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FEP Blue Basic™

Stay in network for care. FEP Blue Basic gives you access to our Preferred provider network that includes over 2 million doctors and hospitals in the U.S.

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FEP Blue Basic™ Benefits


See costs for typical services when you use Preferred providers.

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): $15 copay
Tier 2 (Preferred brand): $60 copay2
Tier 3 (Non-preferred brand): 60% of our allowance ($90 minimum)2
Tier 4 (Preferred specialty): $85 copay2
Tier 5 (Non-preferred specialty): $110 copay2

Mail Service Pharmacy:
Available to members with Medicare Part B primary only. 
Visit the Medicare page for more information.

Tier 1 (Generics): $20 copay
Tier 2 (Preferred brand): $100 copay
Tier 3 (Non-preferred brand): $125 copay

Specialty Pharmacy^:
Tier 4 (Preferred specialty): $85 copay2
Tier 5 (Non-preferred specialty): $110 copay2

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


$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. Learn more here.

FEP Blue Basic™ with MPDP
Preferred Retail Pharmacy

Tier 1 (Generics): $10 for up to a 30-day supply; $30 for a 31 to 90-day supply

Tier 2 (Preferred brand name): $45 for up to a 30-day supply; $135 for a 31 to 90-day supply

Tier 3 (Non-preferred brand name): 50% of our allowance ($60 min) for up to a 30-day supply; $175 min for a 31 to 90-day supply

Tier 4 (Specialty drugs): $75 for up to a 30-day supply; $195 for a 31 to 90-day supply

Mail Service Pharmacy

Tier 1 (Generics): $15 copay

Tier 2 (Preferred brand name): $95 copay

Tier 3 (Non-preferred brand name): $125 copay

Tier 4 (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).

  • ^ 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.

Get up to $800 back with a Medicare Reimbursement Account

Each member of a FEP Blue Basic plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums.

Learn More

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