Combining FEP & Medicare
Discover how the Blue Cross and Blue Shield Federal Employee Program (FEP) and Medicare work together for you.
Combine your coverage to get more
Medicare works best with our coverage when Medicare Part A and Part B are your primary coverage. That means Medicare pays for your service first, and then we pay our portion.
Usually if you’re retired, Medicare is primary. If you’re still actively working, we’re your primary coverage.
Get coverage for the things Medicare doesn’t cover
By combining Medicare coverage with FEP, you can get access to benefits not covered by Medicare Part A and Part B.*
Pay zero out-of-pocket costs for certain covered services
You’ll pay nothing for most services when Medicare Part A and Part B are primary.
See what you’re really getting
Wondering what you can get with Original Medicare (Part A and Part B), Original Medicare plus FEP or just a Medicare Advantage plan? We can help you make an informed decision. Remember: FEP is not a Medicare Advantage plan.
| Original Medicare | Original Medicare + FEP | Medicare Advantage (MA) Plan | |
|---|---|---|---|
| Cost | You pay a monthly premium for Part B + you’ll pay a separate premium for Part D if you need prescription drug coverage |
You pay your FEP plan’s premium + the monthly Part B premium
Basic Option members can get up to $800 back for paying Part B premiums |
You pay your MA plan’s premium in most cases + the monthly Part B premium OPM does not contribute to your MA plan premium if you suspend FEHB Program coverage |
| Coverage | Covers most medically necessary services & supplies. Does not cover acupuncture, hearing aids, dental care, routine exams & eye exams | Covers medically necessary services + many services Medicare does not cover |
Covers medically necessary services |
| Providers | You can go to any doctor or hospital in the U.S. that takes Medicare |
All members have access to FEP’s network that includes over 1.7 million doctors and hospitals in the U.S. Standard Option members can go to any out-of-network provider Covers care for members living or traveling overseas |
You can go to the doctors and providers in the plan’s network With MA plans, it’s important to check provider limitations, additional costs for out-of-network providers and overseas coverage as benefits & coverage vary between plans |
Don’t lose your coverage
As long as you don’t cancel your health insurance, it will never go away for as long as you’re retired. If you do choose to cancel your insurance, you will never be able to re-enroll in a health insurance plan through the Federal Employees Health Benefits (FEHB) Program. If you want to try a different plan such as Medicare Advantage or Tricare, you may suspend your coverage and still retain the right to re-enroll in the FEHB Program. To learn more, visit opm.gov/retire.
Count on comprehensive prescription drug coverage
What about Part D?
Medicare Part A and Part B don’t cover prescription drugs. Some employers provide Part D coverage to eligible retirees through dedicated plans. Eligibility can vary, but it is usually those retirees with Part A and Part B as their primary coverage.
If you decide to keep your FEP coverage, you don’t need a supplemental drug plan, such as Medicare Part D. OPM has determined that our prescription drug coverage is, on average, expected to pay out as much as the standard Medicare prescription drug coverage will pay for all plan participants and is considered Creditable. If you don’t take a Part D plan, you will still have prescription drug coverage and you will not be penalized if you decide to take Part D later.
Pay less with generic drugs
While you do still pay your cost shares for prescriptions, Basic and Standard Option members who combine their coverage pay less for generic drugs than members who don’t combine their coverage. Basic Option members with Part A and Part B also get access to our Mail Service Pharmacy Program. You can learn more about prescription drug coverage here.
Get up to $800 back with a Medicare Reimbursement Account
Basic Option members who have Medicare Part A and Part B can get reimbursed up to $800 a year for paying their Medicare Part B premiums.
Learn More