Compare Our Plans
See the differences between benefits and coverage for our three plan options side by side.
FEP Blue Focus®
- Has a deductible
- Must see Preferred providers
- Out-of-pocket costs include deductible, copays and coinsurance
- Earn a reward for getting annual physical
FEP Blue Basic™
- Has no deductible
- Must see Preferred providers
- Most out-of-pocket costs are copays
- Can get Medicare Part B premium reimbursement
- Earn up to $170 in rewards with the Wellness Incentive Program
FEP Blue Standard™
- Has a deductible
- Can see any provider, even outside the network
- Out-of-pocket costs include deductible, copays and coinsurance
- Access to Mail Service Pharmacy Program
- Earn up to $170 in rewards with the Wellness Incentive Program
2024 Plan Rates
Enrollment code | Bi-weekly | Monthly |
---|---|---|
Self (131) |
$55.30 | $119.83 |
Self + 1 (133) |
$118.88 | $257.58 |
Self & Family (132) |
$130.76 | $283.32 |
Enrollment code | Bi-weekly | Monthly |
---|---|---|
Self (111) |
$95.74 | $207.44 |
Self + 1 (113) |
$238.63 | $517.03 |
Self & Family (112) |
$262.60 | $568.96 |
Enrollment code | Bi-weekly | Monthly |
---|---|---|
Self (104) |
$150.79 | $326.71 |
Self + 1 (106) |
$336.84 | $729.82 |
Self & Family (105) |
$370.68 | $803.14 |
2024 Compare Benefits Chart
See costs for typical services when you use Preferred providers.
FEP Blue Focus® | FEP Blue Basic™ | FEP Blue Standard™ | |
---|---|---|---|
Preventive Care | You pay nothing | You pay nothing | You pay nothing |
Physician Care | $10 per visit for your first 10 primary and/or specialty care visits combined medical and mental health substance use 1 |
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Virtual doctor visits by Teladoc® |
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Urgent Care Center | $25 copay |
$35 copay
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$30 copay |
Prescription Drugs |
Preferred Retail Pharmacy ^ :
Mail Service Pharmacy: Not a benefit Specialty Pharmacy ^:
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Preferred Retail Pharmacy ^ : If you have Medicare Part B primary, your costs for prescription drugs may be lower.
Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicarepage for more information.
Specialty Pharmacy ^ :
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Preferred Retail Pharmacy: If you have Medicare Part B primary, your costs for prescription drugs may be lower.
Mail Service Pharmacy:
Specialty Pharmacy ^ :
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FEP Medicare Prescription Drug Program |
Preferred Retail Pharmacy
^
:
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Preferred Retail Pharmacy ^ :
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Preferred Retail Pharmacy ^ :
Mail Service Pharmacy:
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Maternity Care |
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$0 copay |
Hospital Care |
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Surgery |
30% of our allowance*
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15% of our allowance*
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ER (accidental injury) | $0 within 72 hours | $250 per day per facility | $0 within 72 hours |
ER (medical emergency) |
30% of our allowance1
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$250 per day per facility
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15% of our allowance*
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Lab work (such as blood tests) |
$0 for first 10 specific lab tests**
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15% of our allowance1
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15% of our allowance*
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Diagnostic services (such as sleep studies, CT scans) |
30% of our allowance*
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15% of our allowance*
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Chiropractic Care | $25 for up to 10 visits a year1 2 | $35 for up to 20 visits a year | $30 for up to 12 visits a year |
Dental Care | Not a benefit |
$35 per evaluation; up to 2 evaluations per year |
The difference between the fee schedule amount and the Maximum Allowable Charge (MAC) |
Rewards Program |
Earn a reward, such as a $150 MyBlue Wellness Card, at no out-of-pocket cost for getting an annual physical4
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Network Coverage | In-network care only, except in certain situations like emergency care | In-network care only, except in certain situations like emergency care | In-network and out-of-network care |
Out-of-Pocket Maximum (PPO) |
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FEP Medicare Prescription Drug Program Out-of-Pocket Maximum | $3,250 per member | $3,250 per member | $2,000 per member |
Annual Deductible |
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No deductible |
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Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first).
- * Deductible applies.
- ** Please see brochure for covered lab services.
- ^ What you’ll pay for a 30-day supply of covered drugs.
- 1 You pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
- 2 Up to 10 visits combined for chiropractic care and acupuncture.
- 3 You must be the contract holder or spouse, 18 or older, on a FEP Blue Standard OR FEP Blue Basic plan to earn incentive rewards.
- 4 You must be the contract holder or spouse, 18 or older, on an FEP Blue Focus plan to earn this reward.
This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Before making a final decision, please read the Plan’s Federal brochures (FEP Blue Standard and FEP Blue Basic: RI 71-005; FEP Blue Focus: RI 71-017). All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.