FEP® Blue Focus www.fepblue.org 2019 A Fee-For-Service Plan (FEP Blue Focus) with a Preferred Provider Organization IMPORTANT. Rates: Back Cover. Changes for 2019: Page 15. Summary of benefits: Page 144 This Plan’s health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides.
Together, the Service Benefit Plan and Medicare can protect you from the high cost of medical care.
Under FEP Blue Focus, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care. Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first). 1 Deductible applies. $500 for Self Only and $1,000 for Self + One and Self & Family. Quality Care That’s Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find.BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Learn more about our Total Care and Blue Distinction® Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Primary/Specialty Care - The amount you pay for a visit to a provider focusing on a specific area of medicine. Some plans require a referral from your primary care provider for you to see a specialist. You must get a referral, if required, or your plan may not pay for the services.
Medicare works best with your Service Benefit Plan coverage when Medicare Part A and Part B (also known as Original Medicare) are your primary coverage. That means Medicare pays for your service first, and then we pay our portion. Usually if you’re retired, Medicare is primary. If you’re still actively working, we’re your primary coverage.
Zero Out-of-Pocket Costs for Covered Services
What you’ll pay when Medicare Part A and Part B are primary. Basic Option and FEP Blue Focus members must see Preferred providers.
Standard Option| Basic Option | FEP Blue Focus | ||
|---|---|---|---|
| Primary Care Doctor | $0 copay | $0 copay | $0 copay |
| Specialists | |||
| Virtual Doctor Visits | |||
| Urgent Care Centers | |||
| Inpatient Hospital | |||
| Outpatient Hospital | |||
| Surgery | |||
| ER - Accidental Injury | |||
| ER - Medical Emergency | |||
| Lab Work (such as lab tests and EKGs) | |||
| Diagnostic Services (such as sleep studies, X-rays, CT scans) | |||
| Chiropractic Care | $0 copay for up to 12 visits | $0 copay for up to 20 visits | $0 copay for up to 10 visits* |
| Physical Therapy1 | $0 copay for up to 75 visits | $0 copay for up to 50 visits | $0 copay for up to 25 visits |
*Up to 10 visits combined for chiropractic care and acupuncture.
1Visit limits are combined for physical, speech and occupational therapy.
Covering the Things Medicare Doesn't Cover
By combining your coverage, you get access to benefits not covered by Medicare Part A and Part B.
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Start Planning for Retirement
It’s never too early to start thinking about your retirement. Our guide to Preparing for Government Retirement can help you start planning and understand your options.
Download the Guide
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.
WASHINGTON, Oct. 15, 2020 /PRNewswire/ -- Today, the Blue Cross® and Blue Shield® Federal Employee Program® (FEP®) announced 2021 benefits, including newly expanded telemedicine benefits, along with a new tool to help provide greater cost transparency for members. Additionally, FEP will keep the rates the same in 2021 for its newest product, FEP Blue Focus®, as well as for Blue Cross Blue Shield FEP Vision℠. Rates for Blue Cross Blue Shield FEP Dental℠ products will remain at 2020 levels.
FEP’s medical, dental and vision plans are available to eligible participants in the Federal Employees Health Benefits (FEHB) Program and the Federal Employees Dental and Vision Insurance Program (FEDVIP). FEP provides quality and affordable healthcare to approximately 66 percent of federal employees, retirees and their families across the nation. FEP members enjoy access to a robust provider network with 95 percent of professional providers and over 96 percent of hospitals in the United States alone.
Highlights of What's New for 2021
New Telemedicine Benefits
The COVID-19 pandemic has caused many members to turn to remote, virtual care services to manage their health as they attempt to socially distance and limit their exposure to the coronavirus. FEP was at the forefront expanding its benefits in 2020 during the pandemic to cover members having virtual visits with their primary and specialty doctors. Recognizing that virtual visits are becoming a permanent part of health care, in 2021 FEP will cover virtual consultations, and medical evaluation and management services with primary care providers and specialists as a regular benefit even after the pandemic is over. Members will pay the regular office visit copayments/coinsurance under Standard Option, Basic Option and FEP Blue Focus.
FEP Healthcare Cost Advisor
Available in 2021, FEP members will have access to the FEP Healthcare Cost Advisor application, which provides users with a complete view of their healthcare spending to make better financial planning and healthcare decisions. The tool can also help identify the FEP health plan option that offers the best value for each member’s specific needs.
Newly Redesigned Website
Significant to facilitating an easier online experience for federal employees, FEP has launched Phase 1 of the public website redesign, www.fepblue.org®, Visitors can more easily navigate the vast amount of information the Program has to offer in a more intuitive and welcoming site. Additional enhancements will leverage customer experiences and feedback.
“The COVID-19 pandemic has altered the healthcare landscape, so it is important that we adapt our products and services to meet the changing care needs of our members,” said William A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association. “Alongside great coverage at reasonable prices, members should feel confident knowing we’re adding new telemedicine and virtual care benefits that allow them to easily get the care they need from the safety of their home. FEP will continue to be the best value for the federal workforce – wherever they may be.”
Dental and Vision Plan Updates
FEP is announcing several changes to improve access to care and outreach to eligible FEDVIP participants, including the uniformed services members. One thing we’re doing is changing our product names to make clear up front that your coverage is from the most trusted name in health insurance–Blue Cross Blue Shield FEP Dental and Blue Cross Blue Shield FEP Vision. FEP will continue to offer the same comprehensive benefits with a few new benefit and network changes for 2021 such as increased frame allowances and more e-commerce in network options for vision and removing orthodontia waiting periods for dental.
New Dental and Vision Digital Platforms
In addition, in order to streamline, guide and modernize the member experience both the dental and vision websites have been redesigned to be more responsive and user friendly. Both BCBS FEP Dental and BCBS FEP Vision will be launching mobile applications for users to leverage as well which includes quick and easy access to local providers and benefit information. For prospective and existing members, the launch of new product selection dental and vision tools, AskBlueSM BCBS FEP Dental Plan Finder and AskBlueSM BCBS FEP Vision Plan Finder, will help determine right product for one’s needs.
2021 Approved Rates:
Standard Option:
Self Only biweekly premiums will be $123.45
Self Plus One biweekly premiums will be $280.81
Self and Family biweekly premiums will be $300.12
Basic Option:
Self Only biweekly premiums will be $78.60
Self Plus One biweekly premiums will be $189.17
Self and Family biweekly premiums will be $201.27
FEP Blue Focus:
Self Only biweekly premiums will be $53.14
Self Plus One biweekly premiums will be $114.25
Self and Family biweekly premiums will be $125.67
Blue Cross Blue Shield FEP Vision Premiums in 2021:
High Option:
Self Only biweekly premiums will be $5.49
Self Plus One biweekly premiums will be $10.97
Self and Family biweekly premiums will be $16.46
Standard Option:
Self Only biweekly premiums will be $3.50
Self Plus One biweekly premiums will be $6.99
Self and Family biweekly premiums will be $10.49
Blue Cross Blue Shield FEP Dental Premiums in 2021*
High Option:
Self Only biweekly premiums will be $17.31
Self Plus One biweekly premiums will be $34.63
Self and Family biweekly premiums will be $51.94
Standard Option:
Self Only biweekly premiums will be $9.16
Self Plus One biweekly premiums will be $18.32
Self and Family biweekly premiums will be $27.49
Does Urgent Care Charge A Copay
*Blue Cross Blue Shield FEP Dental rates depend upon the rate region in which a member lives. The rates presented here are for BCBS FEP Dental’s most populous region, Region 1. Please go to bcbsfepdental.com to see the full list of regional rates.
All changes will take effect Jan. 1, 2021. Eligible participants will have an opportunity to make their health care coverage decisions during Open Season, which runs from Nov. 9 through Dec. 14, 2020.
Additional information about 2021 benefits is available at www.fepblue.org/whatsnew. Members can also call the National Information Center at 1-800-411-BLUE (2583).
What Is Copay For Urgent Care
About The Blue Cross and Blue Shield Service Benefit Plan (FEP®)
The Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program® (FEP®), has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. It covers roughly 5.5 million federal employees, retirees and their families out of the more than 8 million people who receive their benefits through the FEHB Program. The Blue Cross Blue Shield Association negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Blue Cross and Blue Shield Service Benefit Plan. The 36 local member companies of the Blue Cross Blue Shield Association are the primary points of contact for Service Benefit Plan members. They are responsible for processing claims and providing customer service to our members. To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit the Contact Us section on fepblue.org.