Is Fepblue a PPO?

Asked by: Ms. Abigail Halvorson  |  Last update: February 11, 2022
Score: 4.3/5 (72 votes)

FEP Blue Focus is a national PPO product but with no out-of-network benefits. The Preferred network is the same as Standard and Basic Option. Members must use Preferred providers to receive benefits. Use our National Doctor and Hospital Finder to search the directory.

What type of insurance is FEP blue?

Washington – Today the Blue Cross and Blue Shield (BCBS) Government-wide Service Benefit Plan, also known as the Federal Employee Program® (FEP®), introduced FEP Blue FocusSM, a new coverage option for the federal workforce and retirees in the Federal Employees Health Benefits (FEHB) Program.

Is federal BCBS a PPO?

As a Preferred Provider Organization, or PPO, we have a network of doctors, hospitals and facilities that have contracted with us to provide medical services at a discounted rate. You'll pay less if you see someone in our network.

What is FEP Blue Cross Blue Shield?

For 60 years, the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program—or simply FEP—has provided health insurance to the federal employee workforce. We are proud to have been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960.

What is the difference between BCBS basic and FEP blue focus?

Both Standard Option and Basic Option offer some level of dental benefits. Basic Option provides coverage for preventive dental care services only, while Standard Option provides coverage for preventive dental care and some other non-routine services. FEP Blue Focus does not offer dental benefits.

PPO Vs. HMO: What's the Difference and Which is Better?

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Does Fepblue cover MRI?

Imaging (CT /PET scans, MRIs) 30% coinsurance Not covered Prior approval is required. There is a $100 penalty if prior approval is not obtained. More information about prescription drug coverage is available at fepblue.org/formulary Tier 1 (Preferred generic drugs) $5/prescription (30-day supply).

Which is better BCBS basic or standard?

Assessing other costs is more difficult to do but a major factor is using preferred providers. In my case, Basic is to my advantage due to premium cost. BCBS Basic in many ways has lower cost-sharing (copays/coinsurance) than Standard. In addition, it has lower premiums.

How do you check EOB on Fepblue?

You can view your personal EOBs through your MyBlue® account and on the fepblue app.

Do I need Medicare Part B if I have federal Blue Cross?

Most people who have retiree coverage must enroll in Medicare Part A and Part B when first eligible. ... As a federal retiree, if you don't enroll in Medicare, your FEHB plan will act as your primary insurer and won't pay less because you qualify for Medicare.

How do I contact Fepblue?

Member Questions

Federal Employee Program® (FEP) members should visit the FEP website. Learn about insurance options for Individuals & Families or Employers, or get connected with your local Blue Cross Blue Shield company by calling 888.630. 2583.

Does Fepblue cover cologuard?

In the interim, Centers for Medicare & Medicaid Services has indicated it will cover Cologuard every three years as previously specified and would reevaluate the screening interval after the Food and Drug Administration approval study is completed.

What is PPO insurance?

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.

What is a service benefit plan?

The Service Benefit Plan offers programs to help members manage their health. ... These programs are designed to improve the member's health and quality of life.

How is BCBS funded?

BCBS companies offer coverage through the Affordable Care Act marketplaces, and we also provide coverage through the Office of Personnel Management's multi-state plan. BCBS companies have partnered with the federal government to process Medicare claims and payments since the program's inception in 1966.

Does Fepblue cover medical transportation?

Medical Emergency

Standard Option: 15% of our allowance* and ground ambulance transportation is $100 per day. Basic Option: $175 per day and ground ambulance transportation is $100 per day. FEP Blue Focus: 30% of our allowance* and ground ambulance transportation is 30% of our allowance.

Does Fepblue cover genetic testing?

Benefits are available for specialized diagnostic genetic testing when it is medically necessary to diagnose and/or manage a patient"s existing medical condition.

Which FEHB plans reimburse for Medicare Part B?

Part B Reimbursement—A few FEHB plans now offer partial Part B premium reimbursement, including two national plans: Blue Cross Basic and GEHA High. Of course, if you're enrolled in a CDHP/HDHP plan, you can also use the HRA plan contribution to help pay for your Part B premiums as well.

Do federal employees go on Medicare?

Most Federal employees and annuitants are entitled to Medicare Part A at age 65 without cost. When you don't have to pay premiums for Medicare Part A, it makes good sense to obtain coverage.

Does Fepblue cover Silver Sneakers program?

Yes, FEP does not cover Silver Sneakers.

How do I file a Fepblue claim?

  1. You can fax the form, along with proof that you paid a Medicare Part B premium, to 877-353-9236.
  2. You can upload the form through the EZ Receipts mobile app, available at the App Store® and Google Play.
  3. You can upload the form through the online portal.

Who is a federal worker?

Who are federal employees? Federal employees are individuals who work for the federal government. This includes politicians, judges, and heads of departments such as Labor and State. Federal employees can also be civilians who work government jobs in areas like law enforcement, public health, science and engineering.

Does BCBS FEP cover cataract surgery?

All FEHB plans pay for medically necessary care of your eyes, such as cataract surgery. They are not true insurance plans and will pay neither for lost or broken glasses nor for medical or surgical care. ...

How do I add baby to Fepblue?

If you already have a Self and Family enrollment, log into your BENEFEDS account at www.BENEFEDS.com (external link) and add your new spouse or child to your enrollment. It's best to do this immediately, so there won't be any delay in claims or services.

What is the most popular FEHB plan?

The rankings were released as part of the 2020 FEHB Plan Performance Assessment, which rates 83 health plans across the country in the areas of quality and customer satisfaction. “I could not be any more proud that CDPHP has been named the preeminent health plan in the country for federal employee health benefits.

Whats better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.