Blue Cross Blue Shield Federal Employee Program

Blue Cross Blue Shield FederalThe Blue Cross Blue Shield Federal companies are local run health provider companies in the United States of America; the Blue Cross Blue Shield Association (BCBSA) happens to be the trade association for these two companies.
The corporate headquarters of the BCBSA is located in Chicago, Illinois.
The BCBS Service Benefit Plan is also known as the Blue Cross Blue Shield Federal Employees Program (FEP). Since it’s inception in 1960, it has been an important part of the Federal Employees Health Benefits Program (FEHBP).
Since the very beginning, this benefit plan has provided services to more than 5.3 million of the federal employees covered by this plan, as well as their families, retirees and loved ones.

Every year, the BCBSA negotiates the terms and conditions of their benefit plan with the United States Office of Personnel Management to renew all details.
There are a total of 36 companies in the United States that come under this benefit plan; they also happen to be the primary contact points for the members. These 36 companies are responsible for processing all the claims and providing the service to the members.

Choose Your Right Blue Cross Blue Shield Federal Benefit Plan

There isn’t only one benefit plan for you to accept, but three different ones for you to choose from: basic option, standard option, and FEB Blue Focus.

You can review all three of these Blue Cross Blue Shield Service Benefit Plan and compare between them, based on the information provided below, and then choose the perfect one for you and for your family.
It is better to review all three and then to decide on one because what is right for someone else, might not be a good choice for you.

So instead of deciding on a benefit plan because someone else in your acquaintance is satisfied with it, take your time to choose the right one for your future. After all, this is a very important decision that you are going to make for yourself and for your family.

BASIC OPTION

The Basic option is the most convenient and the most affordable coverage of the three. It can give you all the care you need from in-network providers without any deductible amount. In the following few paragraphs, you will find all the information related to the benefits for 2019.

  • Medical benefits

To be covered for medical benefits under the basic option, you can only receive care from the program’s preferred providers. You won’t have to pay any deductibles for this care, but you will have to pay a sum of $30 for each visit to a primary care provider.

If you visit a preferred specialist, you have to pay $40 for each visit. However, your annual checkups and other preventive services will be completely free, but only if you visit a preferred provider.

  • Maternity benefit options

During your pregnancy period, for you or your spouse, this benefit plan will cover all of the care your family needs. The first prenatal visit will verify the case, and the expectant mother will be given a Maternal Care Box with several items that will help the pregnancy.

Your benefits will also contain the “My Pregnancy Assistant” educational resources that will give you tips and facts to enjoy your pregnancy.

If the case requires, you will be eligible for special tobacco cessation medications from an in-network provider if you had the habit of smoking or any other similar drugs. You will also be given a list of dos and don’ts by “My Pregnancy Assistant” which will help you take the right decisions.

  • Prescription Drug Coverage

Whatever medicines you need for your health, over-the-counter or prescribed by a doctor, can be obtained from your in-network pharmacies.

Under the Basic Option, all members must use one single retail pharmacy for obtaining their prescriptions and drugs. All you need to do is to show the pharmacist your member ID card and prescription to obtain the drugs. No deductibles need to be paid for this, only the cost share amounts.

If you want to use any other non-preferred pharmacies, you might have to pay the full amount when obtaining the prescription. Later, if you collect all the information about the pharmacy and sent the details to the Blue Cross Blue Shield Association, you might be reimbursed the amount you have paid.

If you need specific drugs that are not covered by the benefit plan, you can use your plan to get the “Discount Drug Program” care to get those drugs. However, to get these drugs, you will also require prior approval from the Program. If you want, you can switch from your specialty drugs to generic drugs and save money.

Standard Option

With the Standard option, you get the freedom to choose your providers. Under this benefit plan, you have the flexibility and the independence to receive care from both in-network and out-of-network providers.

  • Medical Benefits

You can receive care from both out-of- and in-network providers, according to your personal choice. This includes both routine exams and regular checkups from your physicians, as well as preventive services.

Under this benefit plan, your doctor can assess your health and recommend certain lifestyle changes that will be beneficiary for you, i.e. for your blood pressure, diabetes, cholesterol, Hepatitis C, tobacco use, etc. This also includes an early screening of cervical cancer, breast cancer and colon cancer for both men and women.

Regular vaccination for children and adults also come under this benefit plan.

  • Maternity Benefits

Under the Standard benefit rule also, you can get all kinds of help before, during and after your pregnancy.

You will receive a Pregnancy Care Box with this benefit too.  filled with pregnancy books, vitamins and other essentials. “My Pregnancy Assistant” will always be helpful in giving important tips and ideas about your pregnancy period, as well.

  • Prescription Drug Coverage

Under the Standard Option, you will be eligible to receive prescriptions and drugs from more than 60,000 preferred pharmacies all over the United States. You can visit these pharmacies in your locality or order your drugs through the “Mail Service Pharmacy Program”.

You can also use any of the non-preferred pharmacies in the country under the Standard option. The “Specialty Drug Pharmacy Program” for specialized drugs and the “Discount Drug Program” for specific drugs not covered by the program are also included in this option.

FEP Blue Focus

If you are covered by the FEP Blue Focus, it means that you can only get health care in the in-network providers, but only the ones that are the budget-friendly ones. You cannot get free healthcare in the ones that are not included in the budget-friendly list, but this also means you have access to more than 65,000 pharmacies, 95% of the doctors and 96% of all hospitals in the country.

This plan, however, doesn’t cover dental care, nursing facilities, non-preferred drugs, long-term care, and hearing aids. The drugs you will have access to are usually the generic ones and only a few brand names. Not all FDA-approved drugs come free under this benefit plan, either.

All your core need are covered by the FEP Blue Focus, but only under preferred providers. However, your eleventh time visiting a specialist, diagnostic services, surgeries, emergency visits or allergy treatments in one year will not be covered. For the first 10 visits or services, you will only need to pay $10/visit.

Telehealth services are included in this plan, even for dermatology. For preventive care such as screening for cancer, you will be completely covered.

Blue Cross Blue Shield Federal Basic Vs. Standard Benefit Options

If you are still not sure about which benefit plan to choose, here is something you can do: If you make a comparison of Blue Cross Blue Shield Basic vs Standardbenefit options, you will know which one is more appropriate one for you.

The Blue Cross Blue Shield Standard Option has a deductible, but the members covered by it can get service by both any in-network and out-of-network providers. On the other hand, the Basic Option does not have a deductible, but the members can only see in-network providers.

For a standard option, your out-of-pocket costs consist of both copayments and coinsurance amounts, but for the members of the basic plan, the only out-of-pocket costs are that of co-payments.

Therefore, if you are satisfied with your in-network providers or if you don’t need to see a specialist for more than a few times every year, the Basic Option will be adequate for you. On the other hand, if you need specialist care, surgeries or advanced medical treatment in the near future, you should opt for the Standard option.

Basic Option Rates 2019

Non-Postal PremiumPostal Premium
Bi-weeklyMonthlyBi-weekly Category 1Bi-weekly Category 2
Self Only (111)$73.72$159.74$70.78$61.19
Self + 1 (113)$170.57$369.56$163.73$143.22
Self & Family (112) $177.24$384.02$169.94$148.06

Standard Option Rates 2019

Non-Postal PremiumPostal Premium
Bi-weeklyMonthlyBi-weekly Category 1Bi-weekly Category 2
Self Only (104)$112.23$243.17$109.03$99.44
Self + 1 (106)$256.54$555.83$249.70$229.19
Self & Family (105)$268.21$581.13$260.91 $239.03

Blue cross blue shield federal basic plan brochure 2019

In the following brochures, you will find all the information that you are going to need to learn more about all the benefit plan options. It would be the right one for you, as well as how they can help you when you need. You can search and choose from a number of coverage plans from our multiple ones on the website, and look through them to know what you require.

Our forms and brochures are all interactive and determined to help you make a decision. To get the  Blue cross blue shield brochure 2019, please click here

How to find the Blue Cross Blue Shield Federal Providers?

In a Standard benefit option, you can choose to take service from both an in-network and out-of-network providers. In a basic option and FEB Blue Focus, on the other hand, only allows you to take service from the in-network provider. This requires you to look for the Providers, health facilities and service providers inside your network who can give you the necessary services you need.

To find a service provider close to you, visit this link and type in your details: Find a Provider. You can find your desired provider by searching via doctor’s name or specialty, and by your location via name or type.

To find pharmacies for your prescriptions and drugs, visit this site to find all your in-network providers: Find a Pharmacy. Here, you can fund any pharmacy by entering your city or state name, ZIP code, or name of your county. You will also be able to filter your searches by store name, language spoken by the pharmacist or assistant, or specific services offered, 24-hour services, drive-thru services, etc.

If you are living overseas but still under the benefit plan, or if you are looking for a provider in another country, you can find all the names and details here: Find an Overseas Provider.

For providers who can give you specialized high-quality services like cancer care, hip and knee replacements, cardiac care, etc., you can find the necessary details here: Find Blue Distinction Centers.

Every kind of service you need will be accessible around you, within your in-network services, and these are the links you can use to find the services and providers you require.

Frequently Asked Questions on Blue Cross Blue Shield Federal Services 

Does Federal Blue Cross cover chiropractic?

Under the Blue Cross and Blue Shield (BCBS) Service Benefit Plan, a number of Doctors of Chiropractors are listed to provide necessary services to members. This decision to include Doctors of Chiropractor as equally important as medical doctors were taken in December 2013.

How do I contact Blue Cross Blue Shield?

The following link is the contact page of the Blue Cross Blue Shield (BCBS) Association: Contact Us. Since the Association is made up of 36 separate independent companies, you can also find you preferred company here. The main headquarter of the Blue Cross Blue Shield Association is in Chicago, Illinois and the Washington headquarters is in 1310 G Street, NW Washington, DC 20005.

Is there a grace period for Blue Cross Blue Shield?

It is important that you pay all your bills on time; if you miss your payments, there is a chance your plan can get cancelled. However, after you have made your first payment, you get a small grace period to pay the next time. But you’ll have to complete the full payment before the grace period ends. If you fail to pay  you will lose your coverage and benefit plan.

For most payments, the grace period is around 31 days or a month. All your claims will be pended during this time. However, if you are eligible for the Advanced Premium Tax Credit, your grace period will be 90-days.

Does Blue Cross Blue Shield cover vasectomy?

Most of the Blue Cross Blue Shield (BCBS) Service providers cover traditional Vasectomy surgeries, as well as the no-scalpel, no-needle vasectomies.  However, since BCBS plans vary in every state, there may be some states in the United States that do not cover vasectomy surgeries. For any queries or appointments regarding this, you can call 646-663-5922.

How do I cancel my Blue Cross health insurance?

You can cancel your Blue Cross Health Insurance if you have purchased it through Healthcare.gov. All yu need to do is to go to healthcare.gov and ask for a cancellation.

If you have purchased your plan but not through healthcare.gov, you have to request for a cancellation through Blue Connect. Here, you have to log in, fill in the necessary details and ask to “Cancel My Plan”; you will also need to fill out a form and submit your request.

For more details, you can call the helpline number at the back of your Membership ID card. This number is both for assistance and for canceling your health insurance.

How do I get a new Blue Cross Blue Shield insurance card?

If you have lost or damaged your ID card, you can always find a replacement. If you are still covered under the benefit plan, you can request for a replacement here. However, this is only applicable if you want the replacement for your card or your Blue Card Network ID Card. If you have lost your red, blue or white Medicare card, you have to contact the U.S. Social Security Administration via their website.