2026 FEHB and PSHB Plan Rates and Benefits
With Open Season running November 11 through December 8, 2025, now’s the time to learn about some of the updates we’re making for next year.
Changes to our Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) plans
Simpler access to genetic testing and hospice care
- We only require prior approval if 1) you don’t show signs/symptoms of a condition, or 2) you request testing to see if you could pass a genetic condition to your child.
- You do not need to request prior approval for outpatient hospice care.
Expanded preventive care coverage
- We will make updates to your preventive care benefits throughout the year based on the latest preventive care guidelines.
FEP Medicare Prescription Drug Program updates
- The annual pharmacy out-of-pocket maximum will be $2,100 per member for all plans.
Changes to FEHB plans
Changes to FEP Blue Focus® only:
- The Medicare Prescription Drug Program will not be available for FEP Blue Focus members.
- The deductible will be $750 for Self Only and $1,500 for Self Plus One and Self & Family.
- The catastrophic out-of-pocket maximum will be $10,000 for Self Only and $20,000 for Self + One and Self & Family.
- The copay for maternity facility care will be $2,500.
Changes to FEP Blue Basic® only:
- We will waive the delivery copay if you give birth at a Blue Distinction Center® for Maternity Care.
- You will pay 35% coinsurance for Preferred brand name, Preferred specialty and Non-preferred specialty prescription drugs.
- The inpatient admission copay will be $425 per day up to $2,975 per admission.
- The emergency room visit copay will be $425.
- The ground ambulance copay will be $250.
- The air or sea ambulance copay will be $750.
- The facility diagnostic testing copay will be $75.
- You will pay 35% coinsurance for oral and transdermal contraceptives, reproductive services, vision services, orthopedic and prosthetic devices, durable medical equipment, medical supplies, accidental dental and facility-billed agents, drugs and/or supplies.
- The outpatient observation services copay will be $425 per day.
Changes to FEP Blue Standard® only:
- You will pay 15% coinsurance for Preferred brand name and 20% coinsurance for Non-preferred brand name prescription drugs obtained via the Mail Service Pharmacy.
- You will have a $100 copay for a 30-day supply of Preferred specialty drugs and $150 copay for a 30-day supply of Non-preferred specialty drugs.
Changes to PSHB plans
Changes to FEP Blue Focus only:
- The deductible will be $750 for Self Only and $1,500 for Self Plus One and Self & Family.
- The catastrophic out-of-pocket maximum will be $10,000 for Self Only and $20,000 for Self + One and Self & Family.
- The copay for maternity facility care will be $3,500.
Changes to FEP Blue Basic only:
- We will waive the delivery copay if you give birth at a Blue Distinction Center® (BDC) for Maternity Care.
- You will pay 35% coinsurance for Preferred brand name, Preferred specialty and Non-preferred specialty prescription drugs.
- You will pay 35% coinsurance for oral and transdermal contraceptives, reproductive services, vision services, orthopedic and prosthetic devices, durable medical equipment, medical supplies, accidental dental and facility-billed agents, drugs and/or supplies.
- The inpatient admission copay will be $425 per day up to $2,975 per admission.
- The outpatient observation services copay will be $425 per day.
- The emergency room visit copay will be $425.
Changes to FEP Blue Standard only:
- You will have a $140 copay for Preferred brand name and $175 copay for Non-preferred brand name prescription drugs obtained via the Mail Service Pharmacy.
- You will have a $100 copay for a 30-day supply of Preferred specialty drugs and $135 copay for a 30-day supply of Non-preferred specialty drugs.
Please note that this is a summary of changes to the Blue Cross and Blue Shield Service Benefit Plan in 2026. This is not an official statement of benefits. Please refer to the brochures to see a full list of benefit changes.
2026 FEHB Plan Rates
| FEP Blue Focus | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (131) | $66.81 |
$144.76 |
| Self + 1 (133) | $143.63 |
$311.21 |
| Self & Family (132) |
$157.97 |
$342.28 |
| FEP Blue Basic | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (111) | $133.77 |
$289.83 |
| Self + 1 (113) | $319.25 |
$691.71 |
| Self & Family (112) |
$356.86 |
$773.20 |
| FEP Blue Standard | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (104) | $188.32 |
$408.02 |
| Self + 1 (106) | $410.88 |
$890.24 |
| Self & Family (105) |
$457.66 |
$991.60 |
2026 PSHB Plan Rates
| FEP Blue Focus | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (35A) | $75.15 |
$162.83 |
| Self + 1 (35C) | $161.56 |
$350.06 |
| Self & Family (35B) |
$177.70 |
$385.03 |
| FEP Blue Basic | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (33A) | $127.59 |
$276.45 |
| Self + 1 (33C) | $313.84 |
$679.99 |
| Self & Family (33B) |
$357.52 |
$774.62 |
| FEP Blue Standard | ||
|---|---|---|
| Enrollment code | Bi-weekly | Monthly |
| Self Only (33D) | $190.10 |
$411.89 |
| Self + 1 (33F) | $424.42 |
$919.58 |
| Self & Family (33E) |
$479.21 |
$1,038.29 |
If you have questions about our benefit plans, call the National Information Center weekdays from 8 a.m. to 8 p.m. ET at 1-800-411-BLUE (2583). For customer service-related questions, please call your local customer service number found here or on the back of your member ID card.
These rates do not apply to all enrollees. If you are in a special enrollment category, contact the agency or Tribal employer that manages your health benefits enrollment.
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 Employees Health Benefits Program brochures (FEP Blue Standard and FEP Blue Basic®: RI 71-005; FEP Blue Focus®: RI 71-017) and the Postal Service Health Benefits Program brochures (FEP Blue Standard and FEP Blue Basic RI 71-020; FEP Blue Focus: RI 71-025). All benefits are subject to the definitions, limitations and exclusions set forth in the brochures.
The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies.
The Blue Cross® and Blue Shield® words and symbols, Federal Employee Program® and FEP® are all trademarks owned by Blue Cross Blue Shield Association.