Compare Our Plans

FEP Blue Focus^®

Must stay in-network
Out-of-pocket costs include copays and coinsurance
Earn $150 on your MyBlue® Wellness Card for getting an annual physical
Has a deductible

FEP Blue Basic™

Must stay in-network
Most out-of-pocket costs are copays
Earn up to $170 a year on your MyBlue® Wellness Card
Eligible members with Medicare can get up to $800 Medicare Part B reimbursement
Access to Mail Service Pharmacy Program for members with Medicare Part B
Has no deductible

FEP Blue Standard™

Can see any provider, even outside the network
Out-of-pocket costs include copays and coinsurance
Access to Mail Service Pharmacy Program
Earn up to $170 a year on your MyBlue® Wellness Card
Has a deductible

2025 Plan Rates

FEP Blue Focus^®
Enrollment code	Bi-weekly	Monthly
Self Only (131)	$59.17	$128.21
Self + 1 (133)	$127.21	$275.63
Self & Family (132)	$139.92	$303.17

FEP Blue Basic™
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

FEP Blue Standard™
Enrollment code	Bi-weekly	Monthly
Self Only (104)	$174.81	$378.76
Self + 1 (106)	$384.14	$832.31
Self & Family (105)	$424.65	$920.07

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.

Compare Benefits Chart

See costs of typical services when you use Preferred providers.

Download the 2025 Benefits at a Glance Brochure

	FEP Blue Focus® View plan page	FEP Blue Basic™ View plan page	FEP Blue Standard™ View plan page
Virtual doctor visits by Teladoc Health^®	$0 copay	$0 copay	$0 copay
Preventive Care	$0 copay for covered preventive screenings, immunizations and services	$0 copay for covered preventive screenings, immunizations and services	$0 copay for covered preventive screenings, immunizations and services
Physician and Mental Health Care	$10 per visit for your first 10 primary and/or specialty care visits ¹	$35 copay for primary care ¹ $50 copay for specialists ¹ $35 copay for mental health visits	$30 copay for primary care $40 copay for specialists $30 copay for mental health visits
Urgent Care Center	$25 copay	$50 copay	Accidental Injury: $0 Medical Emergency: $30 copay
Chiropractic Care	$25 for up to 10 visits a year^1,2	$35 for up to 20 visits a year	$30 for up to 12 visits a year
Prescription Drugs	Retail Pharmacy^{^}: Generics: $5 copay Preferred brand: 40% of our allowance ($350 maximum) Mail Service Pharmacy: Not a benefit Specialty Pharmacy^{^}: Preferred specialty: 40% of our allowance ($350 maximum)	If you have Medicare Part B primary, your costs for prescription drugs may be lower. Retail Pharmacy^{^}: Generics: $15 copay Preferred brand: $75 copay Non-preferred brand: 60% of our allowance ($90 minimum) Preferred specialty: $120 copay Non-preferred specialty: $200 copay Mail Service Pharmacy^{^}: Available to members with Medicare Part B primary only. Visit the Medicarepage for more information. Generics: $20 copay Preferred brand: $100 copay Non-preferred brand: $125 copay Specialty Pharmacy^{^}: Preferred specialty: $120 copay² Non-preferred specialty: $200 copay²	If you have Medicare Part B primary, your costs for prescription drugs may be lower. Retail Pharmacy: Generics: $7.50 copay^{^} : Preferred brand: 30% of our allowance Non-preferred brand: 50% of our allowance Preferred specialty: 30% of our allowance ^{^} : Non-preferred specialty: 30% of our allowance ^{^} : Mail Service Pharmacy: Generics: $15 copay Preferred brand: $90 copay Non-preferred brand: $125 copay Specialty Pharmacy^{^}: Preferred specialty: $65 copay Non-preferred specialty: $85 copay
FEP Medicare Prescription Drug Program	Retail Pharmacy^{^}: Generics: $5 copay Preferred brand: 40% of our allowance ($350 maximum) Non-preferred brand: 40% of our allowance ($350 maximum) Specialty: 40% of our allowance ($350 maximum) Mail Service Pharmacy: Not a benefit	Retail Pharmacy ^{^} : Generics: $10 copay Preferred brand: $45 copay Non-preferred brand: 50% of our allowance ($60 minimum) Specialty: $75 copay Mail Service Pharmacy: Generics: $15 copay Preferred brand: $95 copay Non-preferred brand: $125 copay Specialty: $150 copay	Retail Pharmacy ^{^} : Generics: $5 copay Preferred brand: $35 copay Non-preferred brand: 50% of our allowance Specialty: $60 copay Mail Service Pharmacy: Generics: $5 copay Preferred brand: $85 copay Non-preferred brand: $125 copay Specialty: $150 copay
Maternity Care	$0 for doctor's visits $1,500 for facility care	$350 inpatient $0 outpatient	$0 copay
Hospital Care	30% of our allowance for outpatient care¹ 30% of our allowance for inpatient care¹ (precertification is required)	$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)	15% of our allowance for outpatient care $350 per admission copay for inpatient care (precertification is required)^*
Surgery	30% of our allowance^*	$150 copay per surgeon in an office¹ $200 copay per surgeon in other settings¹	15% of our allowance^*
ER (accidental injury)	$0 within 72 hours	$350 copay per day per facility	$0 within 72 hours
ER (medical emergency)	30% of our allowance¹	$350 copay per day per facility	15% of our allowance^*
Lab work (such as blood tests)	$0 for first 10 specific lab tests^**	15% of our allowance¹	15% of our allowance^*
Diagnostic services (such as sleep studies, CT scans)	30% of our allowance^*	Up to $100 in an office¹ Up to $250 in a hospital¹	15% of our allowance^*
Dental Care	Not a benefit	$35 per evaluation; up to 2 evaluations per year	See 2025 FEP Blue Standard and FEP Blue Basic brochure
Rewards Program	Earn $150 on your MyBlue Wellness Card for getting an annual physical⁴	Earn $50 for completing the Blue Health Assessment ³ Earn up to $120 for completing three eligible Daily Habits goals³	Earn $50 for completing the Blue Health Assessment ³ Earn up to $120 for completing three eligible Daily Habits goals³
Annual Deductible	Self Only: $500 Self + One and Self & Family: $1,000	No deductible	Self Only: $350 Self + One and Self & Family: $700
Out-of-Pocket Maximum (PPO)	Self Only: $9,000 Self + One and Self & Family: $18,000	Self Only: $7,500 Self + One and Self & Family: $15,000	Self Only: $6,000 Self + One and Self & Family: $12,000
FEP Medicare Prescription Drug Program Out-of-Pocket Maximum	$2,000 per member	$2,000 per member	$2,000 per member

Compare Benefits Chart

See costs of typical services when you use Preferred providers.

Download the 2024 Benefits at a Glance Brochure

	FEP Blue Focus^®	FEP Blue Basic™	FEP Blue Standard™
Preventive Care	You pay nothing	You pay nothing	You pay nothing
Physician Care	$10 per visit for your first 10 primary and/or specialty care visits combined medical and mental health substance use ¹	$35 copay for primary care ¹ $45 copay for specialists ¹ $35 copay for mental health visits	$30 copay for primary care $40 copay for specialists $30 copay for mental health visits
Virtual doctor visits by Teladoc^®	$0 for first 2 visits and all nutrition visits $10 all additional visits	$0 for first 2 visits and all nutrition visits $15 all additional visits	$0 for first 2 visits and all nutrition visits $10 all additional visits
Urgent Care Center	$25 copay	$35 copay	$30 copay
Prescription Drugs	Preferred Retail Pharmacy ^{^} : Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 40% of our allowance ($350 maximum) Mail Service Pharmacy: Not a benefit Specialty Pharmacy ^{^}: Tier 2 (Preferred specialty): 40% of our allowance ($350 maximum)	Preferred Retail Pharmacy ^{^} : If you have Medicare Part B primary, your costs for prescription drugs may be lower. Tier 1 (Generics): $15 copay Tier 2 (Preferred brand): $60 copay Tier 3 (Non-preferred brand): 60% of our allowance ($90 minimum) Tier 4 (Preferred specialty): $85 copay Tier 5 (Non-preferred specialty): $110 copay Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicarepage 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 copay Tier 5 (Non-preferred specialty): $110 copay	Preferred Retail Pharmacy: If you have Medicare Part B primary, your costs for prescription drugs may be lower. Tier 1 (Generics): $7.50 copay ^{^} : Tier 2 (Preferred brand): 30% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Preferred specialty): 30% of our allowance ^{^} : Tier 5 (Non-preferred specialty): 30% of our allowance ^{^} : Mail Service Pharmacy: Tier 1 (Generics): $15 copay Tier 2 (Preferred brand): $90 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy ^{^} : Tier 4 (Preferred specialty): $65 copay Tier 5 (Non-preferred specialty): $85 copay
FEP Medicare Prescription Drug Program	Preferred Retail Pharmacy ^{^} : Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 40% of our allowance ($350 maximum) Tier 3 (Non-preferred brand): 40% of our allowance ($350 maximum) Tier 4 (Specialty): 40% of our allowance ($350 maximum)	Preferred Retail Pharmacy ^{^} : Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $45 copay Tier 3 (Non-preferred brand): 50% of our allowance ($60 minimum) Tier 4 (Specialty): $75 copay Mail Service Pharmacy: Tier 1 (Generics): $15 copay Tier 2 (Preferred brand): $95 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty): $150 copay	Preferred Retail Pharmacy ^{^} : Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): 15% of our allowance Tier 3 (Non-preferred brand): 50% of our allowance Tier 4 (Specialty): $60 copay Mail Service Pharmacy: Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $85 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty): $150 copay
Maternity Care	$0 for doctor's visits $1,500 for facility care	$250 inpatient $0 outpatient	$0 copay
Hospital Care	Inpatient (Precertification is required): 30% of our allowance^* Outpatient: 30% of our allowance^*	Inpatient (Precertification is required): $250 per day; up to $1,500 per admission Outpatient: $150 per day per facility¹	Inpatient (Precertification is required): $350 per admission Outpatient: 15% of our allowance^*
Surgery	30% of our allowance^*	$150 per surgeon in an office¹ $200 per surgeon in other settings¹	15% of our allowance^*
ER (accidental injury)	$0 within 72 hours	$250 per day per facility	$0 within 72 hours
ER (medical emergency)	30% of our allowance¹	$250 per day per facility	15% of our allowance^*
Lab work (such as blood tests)	$0 for first 10 specific lab tests^**	15% of our allowance¹	15% of our allowance^*
Diagnostic services (such as sleep studies, CT scans)	30% of our allowance^*	Up to $100 in an office¹ Up to $200 in a hospital¹	15% of our allowance^*
Chiropractic Care	$25 for up to 10 visits a year¹ ²	$35 for up to 20 visits a year	$30 for up to 12 visits a year
Dental Care	Not a benefit	$35 per evaluation; up to 2 evaluations per year	The difference between the fee schedule amount and the Maximum Allowable Charge (MAC)
Rewards Program	Earn a reward, such as a $150 MyBlue Wellness Card, at no out-of-pocket cost for getting an annual physical⁴	Earn $50 for completing the Blue Health Assessment ³ Earn up to $120 for completing three eligible Daily Habits goals³	Earn $50 for completing the Blue Health Assessment ³ Earn up to $120 for completing three eligible Daily Habits goals³
Network Coverage	In-network care only, except in certain situations like emergency care	In-network care only, except in certain situations like emergency care	In-network and out-of-network care
Out-of-Pocket Maximum (PPO)	Self Only: $9,000 Self + One and Self & Family: $18,000	Self Only: $6,500 Self + One and Self & Family: $13,000	Self Only: $6,000 Self + One and Self & Family: $12,000
FEP Medicare Prescription Drug Program Out-of-Pocket Maximum	$3,250 per member	$3,250 per member	$2,000 per member
Annual Deductible	Self Only: $500 Self + One and Self & Family: $1,000	No deductible	Self Only: $350 Self + One and Self & Family: $700

Cost sharing may not apply or may be different if Medicare is your primary coverage (it pays first).

^* Deductible applies.
^** Please see brochure for covered lab services.
^{^} What you’ll pay for a 30-day supply of covered drugs.
¹ You pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
² Up to 10 visits combined for chiropractic care and acupuncture.
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.
⁴ You must be the contract holder or spouse, 18 or older, on an FEP Blue Focus plan to earn this reward.

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 brochures (FEP Blue Standard and FEP Blue Basic: RI 71-005; FEP Blue Focus: RI 71-017). All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.

Compare Our Plans

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FEP Blue Focus^®

FEP Blue Basic™

FEP Blue Standard™

2025 Plan Rates

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Compare Our Plans

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FEP Blue Focus®

FEP Blue Basic™

FEP Blue Standard™

2025 Plan Rates

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FEP Blue Focus^®