FEP Blue Focus
Get quality healthcare coverage that’s easy on your wallet. FEP Blue Focus was designed with your needs and budget in mind.
FEP Blue Focus Benefits
See costs for typical services when you use Preferred providers.
| FEP Blue Focus | |
|---|---|
| Preventive Care | Nothing for covered preventive screenings, immunizations and services |
| Physician Care | $10 per visit for your first 10 primary and/or specialty care visits combined medical and mental health substance use5 |
| Virtual doctor visits by Teladoc® |
$0 for first 2 visits $10 all additional visits |
| Urgent Care Center | $25 copay |
| Prescription Drugs |
Preferred Retail Pharmacy:
Mail Service Pharmacy
Specialty Pharmacy
|
| Maternity Care |
$0 for doctor's visits $1,500 for facility care |
| Hospital Care |
Inpatient (Precertification is required): 30% of our allowance1 Outpatient: 30% of our allowance1 |
| Surgery | 30% of our allowance1 |
| ER (accidental injury) | $0 within 72 hours |
| ER (medical emergency) | 30% of our allowance1 |
| Lab work (such as blood tests) | $0 for first 10 specific lab tests3,4 |
| Diagnostic services (such as sleep studies, X-rays, CT scans) | 30% of our allowance1 |
| Chiropractic Care |
$25 per treatment; for up to 10 visits per year combined for chiropractic care and acupuncture5 |
| Dental Care | Not covered |
| Rewards Program | Earn a reward, such as a Fitbit®, at no out-of-pocket cost for getting an annual physical6 |
| Network Coverage | In-network care only, except in certain situations like emergency care |
| Out-of-Pocket Maximum (PPO) |
Self Only: $7,500 Self + One and Self & Family: $15,000 |
| Annual Deductible |
Self Only: $500 Self + One and Self & Family: $1,000 |
Under FEP Blue Focus, 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).
1 Deductible applies. $500 for Self Only and $1,000 for Self + One and Self & Family.
2 Specialty drugs are limited to a 30-day supply.
3 Professional charges for facility-based intensive outpatient treatment and professional charges for outpatient diagnostic tests to include psychological testing are not part of the 10 for $10 benefit.
4 Please see brochure for covered lab services.
5 You pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
6 You must be the contract holder or spouse, 18 or older, on a FEP Blue Focus plan to earn incentive rewards.
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 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.
Get to know FEP Blue Focus
Take a closer look at this budget-friendly option and how it can help you focus on the essentials of good health.
Have questions? Check out our FEP Blue Focus FAQs for more information.