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FEP Medicare Prescription Drug Program (MPDP)

New for 2024: 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.

A closer look at MPDP

Same FEP Benefits

Continue to receive the same FEP health plan benefits you’re used to.

Additional Approved Drugs

Have additional approved prescription drugs in some tiers than your current benefit.

Lower Costs

Get lower out-of-pocket costs for higher cost drugs.

Out-of-Pocket Maximum

Have a cap on the amount you pay out-of-pocket on prescriptions annually.

Eligibility

You are eligible for MPDP if you are:

  • An FEP member
  • Enrolled in Medicare Part A and/or Part B primary
  • A resident of the U.S. or a U.S. territory
 

Drug Tiers

MPDP has four drug tiers:

  • Tier 1: Generics
  • Tier 2: Preferred brand name
  • Tier 3: Non-preferred brand name
  • Tier 4: Specialty drugs
 

2024 FEP Blue Focus MPDP Drug List

 

English

Espanol

2024 Basic Option MPDP Drug List

 

English

Espanol

2024 Standard Option MPDP Drug List

English

Espanol

Want to disenroll from MPDP?

Mail the completed disenrollment form to FEP Medicare Prescription Drug Program, PO Box 3539, Scranton, PA 18505 or fax to 855-865-1817.

Download Form

MPDP is a Medicare Part D plan

You may already know that Medicare has 4 parts. Part A and Part B don’t cover prescription drugs. Part D plans offer prescription drug coverage. 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 More

MPDP benefits by plan compared to your benefits with Medicare

FEP Blue Focus Traditional Pharmacy Benefit with Medicare Part B FEP Blue Focus with MPDP Pharmacy Benefits

In-network Retail Pharmacy^

Tier 1: $5 copay

Tier 2: 40% of our allowance ($350 max)

Tier 1: $5 copay

Tier 2: 40% of our allowance ($350 max)

Tier 3: 40% of our allowance ($350 max)

Tier 4: 40% of our allowance ($350 max)

FEP Mail Service Pharmacy**

Not a benefit Not a benefit

FEP Specialty Pharmacy

Tier 2: 40% of our allowance ($350 max) Your specialty drug benefits are in Tier 4 (see above)
Annual Pharmacy Out-of-Pocket Maximum*
Not a benefit $3,250 per member

MPDP benefits by plan compared to your benefits with Medicare

Basic Option Traditional Pharmacy Benefit with Medicare Part B Basic Option with MPDP Pharmacy Benefits

In-network Retail Pharmacy^

Tier 1: $10 copay

Tier 2: $50 copay

Tier 3: 50% of our allowance ($60 min)

Tier 4: $80 copay

Tier 5: $100 copay

Tier 1: $10 copay

Tier 2: $45 copay

Tier 3: 50% of our allowance ($60 min)

Tier 4: $75 copay

FEP Mail Service Pharmacy**

Tier 1: $20 copay

Tier 2: $100 copay

Tier 3: $125 copay

Tier 1: $15 copay

Tier 2: $95 copay

Tier 3: $125 copay

Tier 4: $150 copay

FEP Specialty Pharmacy

Tier 4: $80 copay

Tier 5: $100 copay

Your specialty drug benefits are in Tier 4 (see above)
Annual Pharmacy Out-of-Pocket Maximum*
Not a benefit $3,250 per member

MPDP benefits by plan compared to your benefits with Medicare

Standard Option Traditional Pharmacy Benefit with Medicare Part B Standard Option with MPDP Pharmacy Benefits

In-network Retail Pharmacy^

Tier 1: $5 copay

Tier 2: 30% of our allowance

Tier 3: 50% of our allowance

Tier 4: 30% of our allowance

Tier 5: 30% of our allowance

Tier 1: $5 copay

Tier 2: 15% of our allowance

Tier 3: 50% of our allowance

Tier 4: $60 copay

FEP Mail Service Pharmacy**

Tier 1: $10 copay

Tier 2: $90 copay

Tier 3: $125 copay

Tier 1: $5 copay

Tier 2: $85 copay

Tier 3: $125 copay

Tier 4: $150 copay

FEP Specialty Pharmacy

Tier 4: $65 copay

Tier 5: $85 copay

Your specialty drug benefits are in Tier 4 (see above)
Annual Pharmacy Out-of-Pocket Maximum*
Not a benefit $2,000 per member

^ What you'll pay for a 30-day supply of covered drugs. You can see what you'll pay for a 31- to 90-day supply of covered drugs in the benefits brochure.

** What you'll pay for up to a 90-day supply of covered drugs.

 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.

What 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.

Try our Prescription Drug Cost Tool

Our Prescription Drug Cost Tool lets you check drug costs 24/7. See if your drug is covered under MPDP and compare costs of covered drugs for all three plans.

Check Drug Costs

Auto Enrollment Process

FEP will automatically enroll eligible members in MPDP.

Every year in September or October, 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 in September or October.

You can disenroll if you don’t want MPDP.

You can tell us at any point that you want the regular FEP prescription drug benefits instead of MPDP.

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.

If you decide to disenroll, you can re-enroll during this upcoming or a future year’s Open Season.

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 on or after the first day of Open Season. Download an enrollment form to get started:

FEP Blue Focus Enrollment Form

Basic Option Enrollment Form

Standard Option 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 MTM

MPDP 2024 Summary of Benefits

2024 Summary of Benefits - FEP Blue Focus

English

Spanish

2024 Summary of Benefits - Basic Option

English

Spanish

2024 Summary of Benefits - Standard Option

English

Spanish

The 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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