2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(f). Prescription Drug Benefits
Page 100
Section 5(f). Prescription Drug Benefits
Page 100
Benefits Description
Drugs From Other Sources (cont.)
Note: Prior approval is required for certain medical benefit drugs that will be submitted on a medical claim for reimbursement. Contact the customer service number on the back of your ID card or visit us at www.fepblue.org/medicalbenefitdrugs for a list of these drugs. See Section 3 for more information on prior approval.
You Pay
Preferred professional providers and facilities: 30% of the Plan allowance (deductible applies)
Non-preferred professional providers (Participating/Non-participating) and Non-preferred facilities (Member/Non-member): You pay all charges
Drugs From Other Sources (cont.)
Note: Prior approval is required for certain medical benefit drugs that will be submitted on a medical claim for reimbursement. Contact the customer service number on the back of your ID card or visit us at www.fepblue.org/medicalbenefitdrugs for a list of these drugs. See Section 3 for more information on prior approval.
You Pay
Preferred professional providers and facilities: 30% of the Plan allowance (deductible applies)
Non-preferred professional providers (Participating/Non-participating) and Non-preferred facilities (Member/Non-member): You pay all charges
Benefits Description
For members covered under our traditional pharmacy drug program
Auto-immune infusion medications: Remicade, Renflexis and Inflectra
Notes:
You Pay
Preferred professional providers and facilities: 30% of the Plan allowance (deductible applies)
Non-preferred professional providers (Participating/Non-participating) and Non-preferred facilities (Member/Non-member): You pay all charges
For members covered under our traditional pharmacy drug program
Auto-immune infusion medications: Remicade, Renflexis and Inflectra
Notes:
- Benefits for certain auto-immune infusion medications (limited to Remicade, Renflexis and Inflectra) are covered only when they are obtained by a non-pharmacy provider, such as a physician or facility (hospital or ambulatory surgical center).
- Members covered under the FEP Medicare Prescription Drug Program may obtain these drugs under their pharmacy benefits.
You Pay
Preferred professional providers and facilities: 30% of the Plan allowance (deductible applies)
Non-preferred professional providers (Participating/Non-participating) and Non-preferred facilities (Member/Non-member): You pay all charges