Choose the Right Plan
We can help you select the right Service Benefit Plan option to combine with Medicare.
Combining your Service Benefit Plan coverage with Medicare is a choice. Our three plan options provide the coverage and benefits you need today and as your health care needs change throughout retirement.
Covering the things Medicare doesn’t cover
Combining coverage gives you access to benefits not covered by Medicare.
| FEP Blue Focus | Basic Option | Standard Option | |
|---|---|---|---|
| Hearing Aids |
Get hearing aid discounts through our Blue365® Discount Program |
Receive an allowance of up to $2,500 every five years for the purchase of hearing aids and hearing aid supplies. Prior approval will be required in 2024. Get hearing aid discounts through our Blue365® Discount Program. You can combine this discount with the hearing aid benefit above. |
Receive an allowance of up to $2,500 every five years for the purchase of hearing aids and hearing aid supplies. Prior approval will be required in 2024. Get hearing aid discounts through our Blue365® Discount Program. You can combine this discount with the hearing aid benefit above. |
| Routine Foot Care | If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments. | If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments. | If you have a long-term condition such as diabetes, your Service Benefit Plan coverage will cover necessary routine foot care, and when combined with Medicare coverage, you’ll pay nothing out-of-pocket for these treatments. |
|
Acupuncture |
Receive up to 10 visits per year at no cost to you |
Receive up to 12 visits per year at no cost to you | Receive up to 24 visits per year at no cost to you |
| Dental Care | Not covered | You pay nothing for preventive dental services (up to 2 cleanings a year) | We'll pay up to the fee schedule amount listed in the Standard Option brochure for dental services |
| Overseas Care |
All three of our plans cover you abroad. Learn more about overseas coverage. |
All three of our plans cover you abroad. Learn more about overseas coverage. |
All three of our plans cover you abroad. Learn more about overseas coverage. |
Pay zero out-of-pocket costs for covered services
You’ll pay nothing for these services when Medicare Part A and Part B are primary. Basic Option and FEP Blue Focus members must see Preferred providers.
New in 2024: 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 Focus | Basic Option | Standard Option | |
|---|---|---|---|
| In-network (Preferred) Retail Pharmacy |
Tier 1 (Generics): $5 for up to a 30-day supply; $15 for a 31 to 90-day supply
|
Tier 1 (Generics): $10 for up to a 30-day supply; $30 for a 31 to 90-day supply |
Tier 1 (Generics): $5 for up to a 30-day supply; $15 for a 31 to 90-day supply Tier 2 (Preferred brand): 15% of our allowance for up to a 90-day supply Tier 3 (Non-preferred brand): 50% of our allowance for up to a 90-day supply Tier 4 (Specialty drugs): $60 for up to a 30-day supply; $170 for a 31 to 90-day supply |
| FEP Mail Service Pharmacy | Not a benefit |
Tier 1 (Generics): $15 copay Tier 2 (Preferred brand): $95 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty drugs): $150 copay |
Tier 1 (Generics): $5 copay Tier 2 (Preferred brand): $85 copay Tier 3 (Non-preferred brand): $125 copay Tier 4 (Specialty drugs): $150 copay |
| FEP Specialty Pharmacy |
Your specialty drug benefits are in Tier 4 (see above) |
Your specialty drug benefits are in Tier 4 (see above) |
Your specialty drug benefits are in Tier 4 (see above) |
| Annual Pharmacy Out-of-Pocket Maximum* | $3,250 per member | $3,250 per member | $2,000 per member |
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 (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: RI 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.
Check Drug Costs
Our Prescription Drug Cost Tool lets you check drug costs 24/7, see if your drug is covered under your selected plan and compare costs of covered drugs for all three plans.
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.
Please note: The Medicare information on this page focuses on the Original Medicare Plan and when Medicare Part A and Part B are your primary coverage, unless otherwise noted. The Service Benefit Plan information refers to Standard Option, Basic Option and FEP Blue Focus.
Explore More
View Our Guide
Learn more about the benefits of combining Medicare coverage with the Service Benefit Plan.
Learn MoreGet Reimbursed
With a Medicare Reimbursement Account, Basic Option members can get up to $800 back.
Learn MoreUse Your Benefits
Learn how to get the most out of your Service Benefit Plan coverage with Medicare.
Learn More