Here are the 2022 FEP Blue Cross and Blue Shield Service Benefit Plan benefit changes

Blue Cross and Blue Shield Federal Employee Program^® Service Benefit Plan 2022 benefit changes will take effect Jan. 1, 2022. Below is an overview of the benefit changes.

Breast pump

• Standard Option, Basic Option and FEP Blue Focus
• The selection of breast pumps is expanding. Each breast pump will come with a selection of milk storage bags.

Dental – accidental injury

• Basic Option
• Coinsurance of 30% for all covered dental codes except for the oral examination to promptly repair injury.

Oral/maxillofacial surgery

• Standard Option and Basic Option
• Prior approval is no longer needed for surgery to correct accidental injuries to jaws, cheeks, lips, tongue, roof and floor of mouth for care provided within 72 hours of the accidental injury.

EKG

• Standard Option, Basic Option and FEP Blue Focus
• EKGs will be covered under the regular medical benefits instead of preventive benefits.

Facility

• Standard Option
• For admission to a participating or non-participating facility due to a medical emergency or accidental injury, copayment is reduced to $350 per admission for unlimited days, then benefits cover 100% of the plan allowance.

Gender reassignment surgery

• Standard Option, Basic Option and FEP Blue Focus
• Reconstruction of the nipple after a mastectomy for female to male gender reassignment surgery is covered.

Group counseling

• Standard Option, Basic Option and FEP Blue Focus
• Group counseling for prevention and reduction of health risks, and group nutritional counseling will be covered under the preventive benefit, with no out-of-pocket cost to members who see a Preferred provider.
  

Pharmacy

• Standard Option, Basic Option and FEP Blue Focus
• Tubeless insulin pumps covered under the Tier 2 and Tier 3 pharmacy benefits for Standard and Basic Option members. FEP Blue Focus members will pay a Tier 2 copayment.
• Specialty Pharmacy Program will be administered by CVS Caremark®.
• Standard Option only
• Updates made to the approved drug lists
• Basic Option only
• Copayment changes for members without Medicare Part B
• Tier 4 Preferred specialty drug copayment is now $85 and limited to one purchase of up to a 30-day supply at a Preferred retail pharmacy. All refills must be obtained through the Specialty Pharmacy Program.
• Tier 5 Non-preferred specialty drug copayment is now $110 and limited to one purchase of up to a 30-day supply at a Preferred retail pharmacy. All refills must be obtained through the Specialty Pharmacy Program.
• Copayment changes for members with Medicare Part B primary
• Tier 4 Preferred specialty drug copayment is now $80 and limited to one purchase of up to a 30-day supply at a Preferred retail pharmacy. All refills must be obtained through the Specialty Pharmacy Program.
• Tier 5 Non-preferred specialty drug copayment is now a $100 and limited to one purchase of up to a 30-day supply at a Preferred retail pharmacy. All refills must be obtained through the Specialty Pharmacy Program.
• Updates made to the approved drug lists
• FEP Blue Focus only
• Walgreens^® and Duane Reade^® pharmacies are no longer in network.
• Members must use in-network pharmacies for their pharmacy benefit.
• Updates made to the approved drug lists

Transplants – Blue Distinction^® Centers

• Standard Option and Basic Option
• Kidney transplants now part of the Blue Distinction Centers for Transplant  Program and require prior approval.
• Standard Option, Basic Option and FEP Blue Focus
• Pancreas transplants will no longer be part of the Blue Distinction Centers for Transplants Program.

For complete 2022 Blue Cross and Blue Shield Service Benefit Plan benefit information, go to www.fepblue.org/brochure or call Customer Service at 1-800-482-3600.