Compare Overseas Benefits

^† We waive the $350 Standard Option copay, $175 per day Basic Option copay, and the FEP Blue Focus $500 deductible and 30% coinsurance for inpatient care you receive overseas. For Basic Option and FEP Blue Focus, your provider must be a DoD facility or have a direct billing or guarantee of benefits arrangement with GMMI for you to receive this benefit. Otherwise, the Basic Option per day copay and the FEP Blue Focus deductible and coinsurance apply.

* Is subject to the calendar year deductible. The deductible for FEP Blue Focus is $500 per person or $1,000 in total per family. Basic Option does not have a calendar year deductible. Certain out-of-pocket costs do not apply if Medicare is your primary coverage for medical services (it pays first).

** In order to receive prescriptions through the Mail Service or Specialty Pharmacy Program, your address must have a U.S. zip code and the prescribing physician must be licensed within the U.S., Puerto Rico or the U.S. Virgin Islands. For countries with laws restricting the importation of prescription drugs from any other country, we cannot ship drugs from our Mail Service Pharmacy Program, or from our Specialty Pharmacy Program to members living overseas, even when you have a valid APO or FPO address. You may continue to receive your prescription drugs from a local overseas pharmacy and submit a claim to us for reimbursement.

¹ You pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.

² Deductible applies. In addition, you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.

³ Please see the brochure for covered lab services.

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.