Blue Cross Blue Shield Basic vs Standard

Secure Your Spot: Limited-time for Free Consultations With Top Advisors Ending Soon

1,000+ Federal Employees have already secured a spot.

Get Yours Now! With -

Retirement Planning, Financial Planning, Life Insurance Planning, Investment Advice, 403 b plan, Social Security, FERS and TSP.

Click To Grab This Opportunity

January 23, 2025

Blue Cross Blue Shield Basic vs Standard

Blue cross blue shield basic vs standard plans are both health insurance options, but they have key differences in terms of coverage, costs, and out-of-pocket expenses. Here's a breakdown:

Blue Cross Blue Shield Basic

‍

Lower Premiums: Generally, the Basic plan has lower monthly premiums compared to the Standard plan.
No Deductible: This means you don't have to pay a certain amount out-of-pocket before your insurance starts covering costs.
Limited Out-of-Network Coverage: Typically, the Basic plan has limited or no coverage for out-of-network providers.
Medicare Part B Reimbursement: The Basic plan often includes a reimbursement for Medicare Part B premiums.
May Have Higher Co-pays: You might have higher co-pays for certain services compared to the Standard plan.

Blue Cross Blue Shield Standard

Higher Premiums: The Standard plan usually has higher monthly premiums than the Basic plan.
Deductible: You'll typically have a deductible that you need to meet before your insurance starts covering most costs.
Broader Network: The Standard plan usually offers broader coverage for out-of-network providers.
No Medicare Part B Reimbursement: The Standard plan typically doesn't include a reimbursement for Medicare Part B premiums.
May Have Lower Co-pays: You might have lower co-pays for some services compared to the Basic plan.

Which Plan is Right for You?

‍

The best plan for you depends on your individual needs and circumstances. Consider these factors:

Budget: If you're on a tight budget, the Basic plan's lower premiums might be more appealing.
Health Needs: If you have significant health concerns or anticipate needing frequent medical care, the Standard plan's broader coverage and potentially lower co-pays might be more beneficial.
Out-of-Network Care: If you prefer to see out-of-network providers or are concerned about needing out-of-network care, the Standard plan's broader coverage is likely a better choice.
Medicare Coverage: If you have Medicare Part A and B, the Basic plan's reimbursement for Medicare Part B premiums could be a significant cost savings.

FEP Blue Focus^®

Must stay in-network
Out-of-pocket costs include copays and coinsurance
Earn $150 on your MyBlue® Wellness Card for getting an annual physical
Has a deductible

FEP Blue Basic™

Must stay in-network
Most out-of-pocket costs are copays
Earn up to $170 a year on your MyBlue® Wellness Card
Eligible members with Medicare can get up to $800 Medicare Part B reimbursement
Access to Mail Service Pharmacy Program for members with Medicare Part B
Has no deductible

FEP Blue Standard™

Can see any provider, even outside the network
Out-of-pocket costs include copays and coinsurance
Access to Mail Service Pharmacy Program
Earn up to $170 a year on your MyBlue® Wellness Card
Has a deductible

‍

2025 FEHB Plan Rates

Enrollment Code	Bi-weekly	Monthly
Self Only 131	$59.17	$128.21
Self + 1 133	$127.21	$275.63
Self & Family 132	$139.92	$303.17

‍

FEP Blue Basic™ - 2025 Plan Rates

Enrollment Code	Bi-weekly	Monthly
Self Only (111)	$113.16	$245.18
Self + 1 (113)	$274.14	$593.97
Self & Family (112)	$303.61	$657.82

‍

FEP Blue Standard™ - 2025 Plan Rates

Enrollment Code	Bi-weekly	Monthly
Self Only (104)	$174.81	$378.76
Self + 1 (106)	$384.14	$832.31
Self & Family (105)	$424.65	$920.07

‍

Compare FEHB Benefit Options

‍

Comparison of FEP Blue Plans - 2025

Virtual Doctor Visits

Plan	Details
FEP Blue Focus®	$0 copay
FEP Blue Basic™	$0 copay
FEP Blue Standard™	$0 copay

Preventive Care

Plan	Details
FEP Blue Focus®	$0 copay for covered preventive screenings, immunizations, and services
FEP Blue Basic™	$0 copay for covered preventive screenings, immunizations, and services
FEP Blue Standard™	$0 copay for covered preventive screenings, immunizations, and services

Physician and Mental Health Care

Plan	Primary Care	Specialist Care	Mental Health Visits
FEP Blue Focus®	$10 per visit for first 10 visits	$10 per visit for first 10 visits	$10 per visit for first 10 visits
FEP Blue Basic™	$35 copay	$50 copay	$35 copay
FEP Blue Standard™	$30 copay	$40 copay	$30 copay

Prescription Drugs

Plan	Retail Pharmacy	Mail Service Pharmacy	Specialty Pharmacy
FEP Blue Focus®	Generics: $5 copay Preferred Brand: 40% of allowance ($350 max)	Not a benefit	Preferred Specialty: 40% of allowance ($350 max)
FEP Blue Basic™	Generics: $15 copay Preferred Brand: $75 copay Non-Preferred: 60% of allowance ($90 min)	Generics: $20 copay Preferred Brand: $100 copay Non-Preferred: $125 copay	Preferred Specialty: $120 Non-Preferred Specialty: $200
FEP Blue Standard™	Generics: $7.50 copay Preferred Brand: 30% of allowance Non-Preferred: 50% of allowance	Generics: $15 copay Preferred Brand: $90 copay Non-Preferred: $125 copay	Preferred Specialty: $65 Non-Preferred Specialty: $85

Deductibles and Out-of-Pocket Maximums

Plan	Annual Deductible	Out-of-Pocket Maximum (PPO)	Medicare Drug Program Max
FEP Blue Focus®	Self Only: $500 Self + One/Family: $1,000	Self Only: $9,000 Self + One/Family: $18,000	$2,000 per member
FEP Blue Basic™	None	Self Only: $7,500 Self + One/Family: $15,000	$2,000 per member
FEP Blue Standard™	Self Only: $350 Self + One/Family: $700	Self Only: $6,000 Self + One/Family: $12,000	$2,000 per member

I’m an Active Federal Employee, How Can I Enroll in The Service Benefit Plan?

‍

If you are a new employee to the federal government or need to make changes to your current plan and are currently eligible to update or enroll in coverage, visit our How to Enroll page to get started.

‍

I’m Already a Member, do I Need to Re-Enroll Every Year?

‍

No, your coverage will automatically carry over year over year unless you decide to make a change.

When is Open Season?

‍

Open Season is typically the second Monday of November through the second Monday of December each year.

What is the Difference Between FEP Blue Focus®, FEP Blue Basic™ and FEP Blue Standard™?

‍

While all of our plans offer comprehensive benefits for you and your family, they are structured differently to complement different health care needs. FEP Blue Focus offers quality health care coverage from in-network providers, plus budget-friendly benefits. With FEP Blue Basic, you can enjoy no deductible with care from in-network providers. FEP Blue Standard gives you the flexibility to receive care both in and out-of-network.

‍

For More Information About The Differences Between The Three Plans, You Can:

‍

Visit the Compare Our Plans page
Consult the Blue Cross and Blue Shield Service Benefit Plan brochures
Use the AskBlue FEP Medical Plan Finder interactive comparison tool

‍

What is a Prior Approval?

‍

Certain medical services and treatments need approval before you receive care. We review them to ensure they are medically necessary. If you do not get prior approval (also known as prior authorization), we may reduce or deny your benefit. In most cases, your doctor or facility will submit approval requests. However, you should always ask your provider if they have contacted us and provided the information we need—you are responsible for ensuring your care is approved. Special rules may apply when Medicare or another insurance is your primary coverage.

For the full list of services and treatments, including rules and exceptions, see Section 3 of the FEP Blue Standard and FEP Blue Basic brochure or the FEP Blue Focus brochure.

‍