Q & A

What if I need out of state non-emergency medical care?

If you have an HMO contract and are traveling out of state and need to seek treatment for non-emergency care, we request that you call the number on the back of your ID card 1-800-4HMO-USA to obtain information on local providers in that area. Follow-up care should be received from an HMOLA network provider.

What if I need medical care in a foreign country?

If you have an HMO contract and are traveling out of the country and need emergency medical care, you should go to the nearest hospital available. If possible, you should call the number on the back of your ID card 1-800-4HMO-USA to obtain information on local hospitals in that area. HMOLA must be notified of the emergency medical service within forty-eight [48] hours after receiving treatment or as soon as medical circumstances permit.

How do my maternity benefits work?

If your Individual HMO contract provides coverage for Pregnancy Care benefits and the pregnancy is not pre-existing, you will be responsible for payment of a Pregnancy Care co-pay if covered services are performed by a Network Provider. You will also be responsible for an Inpatient Hospital Admission co-pay. Of course with respect to the Individual HMO/POS product covered services rendered out of network are subject to a deductible and coinsurance.

When do I need a referral to see my OB/GYN? (HMO)?

You are allowed two (2) routine visits to a network OB/GYN per benefit period. You do not need a referral for these services. You may also schedule follow-up visits within 60 days of a routine gynecological exam without a referral from your PCP for treatment of a condition that was diagnosed or treated during a routine gynecological exam. All other situations would require a referral from your PCP.

When do I need a referral? What is the difference in a streamline referral and a plan approved referral?

Unless you are receiving emergency medical services, a referral is normally needed whenever services are going to be performed at a location other than your primary care physician's office in order to receive benefits or the highest level of benefits. A streamline referral is the expedited process by which your PCP is allowed to refer you to a network specialist or other providers by completing the Physician Referral Authorization Form. A plan-approved referral is used for services performed in an outpatient or inpatient setting. This referral is also used for targeted procedures referred to in your schedule of benefits as "outpatient pre-service authorization" services.

How can I contact the Federal Employee Program?
  • Your FEP claims and customer service inquiries can be mailed to: Blue Cross and Blue Shield of Louisiana Federal Employee Program P.O. Box 98028 Baton Rouge, LA 70898-9028

  • The www.fepblue.org website provides a lot of self-service options as well as valuable information for you and your family.  You may view the status of a claim, request an ID card, update member information, change your address, download claim forms and more.

  • Our dedicated FEP Customer Service Unit can provide assistance with all of your customer service needs by calling 1-800-272-3029 or by fax at 225-295-2364.

  • The FEP Mail Order Drug Program (CVS Caremark*) phone number is 1-800-262-7890

  • The FEP Retail Pharmacy Program phone number is 1-800-624-5060.
What is covered under my FEP Federal contract?

Call FEP Customer Service at 1-800-272-3029 to receive a benefit brochure and summary or to speak to a customer service representative.

*CVS Caremark is an independent company that serves as the pharmacy benefit manager for the Blue Cross and Blue Shield Service Benefit Program.