2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 9. Coordinating Benefits With Medicare and Other Coverage
Page 128
Section 9. Coordinating Benefits With Medicare and Other Coverage
Page 128
Please review the following examples illustrating your cost-share liabilities when Medicare is your primary payor and your provider is in our network and participates with Medicare compared to what you pay without Medicare. Please do not rely on this chart alone but read all information in this section of the brochure. You can find more information about how our Plan coordinates with Medicare in our Medicare and You Guide for Federal Employees available online at www.fepblue.org.
Benefit Description: Deductible
FEP Blue Focus You Pay Without Medicare Parts A & B: $500-Self, $1,000-Family
FEP Blue Focus You Pay With Medicare Parts A & B: $500-Self, $1,000-Family
Benefit Description: Catastrophic Protection Out-of-Pocket Maximum
FEP Blue Focus You Pay Without Medicare Parts A & B: $9,000-Self, $18,000-Family
FEP Blue Focus You Pay With Medicare Parts A & B: $9,000-Self, $18,000-Family
Benefit Description: Part B Premium Reimbursement
FEP Blue Focus You Pay Without Medicare Parts A & B: N/A
FEP Blue Focus You Pay With Medicare Parts A & B: N/A
Benefit Description: Primary Care Provider
FEP Blue Focus You Pay Without Medicare Parts A & B: $10 or 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Specialist
FEP Blue Focus You Pay Without Medicare Parts A & B: $10 or 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Inpatient Hospital
FEP Blue Focus You Pay Without Medicare Parts A & B: 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Outpatient Hospital
FEP Blue Focus You Pay Without Medicare Parts A & B: 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Incentives Offered
FEP Blue Focus You Pay Without Medicare Parts A & B: N/A
FEP Blue Focus You Pay With Medicare Parts A & B: N/A
Benefit Description: Deductible
FEP Blue Focus You Pay Without Medicare Parts A & B: $500-Self, $1,000-Family
FEP Blue Focus You Pay With Medicare Parts A & B: $500-Self, $1,000-Family
Benefit Description: Catastrophic Protection Out-of-Pocket Maximum
FEP Blue Focus You Pay Without Medicare Parts A & B: $9,000-Self, $18,000-Family
FEP Blue Focus You Pay With Medicare Parts A & B: $9,000-Self, $18,000-Family
Benefit Description: Part B Premium Reimbursement
FEP Blue Focus You Pay Without Medicare Parts A & B: N/A
FEP Blue Focus You Pay With Medicare Parts A & B: N/A
Benefit Description: Primary Care Provider
FEP Blue Focus You Pay Without Medicare Parts A & B: $10 or 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Specialist
FEP Blue Focus You Pay Without Medicare Parts A & B: $10 or 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Inpatient Hospital
FEP Blue Focus You Pay Without Medicare Parts A & B: 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Outpatient Hospital
FEP Blue Focus You Pay Without Medicare Parts A & B: 30%
FEP Blue Focus You Pay With Medicare Parts A & B: $0.00
Benefit Description: Incentives Offered
FEP Blue Focus You Pay Without Medicare Parts A & B: N/A
FEP Blue Focus You Pay With Medicare Parts A & B: N/A