Blue Cross Blue Shield Federal Employee Program logo
 
 
 
2023 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 2. Changes for 2023
Changes to our Basic Option only
 
Changes to our Basic Option only
  • Your cost-share for outpatient surgical and treatment services performed and billed by a facility is now a $150 copayment per day per facility. Previously, you paid a $100 copayment per day per facility for these services. (See page 81.)
     
  • Your cost-share for laboratory tests (such as blood tests and urinalysis), pathology services, and EKGs is now a 15% coinsurance. Previously, you paid nothing for these services. (See page 40 and 85.)
     
  • Your copayment for an inpatient admission is now a $250 per day copayment for up to $1,500 per admission for unlimited days. Previously, you paid a $175 copayment per admission up to $875 for unlimited days. (See pages 4776, 7987 and 100.)
     
  • We now cover 12 acupuncture visits per calendar year. Previously, we covered 10 acupuncture visits per calendar year. (See page 60.)
     
  • Your copayment for outpatient observation services performed and billed by a hospital or freestanding ambulatory facility is now a $250 per day copayment up to $1,500. Previously, you paid a $175 per day copayment up to $875. (See page 82.)
     
  • Your cost-share for outpatient diagnostic testing and treatment services performed and billed by a facility is now a $200 copayment per day per facility. Previously, you paid a $150 copayment per day per facility for these services. (See page 83.)
     
  • Your cost-share for outpatient hospital emergency room services and supplies, including professional provider services, diagnostic studies, radiology services, laboratory tests, and pathology services, when billed by the hospital is now a $250 per day per facility copayment. Previously, your copayment for these services was $175. (See pages 95 and 96.)
     
  • Your copayment for Tier 1 (generic drugs) without Medicare Part B primary, is now $15 for each purchase of up to a 30-day supply ($40 for a 31 to 90-day supply). Previously, your copayment was $10 for each purchase of up to a 30-day supply ($30 for a 31 to 90-day supply). (See page 114.)
     
  • Your copayment for Tier 2 (preferred brand-name drugs) without Medicare Part B primary, is now $60 for each purchase of up to a 30-day supply ($180 for a 31 to 90-day supply). Previously, your copayment was $55 for each purchase of up to a 30-day supply ($165 for a 31 to 90-day supply). (See page 114.)
     
  • You are now responsible for up to a $90 minimum copayment for Tier 3 (non-preferred brand-name) drugs for up to a 30-day supply ($250 minimum for a 31 to 90-day supply) without Medicare Part B primary. Previously, you were responsible for a $75 minimum for up to a 30-day supply ($210 minimum for a 31 to 90-day supply). (See page 114.)