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Cover Page and Inside Cover
Table of Contents
Introduction/Plain Language/Advisory
FEHB Facts
Section 1
Section 2
Section 3
Section 4
Section 5
5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
5(b). 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(d). Emergency Services/Accidents
5(e). Mental Health and Substance Use Disorder Benefits
5(f). Prescription Drug Benefits
5(g). Dental Benefits
5(h). Wellness and Other Special Features
5(i). Services, Drugs, and Supplies Provided Overseas
Non-FEHB Benefits Available to Plan Members
Section 6
Section 7
Section 8
Section 9
Section 10
Index
Summary of Benefits – Standard Option
Summary of Benefits – Basic Option
2025 Rate Information
Entire brochure in page-number order
 
Blue Cross Blue Shield Federal Employee Program logo
 
 

 

2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 5. Benefits

Section 5(f). Prescription Drug Benefits
Covered Medications and Supplies

 

Benefits Description

Immunizations when provided by a Preferred retail pharmacy that participates in our vaccine network (see below) and administered in compliance with applicable state law and pharmacy certification requirements.

Note: Our vaccine network is a network of Preferred retail pharmacies that have agreements with us to administer one or more routine immunizations. Check with your pharmacy or call our Retail Pharmacy Program at 800-624-5060, TTY: 711, to find out which vaccines your pharmacy can provide.


Standard Option - You Pay
Preferred retail pharmacy: Nothing (no deductible)

Non-preferred retail pharmacy: You pay all charges (except as noted below)

Note: You pay nothing for influenza (flu) vaccines obtained at Non-preferred retail pharmacies.

Basic Option - You Pay
Preferred retail pharmacy: Nothing

Non-preferred retail pharmacy: You pay all charges (except as noted below)

Note: You pay nothing for influenza (flu) vaccines obtained at Non-preferred retail pharmacies.
 

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