouraging patient adherence to treatment plans. Enhanced Blues On Call
integrates the previously offered services with disease management to provide a comprehensive
approach to total patient care. This integration supports overall patient management and will allow
members access to services through one source, regardless of the condition that they have.

2002 KeystoneBlue 40 Section 5( i) 40
40 Page 41 42
Section 6. General exclusions things we don't cover
The exclusions in this section apply to all benefits. Although we may list a specific service as a benefit, we
will not cover it unless your Plan doctor determines it is medically necessary to prevent, diagnose, or treat your
illness, disease, injury, or condition and we agree, as discussed under
What Services Require Our Prior Approval
on page 11.

We do not cover the following:
Care by non-Plan providers except for authorized referrals or emergencies (see Emergency benefits);
Services, drugs, or supplies you receive while you are not enrolled in this Plan;
Services, drugs, or supplies that are not medically necessary;
Services, drugs, or supplies not required according to accepted standards of medical, dental, or psychiatric practice;

Experimental or investigational procedures, treatments, drugs or devices;
Services, drugs, or supplies related to abortions, except when the life of the mother would be endangered if the fetus were carried to term or when the pregnancy is the result of an act of rape or incest;

Services, drugs, or supplies related to sex transformations; or
Services, drugs, or supplies you receive from a provider or facility barred from the FEHB Program.

2002 KeystoneBlue 41 Section 6 41
41 Page 42 43
Section 7. Filing a claim for covered services
When you see Plan physicians, receive services at Plan hospitals and facilities, or fill your prescription drugs
at Plan pharmacies you will not have to file claims. Just present your ID card and pay your copayments or coinsurance.

You will only need to file a claim when you receive emergency services from non-Plan providers. Sometimes these
providers bill us directly. Check with the provider. If you need to file the claim, here is the process:

Medical and hospital benefits In most cases, providers and facilities file claims for you. Physicians must file on the form HCFA-1500, Health Insurance
Claim Form. Facilities will file on the UB-92 form. For claims
questions and assistance, call us at 1-800/ 421-0959.

When you must file a claim such as for out-of-area care
submit it on the HCFA-1500 or a claim form that includes the
information shown below. Bills and receipts should be itemized
and show:

Covered member's name and ID number;
Name and address of the physician or facility that provided the service or supply;

Dates you received the services or supplies;
Diagnosis;
Type of each service or supply;
The charge for each service or supply;
A copy of the explanation of benefits, payments, or denial from any primary payer such as the Medicare Summary Notice

(MSN); and
Receipts, if you paid for your services.
Submit your claims to: KeystoneBlue, 1800 Center Street,
P. O. Box 890037, Camp Hill, PA 17089-0037

Prescription drugs Mail your completed form and receipts to: Paid Prescriptions, LLC, P. O. Box 1258, Lees Summit, MO 64063-8258. Please
complete a separate form for each covered person. You can obtain
a claim form by calling Member Service at 1-800/ 421-0959.

Deadline for filing your claim Send us all of the documents for your claim as soon as possible. You must submit the claim by December 31 of the year after you
received the service, unless timely filing was prevented by
administrative operations of Government or legal incapacity,
provided the claim was submitted as soon as reasonably possible.

When we need more information Please reply promptly when we ask for additional information. We may delay processing or deny your claim if you do
not respond.

2002 KeystoneBlue 42 Section 7 42
42 Page 43 44
Section 8. The disputed claims process
Follow this Federal Employees Health Benefits Program disputed claims process if you disagree with our decision on your
claim or request for services, drugs, or supplies including a request for preauthorization:

Step Description

1 Ask us in writing to reconsider our initial decision. You must: (a) Write to us within 6 months from the date of our decision; and

(b) Send your request to us at: Keystone Health Plan West, Member Grievance and Appeal Department,
P. O. Box 2717, Pittsburgh, PA 15230.

(c) Include a statement about why you believe our initial decision was wrong, based on specific
benefit provisions in this brochure; and

(d) Include copies of documents that support your claim, such as physicians' letters, operative reports,
bills, medical records, and explanation of benefits (EOB) forms.

2 We have 30 days from the date we receive your request to: (a) Pay the claim (or, if applicable, arrange for the health care provider to give you the care); or

(b) Write to you and maintain our denial go to step 4; or
(c) Ask you or your provider for more information. If we ask your provider, we will send you a copy of our
request go to step 3.

3 You or your provider must send the information so that we receive it within 60 days of our request. We will then decide within 30 more days.

If we do not receive the information within 60 days, we will decide within 30 days of the date the information was
due. We will base our decision on the information we already have.

We will write to you with our decision.

4 If you do not agree with our decision, you may ask OPM to review it. You must write to OPM within:

90 days after the date of our letter upholding our initial decision; or
120 days after you first wrote to us if we did not answer that request in some way within 30 days; or
120 days after we asked for additional information.
Write to OPM at: Office of Personnel Management, Office of Insurance Programs, Contracts Division 3,
1900 E Street, NW, Washington, D. C. 20415-3630.

2002 KeystoneBlue 43 Section 8 43
43 Page 44 45
The Disputed Claims process (continued)
Send OPM the following information:
A statement about why you believe our decision was wrong, based on specific benefit provisions in this brochure;

Copies of documents that support your claim, such as physicians' letters, operative reports, bills, medical records, and explanation of benefits (EOB) forms;
Copies of all letters you sent to us about the claim;
Copies of all letters we sent to you about the claim; and
Your daytime phone number and the best time to call.
Note: If you want OPM to review different claims, you must clearly identify which documents apply to which claim.
Note: You are the only person who has a right to file a disputed claim with OPM. Parties acting as your represen-tative,
such as medical providers, must include a copy of your specific written consent with the review request.

Note: The above deadlines may be extended if you show that you were unable to meet the deadline because of
reasons beyond your control.

5 OPM will review your disputed claim request and will use the information it collects from you and us to decide whether our decision is correct. OPM will send you a final decision within 60 days. There are no other
administrative appeals.

6 If you do not agree with OPM's decision, your only recourse is to sue. If you decide to sue, you must file the suit against OPM in Federal court by December 31 of the third year after the year in which you received the disputed
services, drugs, or supplies or from the year in which you were denied precertification or prior approval. This is the
only deadline that may not be extended.

OPM may disclose the information it collects during the review process to support their disputed claim decision.
This information will become part of the court record.

You may not sue until you have completed the disputed claims process. Further, Federal law governs your lawsuit,
benefits, and payment of benefits. The Federal court will base its review on the record that was before OPM when
OPM decided to uphold or overturn our decision. You may recover only the amount of benefits in dispute.

NOTE: If you have a serious or life threatening condition (one that may cause permanent loss of bodily functions or
death if not treated as soon as possible), and

(a) We haven't responded yet to your initial request for care or preauthorization/ prior approval, then call us at
1-800/ 421-0959 and we will expedite our review; or

(b) We denied your initial request for care or preauthorization/ prior approval, then:
If we expedite our review and maintain our denial, we will inform OPM so that they can give your claim
expedited treatment too, or

You can call OPM's Health Benefits Contracts Division 3 at 202/ 606-0755 between 8 a. m. and 5 p. m. eastern time.

2002 KeystoneBlue 44 Section 8 44
44 Page 45 46
Section 9. Coordinating benefits with other coverage
When you have other
You must tell us if you are covered or a family member is covered under health coverage another group health plan or have automobile insurance that pays health care
expenses without regard to fault. This is called "double coverage."
When you have double coverage, one plan normally pays its benefits in full as
the primary payer and the other plan pays a reduced benefit as the secondary
payer. We, like other insurers, determine which coverage is primary according
to the National Association of Insurance Commissioners' guidelines.

When we are the primary payer, we will pay the benefits described in this
brochure.

When we are the secondary payer, we will determine our allowance. After the
primary plan pays, we will pay what is left of our allowance, up to our regular
benefit. We will not pay more than our allowance.

What is Medicare? Medicare is a Health Insurance Program for:
People 65 years of age and older.

Some people with disabilities, under 65 years of age.
People with End-Stage Renal Disease (permanent kidney failure requiring
dialysis or a transplant).

Medicare has two parts:
Part A (Hospital Insurance). Most people do not have to pay for Part A. If
you or your spouse worked for at least 10 years in Medicare-covered
employment, you should be able to qualify for premium-free Part A
insurance. (Someone who was a Federal employee on January 1, 1983 or
since automatically qualifies.) Otherwise, if you are age 65 or older, you
may be able to buy it. Contact 1-800/ MEDICARE for more information.

Part B (Medical Insurance). Most people pay monthly for Part B. Generally,
Part B premiums are withheld from your monthly Social Security check or
your retirement check.

If you are eligible for Medicare, you may have choices in how you get your health
care. Medicare + Choice is the term used to describe the various health plan
choices available to Medicare beneficiaries. The information in the next few pages
show how we coordinate benefits with Medicare, depending on the type of
Medicare managed care plan you have.

The Original Medicare Plan The Original Medicare Plan (Original Medicare) is available everywhere (Part A or Part B) in the United States. It is the way everyone used to get Medicare benefits and is

the way most people get their Medicare Part A and Part B benefits now. You
may go to any doctor, specialist, or hospital that accepts Medicare. The Original
Medicare pays its share and you pay your share. Some things are not covered
under Original Medicare, like prescription drugs.

(Primary payer chart begins on next page.)

2002 KeystoneBlue 45 Section 9 45
45 Page 46 47
2002 KeystoneBlue 46 Section 9
The following chart illustrates whether the Original Medicare Plan or this Plan should be the primary payer for you
according to your employment status and other factors determined by Medicare. It is critical that you tell us if you or a
covered family member has Medicare coverage so we can administer these requirements correctly.

P rimary Payer Chart
Then the primary payer is A. When either you or your covered spouse are age 65 or over and

Original Medicare This Plan
1) Are an active employee with the Federal government (including
when you or a family member are eligible for Medicare solely
because of a disability),


2) Are an annuitant,
3) Are a reemployed annuitant with the Federal government when
a) The position is excluded from FEHB, or

b) The position is not excluded from FEHB
(Ask your employing office which of these applies to you.)

4) Are a Federal judge who retired under title 28, U. S. C., or a Tax
Court judge who retired under Section 7447 of title 26, U. S. C. (or if
your covered spouse is this type of judge),

5) Are enrolled in Part B only, regardless of your employment status, (for Part B
services)

(for other
services)
6) Are a former Federal employee receiving Workers' Compensation
and the Office of Workers' Compensation Programs has determined
that you are unable to return to duty,

(except for claims
related to Workers'
Compensation.)

B. When you or a covered family member have Medicare based
on end stage renal disease (ESRD) and

1) Are within the first 30 months of eligibility to receive Part A
benefits solely because of ESRD,

2) Have completed the 30-month ESRD coordination period and are
still eligible for Medicare due to ESRD,

3) Become eligible for Medicare due to ESRD after Medicare became
primary for you under another provision,

C. When you or a covered family member have FEHB and
1) Are eligible for Medicare based on disability, and
a) Are an annuitant, or


b) Are an active employee, or
c) Are a former spouse of an annuitant, or

d) Are a former spouse of an active employee



Please note, if your Plan physician does not participate in Medicare, you will have to file a claim with Medicare. 46
46 Page 47 48

When you are enrolled in Original Medicare along with this Plan, you still need
to follow the rules in this brochure for us to cover your care.

We will not waive any of our copayments or coinsurance.
Claims process when you have the Original Medicare Plan You probably will
never have to file a claim form when you have both our Plan and the Original
Medicare Plan.

When we are the primary payer, we process the claim first.
When Original Medicare is the primary payer, Medicare processes your claim first. In most cases, your claims will be coordinated automatically. We will

process your claims for secondary payment based on usual and customary
allowances, rather than Medicare allowances. If there is a remaining balance,
an explanation of benefits will be sent to you detailing how the claim was
processed and showing you any amounts that are your responsibility. To find out
if you need to do something about filing your claims, call us at 1-800/ 421-0959.

We do not waive any costs when you have Medicare.

Medicare managed care plan If you are eligible for Medicare, you may choose to enroll in and get your benefits from a Medicare managed care plan. These are health care choices
(like HMOs) in some areas of the country. In most Medicare managed care
plans, you can only go to doctors, specialists, or hospitals that are part of the
plan. Medicare managed care plans provide all the benefits that Original
Medicare covers. Some cover extras, like prescription drugs. To learn more
about enrolling in a Medicare managed care plan, contact Medicare at
1-800/ MEDICARE (1-800/ 633-4227) or at www. medicare. gov.

If you enroll in a Medicare managed care plan, the following options are
available to you:

This Plan and our Medicare managed care plan: You may enroll in our
Medicare managed care plan and also remain enrolled in our FEHB plan.
In this case, we do not waive any of our copayments or coinsurance for your
FEHB coverage.

This Plan and another plan's Medicare managed care plan: You may enroll
in another plan's Medicare managed care plan and also remain enrolled in our
FEHB plan. We will still provide benefits when your Medicare managed care plan
is primary, even out of the managed care plan's network and/ or service area (if
you use our Plan providers), but we will not waive any of our copayments, or
coinsurance. If you enroll in a Medicare managed care plan, tell us. We will need
to know whether you are in the Original Medicare Plan or in a Medicare managed
care plan so we can correctly coordinate benefits with Medicare.

Suspended FEHB coverage to enroll in a Medicare managed care plan:
If you are an annuitant or former spouse, you can suspend your FEHB coverage
to enroll in a Medicare managed care plan, eliminating your FEHB premium.
(OPM does not contribute to your Medicare managed care plan premium.) For
information on suspending your FEHB enrollment, contact your retirement office.
If you later want to re-enroll in the FEHB Program, generally you may do so only
at the next open season unless you involuntarily lose coverage or move out of the
Medicare managed care plan's service area.

2002 KeystoneBlue 47 Section 9 47
47 Page 48 49
If you do not enroll in If you do not have one or both Parts of Medicare, you can still be covered Medicare Part A or Part B under the FEHB Program. We will not require you to enroll in Medicare Part B
and, if you can't get premium-free Part A, we will not ask you to enroll in it.
TRICARE TRICARE is the health care program for eligible dependents of military per-sons, and retirees of the military. TRICARE includes the CHAMPUS program.
If both TRICARE and this Plan cover you, we pay first. See your TRICARE
Health Benefits Advisor if you have questions about TRICARE coverage.

Workers' Compensation We do not cover services that:
you need because of a workplace-related illness or injury that the Office of Workers' Compensation Programs (OWCP) or a similar Federal or State
agency determines they must provide; or

OWCP or a similar agency pays for through a third party injury settlement or other similar proceeding that is based on a claim you filed under OWCP or
similar laws.
Once OWCP or similar agency pays its maximum benefits for your treatment,
we will cover your care. You must use our providers.

Medicaid When you have this Plan and Medicaid, we pay first.
When other Government agencies We do not cover services and supplies when a local, State, are responsible for your care or Federal Government agency directly or indirectly pays for them.

When others are responsible When you receive money to compensate you for medical or hospital for injuries care for injuries or illness caused by another person or organization, you must
reimburse us for all expenses we paid. This is called subrogation. We will cover
the cost of treatment based on your benefit plan, but we do have the right to be
repaid from the money that you received in the settlement.

If you do not seek damages, we can attempt to recover the benefits we paid on
your behalf. You may be asked to assist us in our recovery efforts. If you need
more information, contact us for our subrogation procedures.

2002 KeystoneBlue 48 Section 9 48
48 Page 49 50

Section 10. Definitions of terms we use in this brochure
Calendar year
January 1 through December 31 of the same year. For new enrollees, the calendar year begins on the effective date of their enrollment and ends on
December 31 of the same year.
Coinsurance Coinsurance is the percentage of our allowance that you must pay for your care. See page 12.

Copayment A copayment is a fixed amount of money you pay when you receive covered services. See page 12.
Covered services Care we provide benefits for, as described in this brochure.
Experimental or The use of any treatment, service, procedure, facility, equipment, drug, Investigational services device or supply (intervention) that is not determined by the Plan or its
Designated Agent to be medically effective for the condition being treated. The
Plan or its Designated Agent will consider an intervention to be
Experimental/ Investigative if:

The intervention does not have FDA approval to market for the specific relevant indication( s); or

Available scientific evidence does not permit conclusions concerning the effect of the intervention on health outcomes; or
The intervention is not proven to be as safe or as effective in achieving an outcome equal to or exceeding the outcome of alternative therapies; or
The intervention is not proven to be applicable outside the research setting. If an intervention as defined above is determined to be Experimental/ Investigative at
the time of service, it will not receive retroactive coverage if, at some future
date, medical opinion changes.

Medically necessary and Those services or medical supplies that based on the opinion of your appropriate primary care physician and/ or KeystoneBlue, are determined to be:
Appropriate for the symptoms and diagnosis or treatment of your condition, illness, disease, or injury; and
Provided for the diagnosis, or the direct care and treatment of your condition, illness, disease, or injury; and
In accordance with standards of good medical practice; and
Not primarily for your convenience, or your provider; and
The most appropriate supply or level of service that can safely be provided to you. When applied to hospitalization, this further means that you require acute

care as an inpatient due to the nature of the services rendered or your condi-tion,
and that you cannot receive safe or adequate care as an outpatient.

Us/ We Us and we refer to KeystoneBlue
You You refers to the enrollee and each covered family member.

2002 KeystoneBlue 49 Section 10 49
49 Page 50 51

Section 11. FEHB facts
No pre-existing condition
We will not refuse to cover the treatment of a condition that you had limitation before you enrolled in this Plan solely because you had the condition before you
enrolled.
Where you can get information See www. opm. gov/ insure. Also, your employing or retirement office about enrolling in the can answer your questions, and give you a Guide to Federal Employees
FEHB Program Health Benefits Plans, brochures for other plans, and other materials you need to make an informed decision about:

When you may change your enrollment;
How you can cover your family members;
What happens when you transfer to another Federal agency, go on leave without pay, enter military service, or retire;

When your enrollment ends; and
When the next open season for enrollment begins.
We don't determine who is eligible for coverage and, in most cases, cannot
change your enrollment status without information from your employing or
retirement office.

Types of coverage available Self Only coverage is for you alone. Self and Family coverage is for you, your for you and your family spouse, and your unmarried dependent children under age 22, including any foster
children or stepchildren your employing or retirement office authorizes coverage
for. Under certain circumstances, you may also continue coverage for a disabled
child 22 years of age or older who is incapable of self-support.

If you have a Self Only enrollment, you may change to a Self and Family enroll-ment
if you marry, give birth, or add a child to your family. You may change your
enrollment 31 days before to 60 days after that event. The Self and Family enroll-ment
begins on the first day of the pay period in which the child is born or
becomes an eligible family member. When you change to Self and Family because
you marry, the change is effective on the first day of the pay period that begins
after your employing office receives your enrollment form; benefits will not be
available to your spouse until you marry.

Your employing or retirement office will not notify you when a family member is
no longer eligible to receive health benefits, nor will we. Please tell us immediate-ly
when you add or remove family members from your coverage for any reason,
including divorce, or when your child under age 22 marries or turns 22.

If you or one of your family members is enrolled in one FEHB plan, that person
may not be enrolled in or covered as a family member by another FEHB plan.

2002 KeystoneBlue 50 Section 11 50
50 Page 51 52
When benefits and The benefits in this brochure are effective on January 1. If you joined this premiums start Plan during Open Season, your coverage begins on the first day of your first pay
period that starts on or after January 1. Annuitants' coverage and premiums begin
on January 1. If you joined at any other time during the year, your employing
office will tell you the effective date of coverage.

Your medical and claims We will keep your medical and claims information confidential. Only records are confidential the following will have access to it:
OPM, this Plan, and subcontractors when they administer this contract;
This Plan and appropriate third parties, such as other insurance plans and the Office of Workers' Compensation Programs (OWCP), when coordinating benefit

payments and subrogating claims;
Law enforcement officials when investigating and/ or prosecuting alleged civil or criminal actions;

OPM and the General Accounting Office when conducting audits;
Individuals involved in bona fide medical research or education that does not disclose your identity; or

OPM, when reviewing a disputed claim or defending litigation about a claim.

When you retire When you retire, you can usually stay in the FEHB Program. Generally, you must have been enrolled in the FEHB Program for the last five years of your Federal
service. If you do not meet this requirement, you may be eligible for other forms
of coverage, such as temporary continuation of coverage (TCC).

When you lose benefits
When FEHB coverage ends You will receive an additional 31 days of coverage, for no additional premium, when:
Your enrollment ends, unless you cancel your enrollment, or
You are a family member no longer eligible for coverage.
You may be eligible for spouse equity coverage or Temporary Continuation of
Coverage.

Spouse equity If you are divorced from a Federal employee or annuitant, you may not coverage continue to get benefits under your former spouse's enrollment. But, you may be

eligible for your own FEHB coverage under the spouse equity law. If you are
recently divorced or are anticipating a divorce, contact your ex-spouse's employing
or retirement office to get RI 70-5, the Guide to Federal Employees Health
Benefits Plans for Temporary Continuation of Coverage and Former Spouse
Enrollees,
or other information about your coverage choices.

Temporary Continuation If you leave Federal service, or if you lose coverage because you no longer qualify of Coverage (TCC) as a family member, you may be eligible for Temporary Continuation of Coverage

(TCC). For example, you can receive TCC if you are not able to continue your
FEHB enrollment after you retire, if you lose your job, if you are a covered depen-dent
child and you turn 22 or marry, etc.

You may not elect TCC if you are fired from your Federal job due to gross
misconduct.

2002 KeystoneBlue 51 Section 11 51
51 Page 52 53

Enrolling in TCC. Get the RI 79-27, which describes TCC, and the RI 70-5, the
Guide to Federal Employees Health Benefits Plans for Temporary Continuation of
Coverage and Former Spouse Enrollees,
from your employing or retirement office
or from www. opm. gov/ insure. It explains what you have to do to enroll.

Converting to You may convert to a non-FEHB individual policy if: individual coverage Your coverage under TCC or the spouse equity law ends (If you canceled your
coverage or did not pay your premium, you cannot convert);
You decided not to receive coverage under TCC or the spouse equity law; or
You are not eligible for coverage under TCC or the spouse equity law.
If you leave Federal service, your employing office will notify you of your right to
convert. You must apply in writing to us within 31 days after you receive this
notice. However, if you are a family member who is losing coverage, the employ-ing
or retirement office will not notify you. You must apply in writing to us with-in
31 days after you are no longer eligible for coverage.

Your benefits and rates will differ from those under the FEHB Program; however,
you will not have to answer questions about your health, and we will not impose a
waiting period or limit your coverage due to pre-existing conditions.

Getting a Certificate of The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a Group Health Plan Coverage Federal law that offers limited Federal protections for health coverage availability
and continuity to people who lose employer group coverage. If you leave the
FEHB Program, we will give you a Certificate of Group Health Plan Coverage that
indicates how long you have been enrolled with us. You can use this certificate
when getting health insurance or other health care coverage. Your new plan must
reduce or eliminate waiting periods, limitations, or exclusions for health related
conditions based on the information in the certificate, as long as you enroll within
63 days of losing coverage under this Plan. If you have been enrolled with us for
less than 12 months, but were previously enrolled in other FEHB plans, you may
also request a certificate from those plans.

For more information, get OPM pamphlet RI 79-27, Temporary Continuation of
Coverage (TCC) under the FEHB Program. See also the FEHB website
(www. opm. gov/ insure/ health); refer to the "TCC and HIPAA" frequently asked
questions. These highlight HIPAA rules, such as the requirement that Federal
employees must exhaust any TCC eligibility as one condition for guaranteed
access to individual health coverage under HIPAA, and have information about
Federal and State agencies you can contact for more information.

2002 KeystoneBlue 52 Section 11 52
52 Page 53 54

Long Term Care Insurance Is Coming Later in 2002!
The Office of Personnel Management (OPM) will sponsor a high-quality long term care insurance program effective in October 2002. As part of its educational effort, OPM asks you to consider these questions:
What is long term care It's insurance to help pay for long term care services you may need if you (LTC) insurance? can't take care of yourself because of an extended illness or injury, or an age-related
disease such as Alzheimer's.
LTC insurance can provide broad, flexible benefits for nursing home care, care in an assisted living facility, care in your home, adult day care, hospice

care, and more. It can supplement care provided by family members, reduc-ing
the burden you place on them.

I'm healthy. I won't need Welcome to the club! long term care. Or will I? 76% of Americans believe they will never need long term care, but the facts

are that about half of them will. And it's not just the old folks. About 40% of
people needing long term care are under age 65. They may need chronic care
due to a serious accident, a stroke, or developing multiple sclerosis, etc.
We hope you will never need long term care, but everyone should have a plan just in case. Many people now consider long term care insurance to be vital to

their financial and retirement planning.
Is long term care expensive? Yes, it can be very expensive. A year in a nursing home can exceed $50,000. Home care for only three 8-hour shifts a week can exceed $20,000 a year.

And that's before inflation!
Long term care can easily exhaust your savings. Long term care insurance can protect your savings.

But won't my FEHB plan, Not FEHB. Look at the "Not covered" blocks in sections 5( a) and 5( c) Medicare or Medicaid cover of your FEHB brochure. Health plans don't cover custodial care or a stay
my long term care? in an assisted living facility or a continuing need for a home health aide to help you get in and out of bed and with other activities of daily living. Limited
stays in skilled nursing facilities can be covered in some circumstances.
Medicare only covers skilled nursing home care (the highest level of nursing care) after a hospitalization for those who are blind, age 65 or older or fully

disabled. It also has a 100 day limit.
Medicaid covers long term care for those who meet their state's poverty guidelines, but has restrictions on covered services and where they can be

received. Long term care insurance can provide choices of care and preserve
your independence.

When will I get more information Employees will get more information from their agencies during the on how to apply for this new LTC open enrollment period in the late summer/ early fall of 2002.

insurance coverage? Retirees will receive information at home.
How can I find out more Our toll-free teleservice center will begin in mid-2002. In the meantime, you about the program NOW? can learn more about the program on our web site at www. opm. gov/ insure/ ltc.

Many FEHB enrollees think that their health plan and/ or Medicare will cover their long-term care needs. Unfortunately, they are WRONG!
How are YOU planning to pay for the future custodial or chronic care you may need? You should consider buying long-term care insurance.

2002 KeystoneBlue 53 Long Term Care Insurance 53
53 Page 54 55

Accidental injury 31
Allergy tests 18
Allogeneic (donor) bone marrow
transplant 26
Alternative treatment 23
Ambulance 32
Anesthesia 27
Autologous bone marrow
transplant 27
Biopsies 24
Blood and blood plasma 28
Breast cancer screening 15
Casts 28
Changes for 2002 8
Chemotherapy 18
Childbirth 16
Chiropractic 22
Cholesterol tests 15
Claims 42
Coinsurance 12
Colorectal cancer screening 15
Congenital anomalies 25
Contraceptive devices and drugs 17
Coordination of benefits 45
Covered charges 9
Covered providers 9
Crutches 22
Definitions 49
Dental care 39
Diagnostic services 14
Disputed claims review 43
Donor expenses (transplants) 27
Dressings 28
Durable medical equipment
(DME) 22
Educational classes and programs 23
Effective date of enrollment 51
Emergency 31
Experimental or investigational 49
Eyeglasses 19

Family planning 17
Fecal occult blood test 15
General Exclusions 41
Hearing services 19
Home health services 22
Hospice care 30
Home nursing care 22
Hospital 28
Immunizations 16
Infertility 17
In hospital physician care 28
Inpatient Hospital Benefits 28
Insulin 36
Laboratory
and pathological
services 15
Long term care insurance 53
Machine diagnostic tests 15
Magnetic Resonance
Imagings (MRIs) 15
Mail Order Prescription Drugs 36
Mammograms 15
Maternity Benefits 16
Medicaid 48
Medically necessary 49
Medicare 45
Members 50
Mental Conditions/ Substance
Abuse Benefits 33
Newborn care 16
Non-FEHB Benefits 40
Nursery charges 16
Obstetrical care 16
Occupational therapy 18
Office visits 14
Oral and maxillofacial surgery 26
Orthopedic devices 21
Out-of-pocket expenses 12
Outpatient facility care 29
Oxygen 22

Pap test 15
Physical examination 15
Physical therapy 18
Physician 9
Pre-admission testing 29
Precertification 10
Preventive care, adult 15
Preventive care, children 16
Prescription drugs 35
Preventive services 15
Prior approval 11
Prostate cancer screening 15
Prosthetic devices 21
Psychologist 33
Psychotherapy 33
Radiation therapy 18
Renal dialysis 18
Room and board 28
Second surgical opinion 14
Skilled nursing facility care 30
Smoking cessation 23
Speech therapy 19
Splints 28
Sterilization procedures 24
Subrogation 48
Substance abuse 33
Surgery 24
Anesthesia 27
Oral 26
Outpatient 29
Reconstructive 25
Syringes 36
Temporary
continuation
of coverage 51
Transplants 26
Treatment therapies 18
Vision services 19
Wheelchairs 22
Workers' compensation 48
X-rays 15

2002 KeystoneBlue 54 Index

Index
Do not rely on this page; it is for your convenience and may not show all pages where the terms appear. 54
54 Page 55 56
Summary of benefits for the KeystoneBlue 2002
Do not rely on this chart alone. All benefits are provided in full unless indicated and are subject to the definitions, limitations, and exclusions in this brochure. On this page we summarize specific expenses we cover; for more detail,
look inside.
If you want to enroll or change your enrollment in this Plan, be sure to put the correct enrollment code from the cover on your enrollment form.

We only cover services provided or arranged by Plan physicians, except in emergencies.
Benefits You pay Page
Medical services provided by physicians:
Diagnostic and treatment services provided in the office . . . . . 14
Services provided by a hospital:
Inpatient. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

Outpatient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nothing 29
Emergency benefits:

In-area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Out-of-area. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Mental health and substance abuse treatment . . . . . . . . . . . . . . . Regular cost sharing 33
Prescription drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Up to a 34-day supply per prescription unit or refill.

Up to a 90-day supply for maintenance drugs through mail order.

Dental Care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Nothing 39
Accidental injury benefit only.

Vision Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
OptiChoice In-Network Annual Benefits Program

Special features: Flexible benefits option; Reciprocity benefit/ travel Nothing 38
Protection against catastrophic costs
(your out-of-pocket maximum) . . . . . . . . . . . . . . . . . . . . . . . . . . 12 We have no out-of-pocket maximum,

except for a $300 per individual and
$500 per family inpatient hospital
copayment limit.

Nothing for most standard services

Retail Pharmacy: $8 copay for
generic drugs; $14 copay for name
brand drugs.

Mail Order (Maintenance drugs
only): $8 copay for generic drugs;
$14 copay for name brand drugs.

$50 copay per visit (waived if
admitted)

$50 copay per visit (waived if
admitted)

$100 copay per admission up to a
maximum of $300 per individual and
$500 per family per calendar year

Office visit copay: $10 primary
care; $10 specialist

2002 KeystoneBlue 55 Summary 55
55 Page 56
2002 KeystoneBlue 56 Rates
2002 Rate Information for
KeystoneBlue

Non-Postal rates apply to most non-Postal enrollees. If you are in a special enrollment category, refer to the
FEHB Guide for that category or contact the agency that maintains your health benefits enrollment.

Postal rates apply to career Postal Service employees. Most employees should refer to the FEHB Guide for
United States Postal Service Employees, RI 70-2. Different postal rates apply and special FEHB guides are
published for Postal Service Nurses and Tool & Die employees (see RI 70-2B); and for Postal Service Inspectors
and Office of Inspector General (OIG) employees (see RI 70-2IN).

Postal rates do not apply to non-career postal employees, postal retirees, or associate members of any postal
employee organization. Refer to the applicable FEHB Guide.

Non-Postal Premium Postal Premium
Biweekly Monthly Biweekly
Type of
Enrollment Code
Gov't
Share
Your
Share
Gov't
Share
Your
Share
USPS
Share
Your
Share

EF1 $97.86 $47.63 $212.03 $103.20 $115.52 $29.97
EF2 $223.41 $208.21 $484.06 $451.12 $263.75 $167.87 Self and Family
Self Only
56

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