Compare Our Plans

See the variations between benefits and coverage  vandelay.es for our three plan options facet by means of side.

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Coronavirus Update
FEP will waive any copays or deductibles for medically necessary diagnostic assessments or remedy that are consistent with CDC steering if identified with COVID-19.

Learn greater here.

Get the Details
Get a handy summary of those coverage options.

Download the 2021 Benefit Summary Book

Standard Option
• Has a deductible
• Can see any provider, even out of doors the community
• Out-of-pocket fees encompass deductible, copays and coinsurance
• Access to Mail Service Pharmacy Program
• Earn up to $170 in rewards with the Wellness Incentive Program

Basic Option
• Has no deductible
• Must see Preferred carriers
• Most out-of-pocket costs are copays
• Can get Medicare Part B premium compensation
• Earn as much as $a hundred and seventy in rewards with the Wellness Incentive Program

 

FEP Blue Focus
• Has a deductible
• Must see Preferred providers
• Out-of-pocket fees include deductible, copays and coinsurance
• Earn a praise for buying annual physical

2021 Plan Rates
Non-Postal Premium
Postal Premium
Standard Option
Enrollment code Bi-weekly Monthly
Self
(104) $123.45 $267.Forty eight
Self + 1
(106) $280.81 $608.43
Self & Family
(one zero five) $three hundred.12 $650.26
Basic Option
Enrollment code Bi-weekly Monthly
Self
(111) $seventy eight.60 $a hundred and seventy.31
Self + 1
(113) $189.17 $409.87
Self & Family
(112) $201.27 $436.08
FEP Blue Focus
Enrollment code Bi-weekly Monthly
Self
(131) $fifty three.14 $one hundred fifteen.15
Self + 1
(133) $114.25 $247.Fifty five
Self & Family
(132) $125.67 $272.29
These charges do now not practice to all enrollees. If you are in a special enrollment class, contact the organization or Tribal corporation that manages your fitness advantages enrollment.
Compare Benefit Options
See prices for regular offerings whilst you operate Preferred vendors.

Download the 2021 Benefits at a Glance brochure

Standard Option Basic Option FEP Blue Focus
Preventive Care You pay nothing You pay nothing You pay not anything
Physician Care $25 for number one care
$35 for specialists $30 for primary care1
$40 for specialists1 $10 consistent with go to for your first 10 number one
and/or uniqueness care visits blended medical and intellectual fitness substance use1
Virtual health practitioner visits by Teladoc® $0 for first 2 visits
$10 all additional visits $0 for first 2 visits
$15 all additional visits $0 for first 2 visits
$10 all extra visits
Urgent Care Center Accidental Injury: $zero
Medical Emergency: $30 copay $35 copay $25 copay
Prescription Drugs Preferred Retail Pharmacy^:
If you have got Medicare Part B number one, your prices for prescribed drugs can be lower.
Tier 1 (Generics): $7.50 copay
Tier 2 (Preferred logo): 30% of our allowance
Tier three (Non-favored brand): 50% of our allowance
Tier 4 (Preferred forte): 30% of our allowance
Tier 5 (Non-preferred area of expertise): 30% of our allowance

Mail Service Pharmacy:
Tier 1 (Generics): $15 copay
Tier 2 (Preferred brand): $ninety copay
Tier 3 (Non-favored logo): $a hundred twenty five copay

Specialty Pharmacy:
Tier four (Preferred distinctiveness): $65 copay
Tier 5 (Non-desired uniqueness): $85 copay Preferred Retail Pharmacy^:
If you have Medicare Part B primary, your prices for prescription drugs can be lower.

Tier 1 (Generics): $10 copay

Tier 2 (Preferred brand): $fifty five copay

Tier 3 (Non-favored brand): 60% of our allowance ($75 minimum)

Tier 4 (Preferred specialty): $65 copay

Tier five (Non-preferred area of expertise): $ninety copay

 

Mail Service Pharmacy:

Available to participants with Medicare Part B number one handiest. Visit the Medicare page for extra facts.

Tier 1 (Generics): $20

Tier 2 (Preferred brand): $one hundred copay

Tier 3 (Non-preferred emblem): $125 copay

 

Specialty Pharmacy:

Tier four (Preferred specialty): $eighty five copay

Tier 5 (Non-preferred strong point): $110 copay

Preferred Retail Pharmacy^:

Tier 1 (Generics): $five copay

Tier 2 (Preferred emblem): 40% of our allowance ($350 max)

 

Mail Service Pharmacy:

Not a benefit

 

Specialty Pharmacy:

Tier 2 (Preferred Generic strong point, and Preferred emblem area of expertise): 40% of our allowance ($350 maximum)

Maternity Care
$zero copay

$a hundred seventy five inpatient
$0 outpatient
$zero for medical doctor’s visits

$1,500 for facility care

Hospital Care Inpatient (Precertification is required): $350 in keeping with admission
Outpatient: 15% of our allowance* Inpatient (Precertification is needed): $175 consistent with day; up to $875 per admission
Outpatient: $100 per day in step with facility1 Inpatient (Precertification is required): 30% of our allowance*
Outpatient: 30% of our allowance*
Surgery
15% of our allowance*

$one hundred fifty in an workplace setting1
$200 in a non-office setting1
30% of our allowance*

ER (unintentional injury) $zero inside seventy two hours $175 according to day in line with facility $zero inside seventy two hours
ER (scientific emergency) 15% of our allowance* $175 in step with day per facility 30% of our allowance*
Lab work (inclusive of blood assessments) 15% of our allowance* $0 copay1 $zero for first 10 particular lab checks**
Diagnostic services (inclusive of sleep studies, CT scans) 15% of our allowance* Up to $a hundred in an office1
Up to $a hundred and fifty in a hospital1 30% of our allowance*
Chiropractic Care $25 according to go to; as much as 12 visits per year $30 according to go to; up to twenty visits in step with year1 $25 in keeping with visit; for up to 10 visits a year1,2
Dental Care The difference among the rate time table quantity and the Maximum Allowable Charge (MAC)
$30 in step with assessment; up to 2 critiques according to year

Not a advantage

Rewards Program
Earn $50 for finishing the Blue Health Assessment3

Earn up to $one hundred twenty for finishing 3 eligible Online Health Coach goals3

Earn $50 for completing the Blue Health Assessment3

Earn up to $one hundred twenty for finishing 3 eligible Online Health Coach goals3

Earn a reward, such as a Fitbit®, at no out-of-pocket fee for getting an annual physical4
Network Coverage In-community and out-of-community care In-community care simplest, besides in sure conditions like emergency care In-community care simplest, besides in sure situations like emergency care
Out-of-Pocket Maximum (PPO) Self Only: $5,000
Self + One and Self & Family: $10,000 Self Only: $five,500
Self + One and Self & Family: $eleven,000 Self Only: $7,500
Self + One and Self & Family: $15,000
Annual Deductible
Self Only: $350

Self + One and Self & Family: $seven hundred

No deductible

Self Only: $500

Self + One and Self & Family: $1,000

Standard Option Plan Page

Basic Option Plan Page

FEP Blue Focus Plan Page

Cost sharing might not observe or can be distinct if Medicare is your number one insurance (it pays first).

* Deductible applies.
** Please see brochure for included lab services.
^ What you’ll pay for a 30-day supply of included drugs.
1 You pay 30% of our allowance for sellers, tablets and/or resources you acquire at some point of your care.
2 Up to ten visits mixed for chiropractic care and acupuncture.
Three You must be the agreement holder or spouse, 18 or older, on a Standard or Basic Option plan to earn incentive rewards.
Four You need to be the contract holder or partner, 18 or older, on an FEP Blue Focus plan to earn this reward.

This is a precis of the capabilities of the Blue Cross and Blue Shield Service Benefit Plan. Before making a very last decision, please study the Plan’s Federal brochures (Standard Option and Basic Option: RI seventy one-1/2; FEP Blue Focus: 71-017). All benefits are challenge to the definitions, obstacles and exclusions set forth in the Federal brochures.

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