All rights reserved. Standard Option, Self and Family, Enrollment Code 105: Postal Premium Category 1: Biweekly your share: $292.31 Category 2: Biweekly your share: $268.89 Basic Option, Self Only, Enrollment Code 111: Non-Postal Premium Blue Cross Blue Shield of Massachusetts is only a phone call away. Find out more about federal compensation throughout your career and around the world. Primary/Specialty Care - The amount you pay for a visit to a primary care practitioner (typically an M.D. By continuing to use this website, you consent to these cookies. Self Only covers only one person, the federal employee eligible to participate in the FEHB. www.opm.gov/fehbpremiums. No matter which enrollment type you choose you receive the same benefits, coverage and overall value. If you are an annuitant under our Plan and also are actively employed, any group health insurance you have from your employer will pay primary and we will pay secondary. always refer to the individual FEHB brochure which is the official statement of benefits. Specialty prescription drugs are high cost, complex drugs placed on a specialty tier of the formulary and/or dispensed from a designated specialty pharmacy. Annual Deductible: The amount you may have to pay for covered health care services before the plan begins to pay. Precertification is the process of approving an inpatient admission before you receive care. In cases of double coverage, who pays my healthcare claims first? copayments, deductibles and coinsurance) during the plan year for covered, in-network services. Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). If youre a new member, you will receive a New Member Welcome Kit with your Blue Cross and Blue Shield Service Benefit Plan member ID card approximately 10 business days from the date we receive your enrollment information. prescription services). Member Cost with Medicare A & B Primary - This is the amount you pay for an inpatient hospital stay. Yes, legally married same-sex spouses of federal employees and retirees are eligible for coverage. The amount of funds available to you for paying your out-of-pocket qualified medical expenses through a premium pass-through contribution or a virtual account.

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2020 Blue Cross and Blue Shield Service Benefit Plan . here to export this list to an Excel spreadsheet. Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members.

What is the difference between the three enrollment types? Who can I call to get information about the Service Benefit Plan? Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). Can members also use the Flexible Spending Account (FSA)? Surgery & Hospital Charges - This is the amount you pay before the Plan pays benefits when you are admitted as an inpatient to a hospital.

If you are using assistive technology to view web content, please ensure your settings allow for the page content to update after initial load (this is sometimes called "forms mode").

For a convenient summary of our three coverage options. Do women who need screening mammograms get them?

Yes, visit www.FSAFEDS.com for more information.

Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Fill out the Health Benefits Election Form (SF-2809) and provide a copy to your Human Resources office. Dental - Does the plan cover Minor Restorative for Adults (e.g., fillings, local anesthesia)? Basic Option. We, like other insurers, determine which coverage is primary according to the National Association of Insurance Commissioners (NAIC) guidelines. Want to see detailed benefits for this plan? When a "yes" appears indicating that there is coverage for a specific service, you must check the plan brochure for your cost share.

Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums. The only difference in the enrollment types is the number of people eligible to be covered under each one. When you have Medicare A and B, some plans will waive the copay. This website uses features which update page content based on user actions.

Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus: 133: Self Plus One: $247.55: $252.51: 2.00%: Blue Cross and Blue Shield Service Benefit Plan Standard Option: 104: Self: $276.19: $308.53: 11.71%: Blue Cross and Blue Shield Service Benefit Plan Standard Option: 105: Self & Family: $680.57: $753.77: 10.76%: Blue Cross and Blue . Postal Service: PostalEASE system or the telephone enrollment system, Department of Energy: Department of Energy automated enrollment systems, Health and Human Services and Environmental Protection: MyPay, Employees of agencies payrolled by the National Finance Center: Employee Personal Page. Nationwide Blue Cross and Blue Shield Service Benefit Plan FEP Blue Focus - FEP Blue Focus Self Plus One: 133: 457.02: 457.02: 347.34: 109.68: . When youre retired, the U.S. Office of Personnel Management becomes your payroll office.

AnnuitantsStandard Option or Basic Option Enrollment: Please visit the Office of Personnel Management (OPM) website for information on how to enroll or call the OPM Open Season Express line at 1-800-332-9798. Mental Health and Substance Use Disorder Benefits, 5(h). All rights reserved.

However, you should always ask your provider if they have contacted us and provided the information we needyou are responsible for ensuring your care is approved. Frequently asked enrollment and benefit questions.

Note: Online resources provided by OPM at www.opm.gov/insure. Enrollees who wish to cover one eligible family member are free to elect either the Self and Family or Self Plus One enrollment type. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c). Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e).

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Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). If you have claims or customer service questions, you can call the customer service number on the back of your member ID card. These include getting married, having a baby, getting divorced or a change in employee status. For benefit information, call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Inpatient care that may need approval includes inpatient hospital stays, inpatient residential treatment center care and/or skilled nursing facility care. You can also access a digital version of your member ID card via the fepblue app or online once you register for a MyBlue account. 111. Services Provided by a Hospital or Other Facility, and Ambulance Services, 5(e). You might be able to change your health plan outside of Open Season if you have a qualifying life event. The protection of your privacy will be governed by the privacy policy of that site. Through the precertification process we review: For more information about precertification rules and exceptions, see section 3 of the Service Benefit Plan brochures. If you need cards for additional covered family members, you can request them via your MyBlue account or by calling the customer service number on the back of your member ID card. Wellness and Other Special Features, 5(i). When you have Medicare C, some plans will waive the copay. FEP Group Number Federal Employee Program group number is 0FEPTX.

Premiums for Tribal employees are shown under the Monthly Premium Rate column.

Treatment Therapies - Your cost share for chiropractic care. No, your coverage will automatically carry over year over year unless you decide to make a change. Certain tribal organizations are able to enroll in the Federal Employees Health Benefits Program. A child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member. Member Cost with Medicare A & B Primary - This is the amount you pay for a Specialty care visit.

You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Wellness and Other Special Features, 5(i). How pleased are customers with the plan overall? We use cookies on this website to give you the best experience and measure website usage.

Member Cost with Medicare Advantage (Part C) Primary - If a plan reimburses you for your Part B premiums, this displays the maximum amount that you will be annually reimbursed. Prescription Drugs - Mail order drug dispensing may be restricted to a specific mail order pharmacy. If you do not get prior approval (also known as prior authorization), we may reduce or deny your benefit. Lab, X-Ray & Other Diagnostic Tests - What is the member cost share for Simple Diagnostic Tests/Procedures (e.g., blood tests, urinalysis, ultrasounds)?

The amounts shown below indicate what you will pay for each class of service. By continuing to use this website, you consent to these cookies. FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB) PLAN. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. Which services and treatments require prior approval or precertification? P.O. With Basic Option, you can enjoy no deductible with care from in-network providers. Open Season is typically the second Monday of November through the second Monday of December each year. Blue Cross and Blue Shield Service Benefit Plan. Blue Cross and Blue Shield Service Benefit Plan 2022 Rate Information for the Blue Cross and Blue Shield Service Benefit Plan SB22.13 Page 2 of 2 1/1/2021 Basic Option, Self Plus One, Enrollment Code 113: Premium Rate Biweekly government share: $524.63 Biweekly your share: $196.13 Monthly your share: $424.95 Basic Option, Self and Family .

Your eligible family member can include either a spouse OR a child up to age 26. 105: blue cross and blue shield service benef --self and family: 01/01/2021 12/31/2020 106: blue cross and blue shield service benef --self plus one: 01/01/2021 12/31/2020 111: blue cross and blue shield service benef --self only . Questions? If you are using assistive technology to view web content, please ensure your settings allow for the page content to update after initial load (this is sometimes called "forms mode").

You'll need the full name of the health plan and the enrollment code to enroll.

Emergency & Urgent Care - What is the member cost share for Urgent Care? Dental - Does the plan cover Preventive Dental for Children? traditional coverage begins. While all of our plans offer comprehensive benefits for you and your family, they are structured differently to complement different health care needs. Member Cost with Medicare Advantage (Part C) Primary - This is the amount you pay for an inpatient hospital stay.

During Open Season, if you want to stay with the same plan, you do not have to make an enrollment change. You must tell us if you or a covered family member has coverage under any other group health plan, including a Medicare plan, or has automobile insurance that pays healthcare expenses without regard to fault. Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals, 5(b). If you are a career bargaining unit employee represented by the agreement with NPPN, you will find your premium rates on, 5(a). If you're a new employee eligible for Federal Employees Health Benefits (FEHB) coverage, you have 60 days from your start date (also known as your entry on duty date) to enroll in a health plan.

Dental - Does the plan cover Preventive Dental for Adults? Blue Cross and Blue Shield Service Benefit Plan (Standard), Blue Cross and Blue Shield Service Benefit Plan (Standard) -, (NA is displayed if a plan did not report or is unable to report a result in this coverage area. Your member ID card is your key to using your medical plan benefits. Member Cost with Medicare A & B Primary - This is the amount you pay for an outpatient hospital visit when you have Medicare Parts A & B as your primary coverage.What is the amount a member with Medicare A and B pays for an outpatient hospital visit? For the full list of services and treatments, including rules and exceptions, see Section 3 of the Standard and Basic Option brochureor the FEP Blue Focus brochure. We use cookies on this website to give you the best experience and measure website usage.

Temporary Continuation of Coverage (TCC) allows former employees to continue their healthcare coverage for up to 18 months and eligible family members to continue their healthcare coverage for up to 36 months. Member Cost with Medicare Advantage (Part C) Primary - This is the amount you pay for a primary care visit.

Members report getting the care they need.

traditional coverage begins. You have the following options to enroll: Office of Personnel Management If you are covered under our Plan as a dependent, any group health insurance you have from your employer will pay primary and we will pay secondary. Your Tribal employer may choose to contribute a higher portion of your premium. If you are an actively working federal employee and want to become a member of the Blue Cross and Blue Shield Service Benefit Plan, there are two ways you can enroll: Youll need the full name of the health plan and the enrollment code to enroll. Hear Federal Employee stories as told in their own words. When you have Medicare C, some plans waive this amount. Enrollment Codes When to enroll Open Season If you are enrolling for the first time or need to make changes to your current plan, follow these steps: Active Employees - Standard Option and Basic Option Enrollment: Confirm your type of enrollment (self or family), the plan you'd like to join, and make a note of the corresponding FEHB enrollment code: Blue Cross and Blue Shield Service Benefit Plan, Enroll online using your agency's method:*, Most Federal Departments participate in Employee Express, Department of Defense: Department of Defense automated enrollment systems, U.S. Standard Option gives you the flexibility to receive care both in and out-of-network. Member Cost with Medicare Advantage (Part C) Primary - This is the amount you pay for a Specialty care visit. The amount shown under employee contribution is the maximum you will pay. Additionally, if you are using assistive technology and would like to be notified of items via alert boxes, please, This website uses features which update page content based on user actions. Basic Option gives you access to our Preferred provider network that includes 96% of hospitals and 95% of doctors in the U.S. With Basic Option, you must see Preferred providers to get care. 2022 Blue Cross Blue Shield Association. 2021 Blue Cross Blue Shield Association. Check premiums on our website at 105: blue cross and blue shield service benef--self and family: 01/01/2002 present 106: blue cross and blue shield service benef --self plus one: 01/01/2016 present 111: blue cross and blue shield service benef--self only .

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