Compare Benefit Options for 2017-Blue Cross and Blue Shield's Federal Employee Program

Compare Benefit Options for 2017

Here are the main differences between our Standard Option and Basic Options for 2017.
If you need help deciding which plan is right for you, AskBlue® can help you choose.

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Standard vs. Basic Option

With the Blue Cross and Blue Shield Service Benefit Plan, you can choose Standard Option or Basic Option. Here are the main differences between them:

  • While Basic Option requires that you use Preferred providers to receive benefits, you can go outside of the network with Standard Option.
  • Standard Option has a calendar year deductible. Basic Option does not.
  • You’ll have a copayment for most of the care you receive under Basic Option. Under Standard Option, your out-of-pocket costs include copayment and coinsurance amounts.

Click here to download a summary of these coverage options.

Need help selecting a plan?

Visit askblue.fepblue.org. AskBlue is an interactive tool that can help you choose between Standard and Basic Option. Simply answer a few questions, and we’ll help you decide which plan may be right for you.

Already decided?

If you’ve already chosen your plan, you can enroll or change your coverage during Open Season, which runs from November 14 to December 12, 2016.


2017 Standard Option Rates
Non-Postal Premium Postal Premium
Bi-weekly Monthly Bi-weekly
Category 1
Bi-weekly
Category 2
Self Only (104) $105.99 $229.64 $96.76 $93.68
Self + One (106) $240.77 $521.67 $220.94 $214.34
Self & Family (105) $254.23 $550.84 $233.17 $226.16
2017 Basic Option Rates
Non-Postal Premium Postal Premium
Bi-weekly Monthly Bi-weekly
Category 1
Bi-weekly
Category 2
Self Only (111) $71.22 $154.32 $61.97 $59.12
Self + One (113) $164.64 $356.72 $144.81 $138.21
Self & Family (112) $173.59 $376.12 $152.53 $145.52
Compare Benefit Options for 2017
Benefits Standard Option Basic Option
Wellness Incentive Program Earn $50 for completing the Blue Health Assessment and up to $120 for achieving up to three eligible Online Health Coach goals

Learn more
Earn $50 for completing the Blue Health Assessment and up to $120 for achieving up to three eligible Online Health Coach goals

Learn more
Preventive Care You pay nothing You pay nothing
Physician Care $25 for primary care
$35 for specialists
$30 for primary care
$40 for specialists
Lab and Diagnostic Services 15%* of our allowance You pay nothing1 for lab tests, pathology services and EKGs; $401 for diagnostic tests such as home sleep studies, EEGs, ultrasounds and X-rays; $1001 for angiography, bone density tests, CT scans, MRIs, PET scans, genetic testing, nuclear medicine and sleep studies in an office setting; $1501 at a hospital
Hospital Care Inpatient: $350 per admission
Outpatient: 15%* of our allowance
Inpatient: $175 per day; up to $875 per admission
Outpatient: $1001 per day per facility
Surgical Services 15%* of our allowance $1501 in an office setting
$2001 in a non-office setting
Maternity Care You pay nothing for delivery and pre- and postnatal care You pay $175 for inpatient care; you pay nothing for outpatient care or pre- and postnatal physician care
Urgent Care $30 for urgent care center $35 for urgent care center
Emergency Care Accidental Injury: You pay nothing for outpatient services within 72 hours
Medical Emergency: Regular benefits for physician and hospital care*
Accidental Injury and Medical Emergency: $125 per visit for emergency room care
Regular benefits for physician care
Prescription Drugs
See the 2017 Blue Cross and Blue Shield Service Benefit Plan brochure for information on supply and refill limits
Preferred Retail Pharmacy:
Tier 1 (Generics): 20% of our allowance

Tier 2 (Preferred brand name): 30% of our allowance

Tier 3 (Non-preferred brand): 45% of our allowance

Tier 4 (Preferred specialty): 30% of our allowance

Tier 5 (Non-preferred specialty): 30% of our allowance

Mail Service Pharmacy:
Tier 1 (Generics): $15 copay

Tier 2 (Preferred brand): $80 copay

Tier 3 (Non-preferred brand): $105 copay

Specialty Pharmacy:
Tier 4 (Preferred specialty): $35 copay

Tier 5 (Non-preferred specialty): $55 copay
Preferred Retail Pharmacy:
Tier 1 (Generics): $10 copay

Tier 2 (Preferred brand): $50 copay

Tier 3 (Non-preferred brand): 60% of our allowance ($65 minimum)

Tier 4 (Preferred specialty): $65 copay

Tier 5 (Non-preferred specialty): $90 copay

Mail Service Pharmacy:
Not a benefit unless you have Medicare Part B primary

Specialty Pharmacy:
Tier 4 (Preferred specialty): $55 copay

Tier 5 (Non-preferred specialty): $80 copay
Network Services In-network and out-of-network care In-network care only, except in certain situations like emergency care
How You Pay for Services Mixture of copayments and coinsurance amounts Set copayments for most services
Out-of-Pocket Maximum Self Only: $5,000
Self + One and Self & Family: $10,000
Self Only: $5,500
Self + One and Self & Family: $11,000
Annual Deductible $350 per individual
$700 per family
No deductible
Routine Dental Care Your out-of-pocket expenses are limited to the balance after our payment up to the Maximum Allowable Charge $30 copayment per evaluation up to 2 per calendar year; Preventive care only

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 71-005). All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.

* Is subject to the 2017 Standard Option calendar year deductible: $350 per person or $700 in total for Self Plus One or Self and Family contracts. Basic Option does not have a calendar year deductible.

1Under Basic Option you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.

If you use a Non-preferred provider under Standard Option, you generally pay any difference between our allowance and the billed amount, in addition to any share of our allowance shown in the table above. Basic Option generally does not provide benefits when you use Non-preferred providers. Certain out-of-pocket costs do not apply if Medicare is your primary coverage for medical services (it pays first).

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