FEP Blue Basic™
Stay in network for care. FEP Blue Basic gives you access to a network with over 2 million doctors and hospitals and over 55,000 retail pharmacies.
Benefits at a Glance
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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.
Get the details
Want to see detailed benefits for this plan? Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below.
See Plan Brochure2025 FEP Blue Basic Rates
Enrollment Code | Bi-weekly | Monthly |
---|---|---|
Self Only (111) | $113.16 | $245.18 |
Self + 1 (113) | $274.14 | $593.97 |
Self & Family (112) | $303.61 | $657.82 |
Get up to $800 back with a Medicare Reimbursement Account
FEP Blue Basic members who have Medicare Part A and Part B can get up to $800 back with a Medicare Reimbursement Account.
Learn MoreSee if your doctor is in our network
Use our National Doctor and Hospital Finder tool to see if your current doctor is in our Preferred provider network or to find a specialist, retail clinic or urgent care center near you.
FEP Blue Basic™ Benefits
See costs for typical services when you use Preferred providers.
FEP Blue Basic™ | |
---|---|
Virtual doctor visits by Teladoc Health® | $0 copay |
Preventive Care | $0 copay for covered preventive screenings, immunizations and services |
Physician and Mental Health Care |
$35 copay for primary care1 $50 copay for specialist1 $35 copay for mental health visits |
Urgent Care Center | $50 copay |
Chiropractic Care |
$30 copay per treatment; up to 20 visits a year1 |
Prescription Drugs |
Retail Pharmacy^:
Generics: $20 copay |
Maternity Care |
$0 copay for outpatient $350 copay for inpatient hospital delivery |
Hospital Care |
$250 copay for outpatient care per day per facility1 $350 per day copay for inpatient care; up to $1,750 per admission (precertification is required) |
Surgery |
$150 copay in an office setting1 $200 copay in a non-office setting1 |
ER (accidental injury) |
$350 per day per facility |
ER (medical emergency) |
$350 per day per facility |
Lab work (such as blood tests) |
15% our allowance1 |
Diagnostic services (such as sleep studies, CT scans) |
Up to $100 copay in an office1 Up to $250 copay in a hospital1 |
Dental Care |
$30 copay per evaluation; up to 2 per year |
Rewards Program |
Earn $50 for completing the Blue Health Assessment3 Earn up to $120 for completing three eligible Daily Habits goals3 |
Annual Deductible | No deductible |
Out-of-Pocket Maximum (PPO) |
Self Only: $7,500 Self + One and Self & Family: $15,000 |
FEP Blue Basic™ | |
---|---|
Preventive Care | Nothing for covered preventive screenings, immunizations and services |
Physician Care |
$35 copay for primary care1 $45 copay for specialists1$35 copay for mental health visits |
Virtual doctor visits by Teladoc® |
$0 for first 2 visits and all nutrition visits $15 all additional visits |
Urgent Care Center | $35 copay |
Prescription Drugs |
Preferred Retail Pharmacy^:
Tier 1 (Generics): $20 copay |
Maternity Care |
$250 copay inpatient $0 outpatient |
Hospital Care |
Inpatient (Precertification is required): $250 per day copay; up to $1,500 per admission Outpatient: $150 copay per day per facility1 |
Surgery |
$150 per surgeon in an office1 $200 per surgeon in other settings1 |
ER (accidental injury) |
$250 per day per facility |
ER (medical emergency) |
$250 per day per facility |
Lab work (such as blood tests) |
15% our allowance1 |
Diagnostic services (such as sleep studies, CT scans) |
Up to $100 copay in an office1 Up to $200 copay in a hospital1 |
Chiropractic Care |
$35 for up to 20 visits a year1 |
Dental Care |
$35 copay per evaluation; up to 2 per year |
Rewards Program |
Earn $50 for completing the Blue Health Assessment3 Earn up to $120 for completing three eligible Daily Habits goals3 |
Network Coverage | In-network care only, except in certain situations like emergency care |
Out-of-Pocket Maximum (PPO) |
Self Only: $6,500 Self + One and Self & Family: $13,000 |
Annual Deductible | No deductible |
FEP Blue Basic™ with 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. New for 2025: the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum. Learn more here.
FEP Blue Basic™ with MPDP | |
---|---|
Retail Pharmacy^ |
Generics: $10 copay Preferred brand name: $45 copay Non-preferred brand name: 50% of our allowance ($60 minimum) Specialty drugs: $75 copay |
FEP Mail Service Pharmacy |
Generics: $15 copay Preferred brand name: $95 copay Non-preferred brand name: $125 copay Specialty drugs: $150 copay |
FEP Blue Basic™ with MPDP | |
---|---|
Retail Pharmacy^ |
Generics: $10 copay Preferred brand name: $45 copay Non-preferred brand name: 50% of our allowance ($60 minimum) Specialty drugs: $75 copay |
FEP Mail Service Pharmacy |
Generics: $15 copay Preferred brand name: $95 copay Non-preferred brand name: $125 copay Specialty drugs: $150 copay |
FEP Specialty Pharmacy | Your specialty drug benefits are in Tier 4 (see above) for a 30-day supply |
Annual Prescription Drug Out-of-Pocket Maximum | $3,250 per member |
Under FEP Blue Basic, 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).
*FEP Blue Basic Traditional Pharmacy drug tiers: Tier 1 Generics, Tier 2 Preferred Brand Name, Tier 3 Non-preferred Brand Name, Tier 4 Preferred Specialty, Tier 5 Non-preferred Specialty.
- ^ What you’ll pay for a 30-day supply of covered drugs.
- 1 Under FEP Blue Basic you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
- 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower.
- 3 You must be the contract holder or spouse, 18 or older, on a FEP Blue Standard™ or FEP Blue Basic Plan to earn incentive rewards.
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.
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.
Try our Prescription Drug Cost Tool
Our Prescription Drug Cost Tool lets you check drug costs 24/7. See if your drug is covered under your current plan and compare costs of covered drugs for all three plans. Please note 2025 pricing information will be available on the tool starting October 19, 2024.
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