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2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 9. Coordinating Benefits With Medicare and Other Coverage
Page 152
 
The PDP EGWP opt out process:

If you were automatically group enrolled into our PDP EGWP and choose to opt out, you may have to wait to re-enroll during Open Season or for a QLE. Contact us at 888.338.7737 for assistance.

The PDP EGWP disenrollment process:

When you are enrolled in our PDP EGWP, you may choose to disenroll at any time. For information about how to disenroll, visit us at www.fepblue.org/medicarerx and look for the disenrollment form under the auto enrollment process and follow the instructions provided.

Warning: If you opt out of or disenroll from our PDP EGWP, you will not have any PSHB Program prescription drug coverage.

Note: If you choose to opt out of or disenroll from our PDP EGWP, your premium will not be reduced, and you may have to wait to re-enroll when and if you are eligible. If you do not maintain creditable coverage, re-enrollment in our PDP EGWP may be subject to a late enrollment penalty. Contact us for assistance at 888.338.7737.
 
• Medicare prescription drug coverage (Part B)

This health plan does not coordinate its prescription drug benefits with Medicare Part B.
 
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