FEP Blue Focus®
Get quality health care coverage that’s easy on your wallet, plus access to a network with over 2 million doctors and hospitals and over 55,000 retail pharmacies.
Benefits at a Glance
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Want to see detailed benefits for this plan? Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Focus below.
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2025 FEP Blue Focus Rates
| Enrollment Code | Bi-weekly | Monthly |
|---|---|---|
| Self Only (131) | $59.17 | $128.21 |
| Self + 1 (133) | $127.21 | $275.63 |
| Self & Family (132) | $139.92 | $303.17 |
FEP Blue Focus® Benefits
See costs for typical services when you use Preferred providers.
| FEP Blue Focus | |
|---|---|
| Virtual doctor visits by Teladoc Health® |
$0 copay |
| Preventive Care | $0 copay for covered preventive screenings, immunizations and services |
| Physician and Mental Health Care | $10 per visit for your first 10 primary and/or specialty care5 |
| Urgent Care Center | $25 copay |
| Chiropractic Care |
$25 copay per treatment; for up to 10 visits per year combined for chiropractic care and acupuncture5 |
| Prescription Drugs |
Retail Pharmacy^: Generics: $5 copayPreferred brand: 40% of our allowance ($350 maximum)2 Mail Service Pharmacy: Specialty Pharmacy^: Preferred specialty: 40% of our allowance ($350 maximum)2 |
| Maternity Care |
$0 for doctor's visits $1,500 copay for facility care |
| Hospital Care |
30% of our allowance for outpatient care1 30% of our allowance for inpatient care1 (precertification is required) |
| Surgery |
30% of our allowance1 |
| ER (accidental injury) | $0 within 72 hours |
| ER (medical emergency) |
30% of our allowance1 |
| Lab work (such as blood tests) |
$0 for first 10 specific lab tests3,4 |
| Diagnostic services (such as sleep studies, X-rays, CT scans) |
30% of our allowance1 |
| Dental Care | Not covered |
| Rewards Program |
Earn $150 MyBlue Wellness Card for getting an annual physical6 |
| Annual Deductible |
Self Only: $500 Self + One and Self & Family: $1,000 |
| Out-of-Pocket Maximum (PPO) |
Self Only: $9,000 Self + One and Self & Family: $18,000 |
| FEP Blue Focus® | |
|---|---|
| Preventive Care | Nothing for covered preventive screenings, immunizations and services |
| Physician Care |
$10 per visit for your first 10 primary and/or specialty care visits combined medical and mental health substance use5 |
| Virtual doctor visits by Teladoc® |
$0 for first 2 visits and all nutrition visits $10 all additional visits |
| Urgent Care Center | $25 copay |
| Prescription Drugs |
Preferred Retail Pharmacy^: Tier 1 (Generics): $5 copayTier 2 (Preferred brand): 40% of our allowance ($350 maximum)2 Mail Service Pharmacy: Specialty Pharmacy^: Tier 2 (Preferred specialty): 40% of our allowance ($350 maximum)2 |
| Maternity Care |
$0 for doctor's visits $1,500 copay for facility care |
| Hospital Care |
Inpatient (Precertification is required): 30% of our allowance1 Outpatient: 30% of our allowance1 |
| Surgery |
30% of our allowance1 |
| ER (accidental injury) | $0 within 72 hours |
| ER (medical emergency) |
30% of our allowance1 |
| Lab work (such as blood tests) |
$0 for first 10 specific lab tests3,4 |
| Diagnostic services (such as sleep studies, X-rays, CT scans) |
30% of our allowance1 |
| Chiropractic Care |
$25 for up to 10 visits a year5 |
| Dental Care | Not covered |
| Rewards Program |
Earn a reward, such as a $150 MyBlue Wellness Card, at no out-of-pocket cost for getting an annual physical6 |
| Network Coverage | In-network care only, except in certain situations like emergency care |
| Out-of-Pocket Maximum (PPO) |
Self Only: $9,000 Self + One and Self & Family: $18,000 |
| Annual Deductible |
Self Only: $500 Self + One and Self & Family: $1,000 |
FEP Blue Focus® with FEP Medicare Prescription Drug Program
Eligible members with Medicare get lower out-of-pocket costs for higher cost drugs and additional approved prescription drugs in some tiers than the traditional pharmacy benefit. New for 2025: the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum. Learn more here.
| FEP Blue Focus® with MPDP | |
|---|---|
| Retail Pharmacy^ |
Generics: $5 copay |
| FEP Mail Service Pharmacy | Not a benefit |
| FEP Blue Focus® with MPDP | |
|---|---|
| In-network (Preferred) Retail Pharmacy |
Tier 1 (Generics): $5 for up to a 30-day supply; $15 for a 31 to 90-day supply |
| FEP Mail Service Pharmacy | Not a benefit |
| FEP Specialty Pharmacy | Your specialty drug benefits are in Tier 4 (see above) for a 30-day supply |
| Annual Pharmacy Out-of-Pocket Maximum7 | $3,250 per member |
Under FEP Blue Focus, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care.
Coinsurance (a type of cost sharing) is the percentage of our allowance you pay. We contract with providers to pay them a set rate, or an allowance. Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first).
- * FEP Blue Focus Traditional Pharmacy drug tiers: Tier 1 Preferred Generics, Tier 2 Preferred Brand Name, Preferred Specialty and Preferred Brand Name Specialty.
- ^ What you’ll pay for a 30-day supply of covered drugs.
- 1 Deductible applies. $500 for Self Only and $1,000 for Self + One and Self & Family.
- 2 Specialty drugs are limited to a 30-day supply.
- 3 Professional charges for facility-based intensive outpatient treatment and professional charges for outpatient diagnostic tests to include psychological testing are not part of the 10 for $10 benefit.
- 4 Please see brochure for covered lab services.
- 5 You pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
- 6 You must be the contract holder or spouse, 18 or older, on a FEP Blue Focus plan to earn incentive rewards.
- 7 You still have an overall medical out-of-pocket maximum. Your MPDP pharmacy out-of-pocket maximum is separate.
The FEP Medicare Prescription Drug Program is a prescription drug plan with a Medicare contract. Enrollment in MPDP depends on contract renewal.
The formulary and/or pharmacy network may change at any time. You will receive notice when necessary.
This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Before making a final decision, please read the Plan’s federal brochure (RI 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.
Get to know FEP Blue Focus
Watch this video to take a closer look at our budget-friendly option and how it can help you focus on the essentials of good health.
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