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FEP Blue Basic™

Stay in network for care. FEP Blue Basic gives you access to a network with over 2 million doctors and hospitals and over 55,000 retail pharmacies.

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Benefits at a Glance


  • In-network care only
  • No deductible 
  • Pay mostly copays 
  • Medicare Part B Reimbursement: up to $800 back a year  
  • Access to 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.

Get the details

Want to see detailed benefits for this plan? Download the 2025 Blue Cross and Blue Shield Service Benefit Plan Brochure – FEP Blue Standard and FEP Blue Basic below. 

See Plan Brochure

View an interactive plan summary book

For a convenient summary of our three coverage options, view an interactive version of the 2025 Benefit Summary Book.

2025 FEP Blue Basic Rates

 
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
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.

Get up to $800 back with a Medicare Reimbursement Account

FEP Blue Basic members who have Medicare Part A and Part B can get up to $800 back with a Medicare Reimbursement Account.

Learn More

See if your doctor is in our network

Use our National Doctor and Hospital Finder tool to see if your current doctor is in our Preferred provider network or to find a specialist, retail clinic or urgent care center near you.

FEP Blue Basic™ Benefits

See costs for typical services when you use Preferred providers.

FEP Blue Basic™
Virtual doctor visits by Teladoc Health® $0 copay
Preventive Care $0 copay for covered preventive screenings, immunizations and services
Physician and Mental Health Care

$35 copay for primary care1

$50 copay for specialist1

$35 copay for mental health visits

Urgent Care Center $50 copay
Chiropractic Care

$30 copay per treatment; up to 20 visits a year1

Prescription Drugs

Retail Pharmacy^:

Generics: $15 copay
Preferred brand: $75 copay2
Non-preferred brand: 60% of our allowance ($90 minimum)2
Preferred specialty: $120 copay2
Non-preferred specialty: $200 copay2

Mail Service Pharmacy:
Available to members with Medicare Part B primary only. 
Visit the Medicare page 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


Maternity Care $0 copay for outpatient
$350 copay for inpatient hospital delivery
 
Hospital Care

$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) 

Surgery

$150 copay in an office setting1

$200 copay in a non-office setting1

ER (accidental injury)

$350 per day per facility

ER (medical emergency)

$350 per day per facility

Lab work (such as blood tests) 15% our allowance1
 
Diagnostic services
(such as sleep studies, CT scans)
Up to $100 copay in an office1
Up to $250 copay in a hospital1
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 Daily Habits goals3
Annual Deductible No deductible
Out-of-Pocket Maximum (PPO)

Self Only: $7,500

Self + One and Self & Family: $15,000

FEP Blue Basic™
Preventive Care Nothing for covered preventive screenings, immunizations and services
Physician Care

$35 copay for primary care1

$45 copay for specialists1

$35 copay for mental health visits

Virtual doctor visits by Teladoc®

$0 for first 2 visits and all nutrition visits

$15 all additional visits

Urgent Care Center $35 copay
Prescription Drugs

Preferred Retail Pharmacy^:

Tier 1 (Generics): $15 copay
Tier 2 (Preferred brand): $60 copay2
Tier 3 (Non-preferred brand): 60% of our allowance ($90 minimum)2
Tier 4 (Preferred specialty): $85 copay2
Tier 5 (Non-preferred specialty): $110 copay2

Mail Service Pharmacy:
Available to members with Medicare Part B primary only. 
Visit the Medicare page 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 copay2
Tier 5 (Non-preferred specialty): $110 copay2


Maternity Care $250 copay inpatient
$0 outpatient
 
Hospital Care

Inpatient (Precertification is required): $250 per day copay; up to $1,500 per admission

Outpatient: $150 copay per day per facility1

Surgery

$150 per surgeon in an office1

$200 per surgeon in other settings1

ER (accidental injury)

$250 per day per facility

ER (medical emergency)

$250 per day per facility

Lab work (such as blood tests) 15% our allowance1
 
Diagnostic services
(such as sleep studies, CT scans)

Up to $100 copay in an office1

Up to $200 copay in a hospital1

Chiropractic Care

$35 for up to 20 visits a year1

Dental Care

$35 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 Daily Habits goals3
Network Coverage In-network care only, except in certain situations like emergency care
Out-of-Pocket Maximum (PPO)

Self Only: $6,500

Self + One and Self & Family: $13,000

Annual Deductible No deductible

FEP Blue Basic™ with 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. New for 2025: the annual pharmacy out-of-pocket maximum is $2,000 per member and separate from the medical out-of-pocket maximum. Learn more here.

FEP Blue Basic™ with MPDP
Retail Pharmacy^

Generics: $10 copay

Preferred brand name: $45 copay 

Non-preferred brand name: 50% of our allowance ($60 minimum)

Specialty drugs: $75 copay

FEP Mail Service Pharmacy

Generics: $15 copay

Preferred brand name: $95 copay

Non-preferred brand name: $125 copay

Specialty drugs: $150 copay

FEP Blue Basic™ with MPDP
Retail Pharmacy^

Generics: $10 copay

Preferred brand name: $45 copay 

Non-preferred brand name: 50% of our allowance ($60 minimum)

Specialty drugs: $75 copay

FEP Mail Service Pharmacy

Generics: $15 copay

Preferred brand name: $95 copay

Non-preferred brand name: $125 copay

Specialty drugs: $150 copay

FEP Specialty Pharmacy Your specialty drug benefits are in Tier 4 (see above) for a 30-day supply
Annual Prescription Drug Out-of-Pocket Maximum $3,250 per member

Under FEP Blue Basic, benefits are not available for services performed by Non-preferred providers, except in certain situations such as emergency care.

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

  • * FEP Blue Basic Traditional Pharmacy drug tiers: Tier 1 Generics, Tier 2 Preferred Brand Name, Tier 3 Non-preferred Brand Name, Tier 4 Preferred Specialty, Tier 5 Non-preferred Specialty.
  • ^ What you’ll pay for a 30-day supply of covered drugs.
  • 1 Under FEP Blue Basic you pay 30% of our allowance for agents, drugs and/or supplies you receive during your care.
  • 2 If you have Medicare Part B primary, your costs for prescription drugs may be lower.
  • 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.
  •  

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.

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 71-005). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.

Try our Prescription Drug Cost Tool

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. If you’re a member and logged in to MyBlue®, you can access a personalized drug cost tool that shows you the cost of prescription drugs for your specific plan.

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