FEP Blue Focus® for FEHB

If you have Medicare primary or receive care overseas, different cost share amounts may apply.

^*Deductible applies.
²You pay 30% coinsurance for agents, drugs and/or supplies you receive during your care.
³Please see brochure for covered lab services.
⁴Up to 10 visits combined for chiropractic care and acupuncture.

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.

Under FEP Blue Focus, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care.

Coinsurance (a type of cost sharing) is the percentage of coinsurance you pay. We contract with providers to pay them a set rate, or an allowance. Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first).

• ^* FEP Blue Focus Traditional Pharmacy drug tiers: Tier 1 Preferred Generics, Tier 2 Preferred Brand Name, Preferred Specialty and Preferred Brand Name Specialty.
• ^{^} What you’ll pay for a 30-day supply of covered drugs.
• ¹ Deductible applies. $750 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% coinsurance 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.
• ⁷ If your pregnancy care starts in 2025 and your baby is born in 2026, your copay will be based on the 2026 amount.