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January 2019
At a glance: FEP Service Benefit Plan coverage options for 2019
The Federal Employee Program® Blue Cross and Blue Shield Service Benefit Plan now offers three coverage types for members. All coverage types offer free preventive care from Preferred providers, worldwide coverage, no referral requirement to visit a specialist and wellness rewards and discounts.
New for 2019 is FEP Blue Focus. This plan covers:
- Full preventative care
- Ten visits to the doctor per year
- Telehealth services
- Low-cost Preferred generic drugs
FEP Blue Focus doesn’t cover routine dental services, non-preferred drugs, skilled nursing facility care, hearing aids and long-term care.
To see a complete list of coverage and exclusions, go to fepblue.org/brochure.
FEP benefit options at a glance
|
Standard Option |
Basic Option |
FEP Blue Focus |
In-network care |
✔ |
✔ |
✔** |
Out-of-network care |
✔ |
X |
X |
Preferred drug coverage |
✔ |
✔ |
✔ |
Non-preferred drug coverage |
✔ |
✔ |
X |
Access to mail service pharmacy |
✔ |
X*** |
X |
Medicare Part B reimbursement $600 |
X |
✔ |
X |
Primary care doctor |
$25 copay |
$30 copay |
$10 per visit first 10 primary or specialist visits |
Specialists |
$35 copay |
$40 copay |
Virtual doctor visits |
$10 copay |
$15 copay |
$0 first 2 visits;
$10 all additional visits |
Urgent care centers |
$30 copay |
$35 copay |
$25 copay |
Maternity |
$0 copay |
$175 inpatient
$0 outpatient |
$0 pre-/postnatal care
$1,500 for facility care |
Inpatient hospital |
$350 copay |
$175 per day; up to $875 per admission |
30% of our allowance**** |
Outpatient hospital |
15% of our allowance **** |
$100 per day per facility^^ |
30% of our allowance^ |
Surgery |
15% of our allowance**** |
$150 in an office^^
$200 in a non-office setting^^ |
30% of our allowance^ |
ER – accidental injury |
$0 within 72 hours |
$125 per day + cost of doctor care |
$0 within 72 hours |
ER – medical emergency |
15% of our allowance*** |
$125 per day + cost of doctor |
30% of our allowance^ |
Lab work |
15% of our allowance**** |
$0 copay^^ |
30% of our allowance^ |
Diagnostic services |
15% of our allowance**** |
Up to $100 in an office^^
Up to $150 in a hospital^^ |
30% of our allowance^ |
Chiropractic care |
$25 for up to 12 visits a year |
$30 for up to 20 visits a year |
$25 for up to 10 visits a year (combined with acupuncture) |
**Must see Preferred providers.
***Available if you have Medicare Part B primary.
****Deductible applies. See brochure for more information.
^Deductible applies. In addition, you pay 30 percent of our allowance for agents, drugs and/or supplies you receive during your care.
^^You pay 20 percent of our allowance for agents, drugs and/or supplies you receive during your care.
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