Frequently asked enrollment and benefit questions.
No, your coverage will automatically carry over year over year unless you decide to make a change.
If you are a new employee to the federal government or need to make changes to your current plan and are currently eligible to update or enroll in coverage, visit our How to Enroll page to get started.
When you’re retired, the U.S. Office of Personnel Management becomes your payroll office. You will need to contact OPM to make updates to your coverage. To learn more, visit our How to Enroll page now.
Self Plus One is an enrollment type that allows you to cover yourself and one eligible family member. Your eligible family member can include either a spouse OR a child up to age 26. A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.
Yes, legally married same-sex spouses of federal employees and retirees are eligible for coverage. Children and stepchildren of same-sex spouses are eligible as well.
Certain tribal organizations are able to enroll in the Federal Employees Health Benefits Program. Talk to your Tribal Benefits Officer to be sure you are eligible for FEHBP coverage. Then go to the U.S. Office of Personnel Management (OPM) website to find out how to enroll.
After you leave the federal government, you may be eligible for a non-FEP Blue Cross Blue Shield Plan through a different employer or through the Affordable Care Act’s Health Insurance Marketplace. For assistance, you can contact your local BCBS company at the number on the back of your member ID card or found here. You can also learn more about the Health Insurance Marketplace at www.healthcare.gov.
Yes. Temporary Continuation of Coverage (TCC) allows former employees to continue their healthcare coverage for up to 18 months and eligible family members to continue their healthcare coverage for up to 36 months. Members enrolling in TCC are responsible for both the employee and employer share of the premium, plus an additional 2% administrative fee.
TCC is available to:
Employees and/or their eligible family members when the employee separates from federal service, except an involuntary separation due to gross misconduct
Individuals who experience a change in circumstance that results in their being ineligible to be considered a dependent (e.g., divorce or annulment from a federal employee or children who reach 26)
Spouse Equity allows certain former spouses of civil service employees, former employees and annuitants to continue coverage. Unlike TCC, there is no time limit on the length of enrollment. Coverage remains in effect as long as the former spouse is eligible. Former spouses are responsible for both the employee and employer share of the premium with no administrative fee.
Spouse Equity is available to:
Former spouses who do not remarry before age 55
Former spouses who were enrolled as a dependent any time during the 18 months preceding the divorce
Former spouses who currently receive, or have future title to receive a portion of the annuity payable to the employee upon retirement
To verify eligibility and enroll, members electing TCC or Spouse Equity must contact their or the contract holder’s employing agency (or OPM for annuitants).
No matter which enrollment type you choose you receive the same benefits, coverage and overall value. The only difference in the enrollment types is the number of people eligible to be covered under each one.
Self Only covers only one person, the federal employee eligible to participate in the FEHB.
Self Plus One covers the federal employee and one eligible dependent, such as a spouse or child.
Self and Family is for the federal employee and multiple eligible dependents, such as a spouse and child(ren).
If you’re a new member, you will receive a New Member Welcome Kit with your Blue Cross and Blue Shield Service Benefit Plan member ID card approximately 10 business days from the date we receive your enrollment information. You can also access a digital version of your member ID card via the fepblue app or online once you register for a MyBlue account.
If you enroll in a Self Only plan, you will receive one physical member ID card. For Self Plus One and Self and Family enrollments, you will receive two physical ID cards (all ID cards are in the contract holder’s name). If you need cards for additional covered family members, you can request them via your MyBlue® account or by calling the customer service number on the back of your member ID card.
For active employees, your effective date is the first day of the first full pay period in January. For annuitants, this date will always be January 1.
Yes, all three of our Plans qualify for MEC.
Open Season is typically the second Monday of November through the second Monday of December each year.
For benefit information, call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. If you have claims or customer service questions, you can call the customer service number on the back of your member ID card. You can also locate the number on our Contact Us page.
While all of our plans offer comprehensive benefits for you and your family, they are structured differently to complement different healthcare needs.
Standard Option gives you the flexibility to receive care both in and out-of-network. With Basic Option, you can enjoy no deductible with care from in-network providers. FEP Blue Focus offers quality healthcare coverage from in-network providers, plus budget-friendly benefits.
For more information about the differences between the three plans, you can:
Both Standard Option and Basic Option offer some level of dental benefits. Basic Option provides coverage for preventive dental care services only, while Standard Option provides coverage for preventive dental care and some other non-routine services. FEP Blue Focus does not offer dental benefits. For more information, visit the Compare Our Plans page or review the Blue Cross and Blue Shield Service Benefit Plan brochures.
We also offer a supplemental dental plan, Blue Cross Blue Shield FEP Blue Dental, if you want additional dental coverage. Learn more here.
You must tell us if you or a covered family member has coverage under any other group health plan, including a Medicare plan, or has automobile insurance that pays healthcare expenses without regard to fault. This is called “double coverage.”
When you have double coverage, one plan normally pays its benefits in full as the primary payor and the other plan pays a reduced benefit as the secondary payor. We, like other insurers, determine which coverage is primary according to the National Association of Insurance Commissioners’ (NAIC) guidelines.
If you are covered under our Plan as a dependent, any group health insurance you have from your employer will pay primary and we will pay secondary.
If you are an annuitant under our Plan and also are actively employed, any group health insurance you have from your employer will pay primary and we will pay secondary.
When you are entitled to the payment of healthcare expenses under automobile insurance, including no-fault insurance and other insurance that pays without regard to fault, your automobile insurance is the primary payor and we are the secondary payor.
Certain medical services and treatments need approval before you receive care. We review them to ensure they are medically necessary. If you do not get prior approval (also known as prior authorization), we may reduce or deny your benefit. In most cases, your doctor or facility will submit approval requests. However, you should always ask your provider if they have contacted us and provided the information we need—you are responsible for ensuring your care is approved. Special rules may apply when Medicare or another insurance is your primary coverage.
Standard or Basic Option
For the full list of services and treatments, including rules and exceptions, see section 3 of the Standard and Basic Option brochure. Some examples of medical services and treatments that may need prior approval before you receive care include:
Surgical services, such as gastric bypass, congenital anomalies and gender reassignment surgery
Surgery by Non-participating providers under Standard Option
Certain prescription drugs and supplies (learn more here)
BRCA testing and testing for genomic rearrangements in the BRCA1 and BRCA2 genes
FEP Blue Focus
For the full list of services and treatments, including rules and exceptions, see section 3 of the FEP Blue Focus brochure. Some examples of medical services and treatments that may need prior approval before you receive care include:
Surgical services, such as gastric bypass, breast reduction/augmentation, gender reassignment surgery, congenital anomalies, oral maxillofacial surgeries, reconstructive surgery, rhinoplasty, varicose vein treatment and orthopedic procedures for hip, knee, ankle, spine and shoulder
Certain prescription drugs and supplies (learn more here)
Radiology, such as MRI, CT scan, PET scan
Organ/tissue transplants and blood or marrow stem cell transplants
Clinical trials for certain blood or marrow stem cell transplants
Specialty durable medical equipment (DME)
Precertification is the process of approving an inpatient admission before you receive care. Inpatient care that may need approval includes inpatient hospital stays, inpatient residential treatment center care and/or skilled nursing facility care. Through the precertification process we review:
Yes, if your procedure is listed as one of the services that requires prior approval and your procedure will require an inpatient hospital stay. See a full list of services that require prior approval in section 3 of the Service Benefit Plan brochures.