Blue Cross and Blue Shield, FEP Blue Focus: 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 131 | $74.16 gov $222.50 | $160.69 | $160.69 | +$7.35 biweekly | $1,928 |
| Self Plus One code 133 | $159.43 gov $478.31 | $345.44 | $345.44 | +$15.80 biweekly | $4,145 |
| Self and Family code 132 | $175.35 gov $526.07 | $379.93 | $379.93 | +$17.38 biweekly | $4,559 |
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 | $1,000 out of network Not applicable | $2,000 out of network Not applicable | $2,000 out of network Not applicable |
| Out-of-pocket maximum | $11,000 out of network Not applicable | $22,000 out of network Not applicable | $22,000 out of network Not applicable |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing No deductible. | Member Pays All Charges |
| Primary care visit | $10 Copayment 30% of the Plan allowance, plus deductible, for the 11th and subsequent visits. | Member Pays All Charges |
| Specialist visit | $10 Copayment 30% of the Plan allowance, plus deductible, for the 11th and subsequent visits. | Member Pays All Charges |
| Urgent care | $25 Copayment No cost when related to an accidental injury care received w/in 72 hours. | $25 Copayment When NSA protections apply. Otherwise, member pays all charges |
| Emergency room | 30% Coinsurance Deductible Applies, no cost when related to an accidental injury care received w/in 72 hours. | 30% Coinsurance Deductible Applies, no cost when related to an accidental injury care received w/in 72 hours. |
| Labs and X-rays | 30% Coinsurance Deductible applies. Select labs are covered with $0 member cost-share for the first 10 tests. | Member Pays All Charges |
| CT, MRI, PET | 30% Coinsurance Deductible applies. Prior approval required for some services. | Member Pays All Charges |
| Hospital stay, per admission | 30% Coinsurance Deductible applies. Precertification required. | Member Pays All Charges |
| Hospital room | Member Pays Nothing These costs are included in the hospital inpatient per admission copayment. | Member Pays All Charges |
| Surgeon, inpatient | 30% Coinsurance Deductible applies. Prior approval required for some surgical services. See brochure. | Member Pays All Charges |
| Outpatient surgery | 30% Coinsurance Deductible applies. Prior approval required for some services. | Member Pays All Charges |
| Mental health, office | $10 Copayment 30% of the Plan allowance, plus deductible, for the 11th and subsequent visits. | Member Pays All Charges |
| Mental health, inpatient | 30% Coinsurance Deductible applies. | Member Pays All Charges |
| Physical therapy | $25 Copayment Limited to 25 combined visits with occupational and speech therapies. | Member Pays All Charges |
| Chiropractic | $25 Copayment Limited to 10 visits combined with acupuncture. | Member Pays All Charges |
| Acupuncture | $25 Copayment limited to 10 visits per year combined with manipulative treatment. | Member Pays All Charges |
| Maternity care | Member Pays Nothing Facility care subject to a $3000 per pregnancy copayment. | Member Pays All Charges |
| Maternity hospital stay | $3,000 Copayment Limited to $3,000 per pregnancy for facility care. | Member Pays All Charges |
| Infertility diagnosis and treatment | 30% Coinsurance Some services require prior approval. | Member Pays All Charges |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Not Covered | Not Covered |
| Durable medical equipment | 30% Coinsurance Deductible Applies, Specialty DME requires Prior Approval. | Member Pays All Charges |
| Home health | $25 Copayment Limited to 2 hours per day 10 visits per year. | Member Pays All Charges |
| Adult dental exams | Not Covered | Not Covered |
| Children's dental exams | Not Covered | Not Covered |
| Routine eye exam | Not Covered | Not Covered |
| Eyeglasses | Not Covered Routine eyeglasses not covered. See brochure for limited coverage. | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $5 Copayment | Not applicable |
| Tier 2 | 40% Coinsurance | Not applicable |
| Tier 3 | 40% Coinsurance | Not applicable |
| Mail order | No | No |
| Prescription out-of-pocket maximum, Self | None | Not listed |
| Prescription out-of-pocket maximum, family | None | Not listed |
| WITH MEDICARE | ||
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 71-017 · 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.
