FEP Medicare Prescription Drug Program (MPDP)
A Medicare prescription drug benefit for eligible members who qualify for Medicare Part A and/or Medicare Part B utilizing Medicare as their Primary Health Care coverage.
Enjoy the great benefits you get now plus lower costs and more approved drugs
We want to help retirees like you get more out of your prescription drug coverage. With MPDP, a prescription drug benefit exclusively for Blue Cross and Blue Shield Federal Employee Program (FEP) members eligible for Medicare, you can save money on your prescriptions. Since this program is part of your Blue Cross and Blue Shield Service Benefit Plan coverage, there’s no separate FEP premium for your prescription drug coverage.
You are eligible if you are an FEP member, enrolled in Medicare Part A and/or Part B primary and a resident of the U.S. or a U.S. territory.
With MPDP, you get:
The same FEP health plan benefits you're used to
More approved prescription drugs than the traditional FEP pharmacy benefit
Lower out-of-pocket costs for higher-cost drugs
A cap on the amount you pay out-of-pocket on prescriptions annually, federal regulations will cap the amount at $2,000 in 2025
A larger pharmacy network
No added FEP premium cost to members eligible for Medicare
Depending on your income level, you may need to pay an Income-Related Monthly Adjustment Amount (IRMAA) to Social Security for this Part D coverage. Most FEP members will not reach the threshold to pay an IRMAA. To learn more, visit medicare.gov.
MPDP is a Medicare Part D plan made for federal retirees like you
While FEP prescription drug benefits are considered creditable coverage (meaning they meet Medicare’s minimum requirements) we’re offering MPDP as a Part D plan to help members with Part A and/or Part B save on their prescriptions. MPDP is just one way we’re making your FEP coverage and Medicare work together for you.
Learn MoreWhat is an out-of-pocket maximum?
A unique benefit of MPDP is that you have an annual pharmacy out-of-pocket maximum. An out-of-pocket maximum is a cap (or maximum) on the amount you’ll pay in copays and coinsurance. In the case of MPDP, it’s a cap on the amount you’ll pay on prescription drugs for the year. Once you reach the maximum for the year, you pay nothing for your prescriptions for the rest of the year.
You still have an overall medical out-of-pocket maximum. Your MPDP pharmacy out-of-pocket maximum is part of it, not added to it.
Here's an example for what you could save if you have FEP Blue Standard
Cost of three generics at an in-network retail pharmacy for the year (30-day supply) | $5 x 3 x 12 = $180 |
Cost of three FEP Mail Service Pharmacy Preferred brand name drugs for the year (90-day supply) | $85 x 3 x 4 = $1,020 |
Cost of three specialty drugs for the year at an in-network pharmacy (30-day supply) | $60 x 3 x 12 = $2,160 |
Total cost of prescriptions for the year | $3,360 |
Check your current drug costs
With our Prescription Drug Cost Tool, you can see if your drug is covered under your plan and what you would pay out-of-pocket with and without MPDP. If you’re a member and logged in to MyBlue®, you can access a personalized drug cost tool that shows you the cost of prescription drugs for your specific plan.
Check Drug CostsFEP Medicare Prescription Drug Program (MPDP)
Eligible members with Medicare get lower out-of-pocket costs for higher cost drugs and additional approved prescription drugs in some tiers than the traditional pharmacy benefit. New for 2025: the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum. You can compare our traditional pharmacy benefits for each plan with what you get with MPDP here.
FEP Blue Focus® | FEP Blue Basic™ | FEP Blue Standard™ | |
---|---|---|---|
Retail Pharmacy^ |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 40% of our allowance ($350 max) Tier 3 (Non-preferred brand): 40% of our allowance ($350 max) Tier 4 (Specialty): 40% of our allowance ($350 max) |
Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $45 copay Tier 3 (Non-preferred brand): 50% of our allowance ($60 min) Tier 4 (Specialty): $75 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $35 copay Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Specialty): $60 copay |
FEP Mail Service Pharmacy (What you'll pay for up to a 90-day supply of covered drugs) | Not a benefit |
Tier 1: $15 copay Tier 2: $95 copay Tier 3: $125 copay Tier 4: $150 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $85 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty): $150 copay |
Annual Pharmacy Out-of-Pocket Maximum* | $2,000 per member | $2,000 per member | $2,000 per member |
FEP Blue Focus® | FEP Blue Basic™ | FEP Blue Standard™ | |
---|---|---|---|
Retail Pharmacy^ |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 40% of our allowance ($350 max) Tier 3 (Non-preferred brand): 40% of our allowance ($350 max) Tier 4 (Specialty): 40% of our allowance ($350 max) |
Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $45 copay Tier 3 (Non-preferred brand): 50% of our allowance ($60 min) Tier 4 (Specialty): $75 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 15% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Specialty): $60 copay |
FEP Mail Service Pharmacy (What you'll pay for up to a 90-day supply of covered drugs) | Not a benefit |
Tier 1: $15 copay Tier 2: $95 copay Tier 3: $125 copay Tier 4: $150 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $85 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty): $150 copay |
Annual Pharmacy Out-of-Pocket Maximum* | $3,250 per member | $3,250 per member | $2,000 per member |
† What you'll pay for up to a 30-day supply of covered drugs.
* You still have an overall medical out-of-pocket maximum. Your MPDP pharmacy out-of-pocket maximum is part of it, not added to it.
Are you traveling or living overseas?
FEP members who have MPDP cannot purchase drugs overseas. Whether you are traveling or moving overseas, you cannot use the MPDP benefit to purchase drugs while abroad. If you take a maintenance medication and you intend to go overseas for an extended period of time, you may be eligible for an extended filling of the prescription before you leave the U.S. This will require a 12-month prescription from your doctor and is not applicable for controlled substances. Contact our Pharmacy Program at 1-888-338-7737 to learn more.
Learn MoreHelpful MPDP resources
Check Drug Costs
See if your drug is covered under MPDP and compare costs of covered drugs for all three plans.
Learn MoreTalk to a Customer Rep
If you have a question, you can call 1-888-338-7737 (TTY: 711). Available 24 hours a day, 365 days a year.
Auto Enrollment Process
FEP will automatically enroll eligible members in MPDP.
Every year in the fall, FEP will automatically enroll eligible members (for an effective date starting the next benefit year) who:
- Have Medicare Part A and Part B primary
- Are not enrolled in a Medicare Advantage (MA) plan
- Do not have Medicare because of End-Stage Renal Disease (ESRD)
- A resident of the U.S. or a U.S. territory
If you meet the above criteria, you will receive an eligibility letter in the mail prior to enrollment.
You can disenroll if you don’t want MPDP.
FEP members can choose to opt-out and/or disenroll from MPDP. If you do, you will be placed in the traditional FEP pharmacy benefit. Before you disenroll, we encourage you to carefully review all the benefits of MPDP.
You can disenroll by mailing the completed disenrollment form to FEP Medicare Prescription Drug Program, PO Box 3539, Scranton, PA 18505 or by fax to 855-865-1817.
Information on your rights and responsibilities is available in your evidence of coverage.
Voluntary Enrollment
If you were not part of the automatic enrollment and want MPDP, you can still get it
You can elect to enroll any time if you meet the eligibility requirements. Download an enrollment form to get started:
FEHB FEP Blue Focus Enrollment Form
FEHB FEP Blue Basic Enrollment Form
FEHB FEP Blue Standard Enrollment Form
PSHB FEP Blue Focus Enrollment Form
Medication Therapy Management (MTM) Program
If you have complex prescription drug needs, this program is available to you to get support from a pharmacist. They’ll help ensure you get the most out of your current drug therapy.
Learn More about MTMThe FEP Medicare Prescription Drug Program is a prescription drug plan with a Medicare contract. Enrollment in MPDP depends on your Medicare contract renewal.
The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.
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