Blue Cross and Blue Shield, Standard Option: 2027 FEHB premiums and benefits
| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code 104 | $204.65 gov $352.04 | $443.41 | $443.41 | +$16.33 biweekly | $5,321 |
| Self Plus One code 106 | $449.89 gov $767.53 | $974.76 | $974.76 | +$39.01 biweekly | $11,697 |
| Self and Family code 105 | $496.90 gov $843.82 | $1,076.61 | $1,076.61 | +$39.24 biweekly | $12,919 |
Traditional, PPO network. Offered nationwide: anyone eligible for FEHB can enroll, in any state. The government share is the lesser of 72% of the program-wide average premium or 75% of this plan's premium (5 U.S.C. 8906).
Educational information only; StandWatch is not acting for OPM, and the brochure and your agency's benefits office are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $500 out of network $500 | $1,000 out of network $1,000 | $1,000 out of network $1,000 |
| Out-of-pocket maximum | $7,000 out of network $9,000 | $14,000 out of network $18,000 | $14,000 out of network $18,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing No deductible. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Primary care visit | $30 Copayment No deductible. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Specialist visit | $40 Copayment No deductible. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Urgent care | $30 Copayment No Deductible. No cost when related to an accidental injury care received w/in 72 hours. | 35% Coinsurance + ded, + any difference between our allowance and the billed amount unless NSA protections apply. |
| Emergency room | 15% Coinsurance Deductible Applies, no cost when related to an accidental injury care received w/in 72 hours. | 15% Coinsurance Deductible Applies, no cost when related to an accidental injury care received w/in 72 hours. |
| Labs and X-rays | 15% Coinsurance Deductible applies. | 35% Coinsurance Deductible applies, plus any difference between our allowance and the billed amount. |
| CT, MRI, PET | 15% Coinsurance Deductible applies. Prior approval required for some services. | 35% Coinsurance Deductible applies, plus any difference between our allowance and the billed amount. |
| Hospital stay, per admission | $450 Copayment Per admission, no deductible, precertification required. | $450 Copayment Per admission + 35% of the Plan allowance, no deductible, any balance after we pay, precert req. |
| Hospital room | Member Pays Nothing These costs are included in the hospital inpatient cost per admission copayment. | Member Pays Nothing These costs are included in the hospital inpatient cost per admission copayment. |
| Surgeon, inpatient | 15% Coinsurance Deductible applies. Prior approval required for some surgical services. See brochure. | 35% Coinsurance Deductible applies, plus any difference between our allowance and the billed amount. |
| Outpatient surgery | 15% Coinsurance Deductible applies. | 35% Coinsurance Deductible applies, plus any difference between our allowance and the billed amount. |
| Mental health, office | $30 Copayment | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Mental health, inpatient | $450 Copayment Precertification Required | 35% Coinsurance And any remaining balance after our payment, precertification required. |
| Physical therapy | $30 Copayment $40 for a specialist, limited to 75 combined visits with occupational and speech therapies. | 35% Coinsurance Plus, ded and difference between our allowance and billed total of 75 visits with OT and ST. |
| Chiropractic | $30 Copayment Limited to 12 visits per year. | 35% Coinsurance Plus deductible plus any difference between Plan allowance and billed amount. Limited to 12/year. |
| Acupuncture | 15% Coinsurance Deductible applies, 24 visits per calendar year. | 35% Coinsurance Deductible applies, plus any difference between our allowance and the billed amount, 24 per year. |
| Maternity care | Member Pays Nothing | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Maternity hospital stay | Member Pays Nothing | $450 Copayment Plus 35% of the Plan allowance and any remaining balance after our payment. |
| Infertility diagnosis and treatment | 15% Coinsurance Deductible applies. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| IVF and assisted reproduction | 15% Coinsurance Deductible applies, limited to $25,000 per person per year. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. Limited to $25,000. |
| Hearing aids | Covered 1 every 5 years for adults, yearly for children under the age of 22. You pay any amount over $2500. | Covered 1 every 5 years for adults, yearly for children under the age of 22. You pay any amount over $2500. |
| Durable medical equipment | 15% Coinsurance Deductible applies. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Home health | 15% Coinsurance Deductible applies, limited to 50 visits per person per calendar year for 2 hours per day. | 35% Coinsurance Plus deductible and any difference between our allowance and the billed amount. |
| Adult dental exams | Covered You pay the difference between our payment and Maximum Allowable Charge. | Covered You pay all charges in excess of our scheduled amounts listed in the brochure. |
| Children's dental exams | Covered You pay the difference between our payment and Maximum Allowable Charge. | Covered You pay all charges in excess of our scheduled amounts listed in the brochure. |
| Routine eye exam | Not Covered | Not Covered |
| Eyeglasses | Not Covered Routine eyeglasses not covered. See brochure for limited coverage. | Not Covered Routine eyeglasses not covered. See brochure for limited coverage. |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $7.50 Copayment | 45% Coinsurance |
| Tier 2 | 30% Coinsurance | 45% Coinsurance |
| Tier 3 | 50% Coinsurance | 45% Coinsurance |
| Tier 4 | 30% Coinsurance | 45% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | None | Not listed |
| Prescription out-of-pocket maximum, family | None | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | None | Not listed |
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
Blue Cross and Blue Shield plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 71-005 · 3122976000
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the Office of Personnel Management or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM FEHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM premium charts for the change from 2026.
