Jeffrey Wade
The Federal Employee Program (FEP) Blue Cross and Blue Shield offers a Medicare Prescription Drug Program (MPDP) that provides prescription drug coverage to its members. The MPDP is a prescription drug plan with a Medicare contract, and eligible members with Medicare get lower out-of-pocket costs for higher-cost drugs and additional approved prescription drugs. The program includes a comprehensive formulary, covering almost all US FDA-approved drugs, and offers convenient access to prescription drugs through over 55,000 retail pharmacies, the FEP Mail Service Program, or the FEP Specialty Pharmacy Program.
| Characteristics | Values |
|---|---|
| Number of drug tiers | 5 for FEP Blue Basic and FEP Blue Standard, 2 for FEP Blue Focus, 4 for MPDP for all plans |
| Types of drugs covered | Generic, Preferred Brand Name, Non-preferred Brand Name, Preferred Specialty, Non-preferred Specialty |
| Number of in-network pharmacies | Over 55,000 |
| Prescription drug delivery | Available for FEP Blue Standard and FEP Blue Basic members with Medicare Part B primary |
| Prescription drug cost tool | Available for members with a MyBlue account |
| Generic drug incentive program | Available for FEP Blue Standard members |
| Prescription drug plan | FEP Medicare Prescription Drug Program (MPDP) |
| MPDP eligibility | FEP member, enrolled in Medicare Part A and/or Part B, resident of the U.S. or a U.S. territory |
| MPDP out-of-pocket maximum | $2,000 in 2025 |
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What You'll Learn
- FEP Blue Standard and FEP Blue Basic have five drug tiers
- Members can get prescriptions delivered to their door
- The FEP Medicare Prescription Drug Program (MPDP) has four drug tiers
- FEP Blue Standard members can purchase prescription drugs from a non-preferred pharmacy
- FEP Blue Standard members can access the Mail Service Pharmacy Program
FEP Blue Standard and FEP Blue Basic have five drug tiers
FEP Blue Cross offers a Federal Employee Program that includes prescription drug coverage and pharmacy programs. The FEP Blue Standard and FEP Blue Basic plans offer comprehensive formulary coverage, meaning they cover almost all U.S. FDA-approved drugs. However, there is a small list of excluded drugs that are not covered by these plans.
- Tier 1 Generics
- Tier 2 Preferred Brand Name, Preferred Generic Specialty, and Preferred Brand Name Specialty
- Tier 3 Non-preferred Brand Name
- Tier 4 Preferred Specialty
- Tier 5 Non-preferred Specialty
The amount you pay for a drug depends on the tier it falls under, with lower-tier drugs generally costing less. FEP Blue Standard members can purchase prescription drugs from non-preferred pharmacies, but they will have to pay the full amount for these items.
FEP Blue Standard members also have access to the Mail Service Pharmacy Program, which allows them to get prescription drugs delivered directly to their door. Additionally, FEP Blue Standard offers a Generic Incentive Program, where members who switch to a generic medication can have their cost share waived for their first four prescription fills or refills.
FEP Blue Basic members taking a ""Managed Not Covered" drug should expect to pay the full cost of the prescription. However, there may be alternative generic or brand-name drugs that can effectively treat the same condition, which may help save money on prescriptions.
Both FEP Blue Standard and FEP Blue Basic members with Medicare Part B primary can get their prescriptions delivered directly to their door through the FEP Mail Service Program or the FEP Specialty Pharmacy Program.
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Members can get prescriptions delivered to their door
Blue Cross and Blue Shield's Federal Employee Program (FEP) offers a range of prescription drug benefits to its members. The FEP Medicare Prescription Drug Program (MPDP) is a prescription drug plan that is available exclusively to FEP members with Medicare. It offers lower out-of-pocket costs for higher-cost drugs and puts a cap on the amount members pay out-of-pocket annually for prescriptions.
FEP members can also take advantage of the FEP Mail Service Program, which allows them to get their prescriptions delivered directly to their door. This program is particularly useful for members who require specialty drugs, as it helps them obtain these medications at a reasonable cost.
The FEP Blue Standard plan provides access to a network of over 55,000 retail pharmacies, as well as out-of-network providers. Members with Medicare get lower out-of-pocket costs for higher-cost drugs and additional approved prescription drugs. The FEP Blue Basic plan also offers prescription drug coverage, although certain drugs known as "Managed Not Covered" drugs are not included.
The FEP website provides a Prescription Drug Cost Tool that allows members to check drug costs, see if their drug is covered under their plan, and compare costs for different drugs. This tool can be accessed through the member's MyBlue® account, which can also be used to access the Mail Service Pharmacy and place mail-order prescriptions for delivery to their home.
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The FEP Medicare Prescription Drug Program (MPDP) has four drug tiers
The FEP Medicare Prescription Drug Program (MPDP) is a prescription drug plan with a Medicare contract. It is a prescription drug benefit exclusively for Blue Cross and Blue Shield Federal Employee Program (FEP) members with Medicare. It is part of the Blue Cross and Blue Shield Service Benefit Plan coverage, which means there is no separate premium for prescription drug coverage.
The MPDP has four drug tiers for all of its plans. The drugs are organised into tiers, with the amount paid dependent on the tier. The lower the tier, the less you pay. The tiers are:
- Generics
- Preferred Brand Name
- Non-preferred Brand Name
- Preferred Specialty
- Non-preferred Specialty
The MPDP offers additional approved prescription drugs in some tiers than the traditional pharmacy benefit. It also offers lower out-of-pocket costs for higher-cost drugs and has a cap on the amount paid out-of-pocket on prescriptions annually. This cap is set at $2,000 per member for 2025.
The FEP Medicare Prescription Drug Program is available to residents of the US or a US territory. It cannot be used to purchase drugs overseas.
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FEP Blue Standard members can purchase prescription drugs from a non-preferred pharmacy
FEP Blue Standard has a comprehensive formulary, meaning it covers almost all U.S. FDA-approved drugs. However, there is a small list of excluded drugs that are not covered. These "Excluded" drugs have alternative options that are generic or brand-name, which may help members save money on their prescriptions.
FEP Blue Standard members can also take advantage of the Generic Incentive Program, where the cost share for the first four prescription fills or refills is waived if they switch to a generic medication. Additionally, FEP Blue Standard members with Medicare Part B primary can get their prescriptions delivered directly to their door at a reasonable cost.
The FEP Medicare Prescription Drug Program (MPDP) is also available to eligible members with Medicare, offering lower out-of-pocket costs for higher-cost drugs and additional approved prescription drugs in some tiers. This program has an annual pharmacy out-of-pocket maximum, meaning there is a cap on the amount members will pay in copays and coinsurance for prescription drugs for the year.
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FEP Blue Standard members can access the Mail Service Pharmacy Program
FEP Blue Standard® is a health insurance plan offered by Blue Cross and Blue Shield as part of their Federal Employee Program. The plan provides access to a network of over 2 million doctors and hospitals, as well as over 55,000 retail pharmacies, and also allows access to out-of-network providers.
The FEP Blue Standard plan has a comprehensive formulary, meaning it covers almost all U.S. FDA-approved drugs. There is a small list of excluded drugs that are not covered, and for these, members will have to pay the full cost of the prescription. The amount members pay for a drug depends on the tier it is in, with five drug tiers under the traditional pharmacy benefit for FEP Blue Standard. In general, the lower the drug tier, the less the member pays.
The FEP Medicare Prescription Drug Program (MPDP) is a prescription drug plan with a Medicare contract, offering additional approved prescription drugs in some tiers, lower out-of-pocket costs for higher-cost drugs, and an annual cap on the amount paid out-of-pocket for prescriptions. Enrollment in MPDP depends on contract renewal, and the formulary and/or pharmacy network may change at any time.
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Frequently asked questions
The FEP Medicare Prescription Drug Program is a prescription drug plan with a Medicare contract. Enrollment in MPDP depends on your Medicare contract renewal.
FEP Blue Basic members taking a “Managed Not Covered” drug should expect to pay the full cost of the prescription. A few drugs are not covered on the FEP Blue Standard formulary. These “Excluded” drugs have other drugs available that treat the same condition. FEP Blue Standard has a comprehensive formulary, meaning it covers almost all U.S. FDA-approved drugs.
Most drugs are covered without requiring prior approval. However, some select drugs require your doctor to provide information about your prescription to determine coverage. Your doctor can submit prior approval electronically, by fax, or by mail.
With FEP Blue Standard, you get access to a network with over 2 million doctors and hospitals and over 55,000 retail pharmacies, plus access to out-of-network providers.
