FEP Medicare Prescription Drug Program (MPDP)

The FEP Medicare Prescription Drug Program, or MPDP, is a prescription drug benefit exclusively for Blue Cross and Blue Shield Federal Employee Program (FEP) members with Medicare. It’s part of your Blue Cross and Blue Shield Service Benefit Plan coverage, which means there’s no separate premium for your prescription drug coverage.

With MPDP, you will have additional approved prescription drugs in some tiers, get lower out-of-pocket costs for higher-cost drugs and have a cap on the amount you pay out-of-pocket on prescriptions annually. You will continue to receive the same FEP health plan benefits you’re used to—these will not change.

Each member on your contract enrolled in MPDP will receive their own member ID card. This new card will include your member ID number, which you should use for all of your medical care. It will include your new MPDP ID number, which the pharmacy needs to fill your prescriptions and submit claims to CVS Caremark. MPDP member ID cards will be mailed in late November or early December of 2023.

With MPDP, you have a larger pharmacy network than the traditional FEP pharmacy benefit. You will have access to over 65,000 in-network (Preferred) retail pharmacies. You can use our Pharmacy Locator tool to find a participating in-network pharmacy.

Yes, you can opt-out and keep your current FEP prescription drug benefits. You can do so once per benefit year. Follow these instructions to opt-out. Contact the FEP Medicare Prescription Drug Program (MPDP) at 888-338-7737 between the hours of 8 a.m. to 5 p.m. ET or complete the opt-out request included in the Enrollment letter and return it to the FEP Medicare Prescription Drug Program, PO Box 3539, Scranton, PA 18505. If it is after the effective date, January 1, 2024, you can place your request in the mail at the address mentioned or call 1-800-MEDICARE. 

With MPDP, you will no longer be required to fill specialty drugs through the current Speciality Pharmacy Program. You may fill your prescriptions at participating in-network retail pharmacies in our network.

If you do not have an existing prior authorization or coverage determination, your doctor can request one effective December 1, 2023, for the new plan year effective January 1, 2024, as the member cannot submit a Prior Authorization request.

You can use our Pharmacy Locator tool to find a participating in-network pharmacy.

We assign each covered drug to a tier. There are four tiers for MPDP:

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

You can use our Prescription Drug Cost tool to see which tier your medication is in.

You can view the approved drug lists (formularies) for each plan with MPDP:  FEP Blue Focus, Basic Option and Standard Option. 

Cost estimates can be found on fepblue.org/medicarerx. You can also use our Prescription Drug Cost Tool to check drug costs.

Yes, the prescription drug benefit for FEP Blue Focus, Basic Option and Standard Option are considered “creditable coverage” under Medicare Part D.

Yes. We are working to transfer members’ prescription history, including claims information and any active prior authorization to a new FEP MPDP account. This will allow you to continue receiving any current mail order prescriptions with minimal disruptions.  

However, the following prescriptions cannot be transferred: 

• Prescriptions that are expired, or have no refills
• C-2 Controlled Substance Rx
• C-3, C-4, C-5 prescription that has not yet been filled at the current pharmacy 
• Compounded Prescriptions

The Mail Service Pharmacy is a convenient and cost-effective way for you to order up to a 90-day supply of maintenance or long-term medication. You can have your long-term medication delivered to your home or doctor’s office of your choice with free standard shipping. By using mail service, you minimize trips to the pharmacy while saving money on your prescriptions.

For prescription refills with no issues (e.g., not expired or out of refills), you can expect your order to be shipped from our pharmacy within two (2) business days after the order is placed. Orders are shipped on the first business day once processing has been completed. You should expect to receive your prescription within five (5) to seven (7) days after it has been shipped. 

For any new prescriptions, we will need to contact your prescriber. You can expect your order to be shipped from our pharmacy within five (5) business days once it is received, provided your prescriber responds to our request. Orders are shipped on the first business day once processing has been completed. You should expect to receive your new prescription within seven (7) to ten (10) days after it has been shipped. 

While we are transferring active and refillable mail order prescriptions to the new MPDP account, we will not mail members’ refills automatically. Members must call Customer Care at 1-888-338-7737 or go to caremark.com (registration required), on or after January 1, 2024, to provide billing information, including payment preferences.

Medications from our Mail Service Pharmacy are shipped from the closest mail service location to the member's address on file. Medications are shipped in accordance with manufacturer’s requirements for safe transportation.

You can choose one of these methods: 

• Call 1-888-338-7737 and let the Mail Service Pharmacy contact your doctor and arrange for your first mail-order supply. We can assist you with most medications. 

• Ask your doctor for a new prescription for up to a 90-day supply, plus refills for up to one (1) year (if appropriate). Then, ask your doctor to e-prescribe or fax the prescription to the Mail Service Pharmacy. (Only your doctor can fax your prescriptions; the fax number is 1-800-378-0323.

You can check your refill order status on MyBlue or by calling 1-888-338-7737 toll-free. 

The Mail Service Pharmacy offers automatic refills, a home delivery service enhancement designed to assist you in never running out of your medication. After enrolling your maintenance prescriptions in the program, we will automatically calculate your prescription usage and day’s supply remaining. When it’s time to refill your prescription, we will fill it automatically and mail it to your home. Through your preferred method of communications, you will receive a notification seven (7) days before your next refill starts processing. You can change the next processing date or cancel the prescription from the automated refills service any time before processing begins.

Your copay for a 90-day supply depends on several factors, including whether the medication is a brand or generic product. To find out your copay, use our Prescription Drug Cost Tool. You can call 1-888-338-7737 toll-free to confirm your copay amount.