Here are 2021 FEP benefit changes

Blue Cross and Blue Shield Federal Employee Program^® 2021 benefit changes will take effect Jan. 1, 2021. Below is an overview of the benefit changes. Complete information on benefit changes for Standard Option, Basic Option and FEP Blue Focus plans are available at www.fepblue.org/brochure.

Catastrophic out-of-pocket maximum

• FEP Blue Focus
• Self only — $7,500
• Self Plus One and Self and Family — $15,000

Hearing aids

• Standard Option and Basic Option — $2,500 hearing aid coverage every five  calendar years for adults age 22 and older. Coverage will allow current three-year accumulation to run out. See table below.
  
  

  Purchase year	Eligible for new hearing aid
  2018	2021
  2019	2022
  2020	2023
  2021	2026

Hepatitis C screening

• Standard Option, Basic Option and FEP Blue Focus — Hepatitis C preventive screening coverage for members age 18 to 79

HIV screening

• FEP Blue Focus — HIV screening for pregnant women covered under preventive care benefits with no member cost share when billed by a Preferred facility

Hospice

• FEP Blue Focus — Continuous home hospice care received from Preferred providers covered at no member cost share

Nutritional counseling

• Standard Option, Basic Option and FEP Blue Focus
• Nutritional counseling expanded to include telemedicine services for individual nutritional counseling therapy and group nutritional counseling therapy
• Group nutritional counseling removed from preventive nutritional counseling cost share applies
• Individual nutritional counseling will continue to be covered under preventive nutritional counseling with no member cost share
  

Outpatient emergency room facility

• Basic Option — Emergency room care for accidental injury and medical emergency, $175 copayment per day, per facility

Pharmacy

• Standard Option, Basic Option and FEP Blue Focus
• Formulary adjustments
• Standard Option — Expanded the list of excluded drugs
• Basic option — Expanded the list of managed formulary exclusions
• FEP Blue Focus — Expanded the list of non-covered medications (closed formulary)
• Certain bowel preparation medication associated with colon cancer screenings no longer have a member cost share for the first prescription filled from a Preferred retail pharmacy.
• Note: Standard Option and Basic Option with Medicare Part B includes the Mail Service Prescription Drug Program.
• For those at risk of HIV but don’t have HIV, Emtricitabine/tenofovir disoproxil fumarate (generic for Truvada) is covered with no member cost share when obtained from a Preferred retail pharmacy.
• Note: Standard Option and Basic Option with Medicare Part B includes the Mail Service Prescription Drug Program.

• Standard Option
• Pharmacy formulary for tiers 2, 3, 4 and 5 no longer apply a reduced copay after 30 prescriptions.

• Standard and Basic Option
• Copayment changes for Tier 4 and Tier 5
  
  

  Tier prescription supply	Standard Option	Basic Option without Medicare Part B	Basic Option with Medicare Part B
  Tier 4: 30-day supply	$65 copay	$85 copay	$80 copay
  Tier 4: 31-day to 90-day supply	$185 copay	$235 copay	$210 copay
  Tier 5: 30-day supply	$85 copay	$110 copay	$100 copay
  Tier 5: 31-day to 90-day supply	$250 copay	$300 copay	$255 copay

Telemedicine

• Standard Option, Basic Option and FEP Blue Focus — Phone consultations and online medical evaluations and management services coverage
• Standard Option
• $25 copayment (no deductible) for a Preferred primary care provider or other health care professional
• $35 copayment (no deductible) for a Preferred specialist
• 35% of the plan allowance (deductible applies) for a participating provider
• 35% of the plan allowance (deductible applies) plus any difference between our allowance and the billed amount for a non-participating provider
• Basic Option
• $30 copayment for a Preferred primary care provider
• $40 copayment for a Preferred specialist
• FEP Blue Focus
• $10 copayment (no deductible) for a Preferred provider per visit up to a combined total of 10 visits per calendar year

X-rays

• Standard Option, Basic Option and FEP Blue Focus — Chest X-ray coverage is being moved from preventive to medical coverage.

If you have any questions about benefit changes, contact Customer Service at 1-800-482-3600.