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MyBlue®:

Choose the Right Plan

We can help you select the right Service Benefit Plan option to combine with Medicare.

Combining your Service Benefit Plan coverage with Medicare is a choice. Our three plan options provide the coverage and benefits you need today and as your health care needs change throughout retirement.

Covering the things Medicare doesn’t cover

Combining coverage gives you access to benefits not covered by Medicare.

FEP Blue Focus Basic Option Standard Option
Hearing Aids Get hearing aid discounts through our Blue365® Discount Program

Receive an allowance of up to $2,500 every five years for the purchase of hearing aids and hearing aid supplies. Prior approval will be required in 2024.

Get hearing aid discounts through our Blue365® Discount Program. You can combine this discount with the hearing aid benefit above.

Receive an allowance of up to $2,500 every five years for the purchase of hearing aids and hearing aid supplies. Prior approval will be required in 2024.

Get hearing aid discounts through our Blue365® Discount Program. You can combine this discount with the hearing aid benefit above.

Routine Foot Care If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments. If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments. If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments.

Acupuncture

Receive up to 10 visits per year at no cost to you

Receive up to 12 visits per year at no cost to you Receive up to 24 visits per year at no cost to you
Dental Care Not covered You pay nothing for preventive dental services (up to 2 cleanings a year) We'll pay up to the fee schedule amount listed in the Standard Option brochure for dental services
Overseas Care All three of our plans cover you abroad.
Learn more about overseas coverage.
All three of our plans cover you abroad.
Learn more about overseas coverage.
All three of our plans cover you abroad.
Learn more about overseas coverage.

Pay zero out-of-pocket costs for covered services

You’ll pay nothing for these services when Medicare Part A and Part B are primary. Basic Option and FEP Blue Focus members must see Preferred providers.

  • Primary Care Visits
  • Inpatient Hospital
  • ER – Medical Emergency
  • Specialist Visits
  • Outpatient Hospital
  • Lab Work (lab tests and EKGs)
  • Virtual Doctor Visits
  • Surgery
  • Diagnostic Services (X-rays, CT scans)
  • Urgent Care Centers
  • ER – Accidental Injury

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. Learn more here

FEP Blue Focus Basic Option Standard Option
In-network (Preferred) Retail Pharmacy

Tier 1 (Generics): $5 for up to a 30-day supply; $15 for a 31 to 90-day supply

Tier 2 (Preferred brand): 40% of our allowance ($350 max) for up to a 30-day supply; 40% of our allowance ($1,050 max) for a 31 to 90-day supply

Tier 3 (Non-preferred brand): 40% of our allowance ($350 max) for up to a 30-day supply; 40% of our allowance ($1,050 max) for a 31 to 90-day supply

Tier 4 (Specialty drugs): 40% of our allowance ($350 max) for up to a 30-day supply; 40% of our allowance ($1,050 max) for a 31 to 90-day supply

 

Tier 1 (Generics): $10 for up to a 30-day supply; $30 for a 31 to 90-day supply

Tier 2 (Preferred brand): $45 for up to a 30-day supply; $135 for a 31 to 90-day supply

Tier 3 (Non-preferred brand): 50% of our allowance ($60 min) for up to a 30-day supply; $175 min for a 31 to 90-day supply

Tier 4 (Specialty drugs): $75 for up to a 30-day supply; $195 for a 31 to 90-day supply

Tier 1 (Generics): $5 for up to a 30-day supply; $15 for a 31 to 90-day supply

Tier 2 (Preferred brand): 15% of our allowance for up to a 90-day supply

Tier 3 (Non-preferred brand): 50% of our allowance for up to a 90-day supply

Tier 4 (Specialty drugs):
$60 for up to a 30-day supply; $170 for a 31 to 90-day supply
FEP Mail Service Pharmacy Not a benefit Tier 1 (Generics): $15 copay

Tier 2 (Preferred brand): $95 copay

Tier 3 (Non-preferred brand): $125 copay

Tier 4 (Specialty drugs): $150 copay
Tier 1 (Generics): $5 copay

Tier 2 (Preferred brand): $85
copay

Tier 3 (Non-preferred brand): $125 copay

Tier 4 (Specialty drugs): $150 copay
FEP Specialty Pharmacy

Your specialty drug benefits are in Tier 4 (see above)

Your specialty drug benefits are in Tier 4 (see above)

Your specialty drug benefits are in Tier 4 (see above)

Annual Pharmacy Out-of-Pocket Maximum* $3,250 per member $3,250 per member $2,000 per member

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 brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: RI 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.

Check Drug Costs

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

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See more benefits and premiums

Compare benefit options and plan rates for FEP Blue Focus, Basic Option and Standard Option.

Learn More
*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.
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.
Please note: The Medicare information on this page focuses on the Original Medicare Plan and when Medicare Part A and Part B are your primary coverage, unless otherwise noted. The Service Benefit Plan information refers to Standard Option, Basic Option and FEP Blue Focus.
 

Explore More

View Our Guide

Learn more about the benefits of combining Medicare coverage with the Service Benefit Plan.

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Get Reimbursed

With a Medicare Reimbursement Account, Basic Option members can get up to $800 back.

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Use Your Benefits

Learn how to get the most out of your Service Benefit Plan coverage with Medicare.

Learn More