| Basic Option | |
|---|---|
| Preventive Care | Nothing for covered preventive screenings, immunizations and services |
| Physician Care | $30 for primary care1 |
| Virtual doctor visits by Teladoc® | $0 for first 2 visits |
| Urgent Care Center | $35 copay |
| Prescription Drugs | Preferred Retail Pharmacy: Tier 1 (Generics): $10 copay Tier 2 (Preferred brand): $55 copay2 Tier 3 (Non-preferred brand): 60% of our allowance ($75 minimum)2 Tier 4 (Preferred specialty): $65 copay2 Tier 5 (Non-preferred specialty): $90 copay2 Mail Service Pharmacy: Available to members with Medicare Part B primary only. Visit the Medicare page for more information. Tier 1 (Generics): $20 Tier 2 (Preferred brand): $100 copay Tier 3 (Non-preferred brand): $125 copay Specialty Pharmacy: Tier 4 (Preferred specialty): $85 copay2 Tier 5 (Non-preferred specialty): $110 copay2 |
| Maternity Care | $175 inpatient $0 outpatient |
| Hospital Care | Inpatient (Precertification is required): $175 per day; up to $875 per admission Outpatient: $100 per day per facility1 |
| Surgery | $150 in an office setting1 $200 in a non-office setting1 |
| ER (accidental injury) | $175 per day per facility |
| ER (medical emergency) | $175 per day per facility |
| Lab work (such as blood tests) | $0 copay1 |
| Diagnostic services (such as sleep studies, CT scans) | Up to $100 in an office1 Up to $150 in a hospital1 |
| Chiropractic Care | $30 per treatment; up to 20 visits per year |
| Dental Care | $30 copay per evaluation; up to 2 per year |
| Rewards Program | Earn $50 for completing the Blue Health Assessment3 Earn up to $120 for completing three eligible Online Health Coach goals3 |
30% of our allowance. Prescription Drugs. See the 2020 Blue Cross and Blue Shield Service Benefit Plan brochures for information on supply and refill limits. Preferred Retail Pharmacy 3: Tier 1 (Generics): $7.50 copay. Tier 2 (Preferred brand): 30% of our allowance. Tier 3 (Non-preferred brand): 50% of our allowance. Information on this website is issued by Highmark Blue Cross Blue Shield on behalf of these companies, which serve the 29 counties of western Pennsylvania and 13 counties in northeast and north central Pennsylvania. We are committed to providing outstanding services to our applicants and members. If you require special assistance, including.
WASHINGTON – The Blue Cross and Blue Shield Federal Employee Program® (FEP®) announced today that it will waive cost-sharing for coronavirus diagnostic testing, waive prior authorization requirements for treatment and take other steps to enhance access to care for those needing treatment for COVID-19 to ensure its members can swiftly access the right care in the right setting during the outbreak.
These changes, which have been approved by the Office of Personnel Management, will ensure that nearly 6 million federal employees, retirees and their families have comprehensive, accessible care. They include:
- FEP will waive prior authorizations for diagnostic tests and for covered services that are medically necessary and consistent with Centers for Disease Control and Prevention (CDC) guidance if diagnosed with COVID-19.
- Similarly, FEP will waive any copays or deductibles for diagnostic tests or treatment that are medically necessary and consistent with CDC guidance if diagnosed with COVID-19.
- FEP will increase access to prescription medications by waiving early medication refill limits on 30-day prescription maintenance medications. FEP will also encourage members to use 90-day mail order benefit.
- FEP will also eliminate any cost share for prescriptions for up to a 14-day supply.
- FEP will waive copays for telehealth services related to COVID-19.
“As Americans continue to monitor the coronavirus outbreak, one thing they should not be concerned with is whether Blue Cross and Blue Shield will be there for them,” said William A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association. “We take our members’ health very seriously and want to make sure there are no barriers to their seeking appropriate care if they become sick.”
FEP and Blue Cross and Blue Shield (BCBS) companies are following CDC prevention guidelines and other federal recommendations and will continue to support and protect the health and well-being of its members, their families and the community. These actions will apply to all FEP members of the 36 U.S. and Puerto Rico-based BCBS companies, including those members located overseas, when applicable.
Bcbs Copay Lookup
For more information on FEP’s policy changes, please visit www.fepblue.org for details on the expansion of benefits and services. Members can also call the National Information Center at 1-800-411-BLUE (2583). If you are not an FEP member and have questions about your health plan, please contact your local BCBS Company: bcbs.com/memberservices.