Foreign Service Benefit Plan
The health plan that covers you in the U.S. and abroad
Coverage at a glance:
You have access to the Aetna Choice POS II network of doctors in the 50 United States for in-network coverage.
For members living in Guam, you have access to the NetCare Guam network for in-network coverage.
When you use an in-network provider, you receive covered services at a reduced cost.
You still have coverage if you choose to go out-of-network.
You will be responsible for the difference between the billed amount and what FSBP covers. You will likely end up paying more when you see an out-of-network provider.
You may choose to visit any doctor outside the U.S. and Guam (including Military Treatment Facilities) and we will cover them at the in-network benefit.
To further simplify your overseas care, we have over 300 Direct Billing Arrangements (DBA) with health care providers across the world. By using these DBA providers when available, you can avoid prepaying the bill. Learn more.
Why choose FSBP?
- Competitive premiums
- Comprehensive worldwide medical coverage
- In and out-of-network benefits
- Excellent prescription benefits
- Generous alternative benefits: 50 massages, 50 chiropractic, 50 acupuncture visits per year
- Wellness Incentive Program
AFSPA is the self-funded carrier of FSBP and also performs the customer service function for the Plan. Claims and clinical functions of FSBP are administered by Aetna. Prescription coverage for the Plan is administered by our Pharmacy Benefit Manager, Express Scripts.
FSBP has been accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) since 2016 and has achieved a full three-year term comprehensive health plan reaccreditation in 2022. Achieving this accreditation shows our commitment to providing the highest levels of quality care to our members by sustaining the same high level of quality in our business practices.
FSBP 2025 Premiums
| Enrollment | ENROLLMENT code | Bi-Weekly | Monthly |
|---|---|---|---|
| Self Only | 401 | $93.36 | $202.28 |
| Self Plus One | 403 | $251.52 | $544.96 |
| Self & Family | 402 | $230.95 | $500.40 |
There are two periods when Federal employees and retirees can enroll for the first time or switch their enrollment type.
All actively working or retired federal employees can enroll in, change or cancel their health plan during Open Season, which is typically the second Monday of November through the second Monday of December each year. Learn more.
New Employees
If you’re a new Federal employee eligible for Federal Employee Health Benefits (FEHB) coverage, you have 60 days from your start date to enroll in a health plan.
Qualifying Life Event
You may make changes to your health plan outside of Open Season if you have a qualifying life event. These include getting married, having a baby, getting divorced or you move outside of the plan’s coverage area. Learn more.
Benefit Information
FSBP is HIPAA compliant. The confidential medical information (i.e., Protected Health Information (PHI)) that you provide to us is kept strictly confidential and secure in our records. Click here for our Notice of Privacy Practices.
There are two ways to enroll in the Foreign Service Benefit Plan.
You must remember your enrollment code and the full name of the health plan.
- Self Only: 401
- Self Plus One: 403
- Self Plus Family: 402
- Use your agency's preferred method
- Contact your agency's HR office
Keep in mind: If you’re already a member of the Foreign Service Benefit Plan and you are happy with your coverage, you don’t have to do anything. Your coverage will automatically carry over each year.
Finding care
What we offer
Request a Call Back
I am satisfied with the service FSBP provides and their claim handling procedures. I have dealt with other carriers before, and thus far, FSBP is the best that I have worked with. In my opinion, FSBP is the best for overseas members.
Tom K.
As a subscriber to AFSPA/FSBP for about the last fifty-four years, I can say that I have always been totally satisfied with the benefits and services I have received over all those years at home and abroad.
Robert M.
FSBP Coverage & Benefits
| YOU PAY |
|---|
| Medical Services | In-Network (Aetna Choice POS II in U.S. , Netcare in Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Preventive care, to include one mental wellness screening, routine immunizations, and tests (includes dietary & nutritional counseling) | Nothing | 30% of our allowance and any difference between our allowance and the billed amount* | Nothing |
| Office & Telemedicine visits - all covered diagnostic, professional, and treatment services | 10% of our allowance* | 30% of our allowance and any difference between our allowance and the billed amount* | 10% of our allowance* |
| Walk in Clinic | Nothing at CVS Minute Clinic Nothing after a $10 copay at other walk-in clinics | 30% of our allowance and any difference between our allowance and the billed amount* | $10 copay per visit |
| Lab, X-ray, and other diagnostic tests | Nothing at LabCorp & Quest Diagnostics (U.S. only) 10% of our allowance at other network facilities* | 30% of our allowance and any difference between our allowance and the billed amount* | 10% of our allowance* |
| Telehealth | Nothing when using Teladoc®️ provider (U.S. Only) | No benefit | Nothing when using vHealth (Worldwide) for general medicine and (new for 2025) Lyra for behavioral health services |
| Complete maternity (obstetrical) care | Nothing Doula services covered up to $1,200 per calendar year | 30% of our allowance and any difference between our allowance and the billed amount | Nothing Doula services covered up to $1,200 per calendar year |
| Basic Infertility and Advanced Reproductive Technology (ART) Note: For Basic Infertility, members will not need prior authorization and services can be rendered by either an in-network or out-of-network provider. ART requires prior authorization and services must be rendered by an Institute of Excellence (IOE) Infertility provider | (new for 2025) 10% of our Plan allowance after deductible is met | N/A for ART services | (new for 2025) 10% of our Plan allowance after deductible is met |
| YOU PAY |
|---|
| Hospital Services | In-Network (Aetna Choice POS II in U.S. , Netcare in Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Inpatient | Nothing | $200 copayment per hospital admission and 20% of the Plan allowance and any difference between our allowance and the billed amount | Nothing |
| Outpatient - Surgical | 10% of our allowance* | 30% of our allowance and any difference between our allowance and the billed amount* | 10% of our allowance* |
| Outpatient - Medical | 10% of our allowance* | 30% of our allowance and any difference between our allowance and the billed amount* | 10% of our allowance* |
| YOU PAY |
|---|
| Emergency Benefits | In-Network (including Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Accidental injury: Initial treatment in an emergency room, urgent care center or doctor’s office, including physician’s charges/ancillary services | Nothing | Only the difference between our allowance and the billed amount | Nothing |
| Medical emergency | 10% of our allowance* | 10% of our allowance and any difference between our allowance and the billed amount* | 10% of our allowance* |
| Urgent care center | $35 copay per occurrence | $35 copay per occurrence and any difference between our allowance and the billed amount | $35 copay per occurrence |
| YOU PAY |
|---|
| Mental Health and substance abuse | In-Network (Aetna Choice POS II in U.S. , Netcare in Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Diagnostic, professional, and treatment services | 10% of our plan allowance* | 30% of our plan allowance and any difference between our allowance and the billed amount | 10% of our plan allowance* |
| Telehealth (behavioral health services) | Nothing when seen from a Teladoc® provider (U.S. only) | All costs (no benefit) | Nothing when seen from a Lyra provider |
| Inpatient hospital | Nothing | 20% of our plan allowance and any difference between our allowance and the billed amount for room and board and other services | Nothing |
| YOU PAY |
|---|
| Prescription drugs | Retail network pharmacies in the U.S. (up to 30-day supply) | Home Delivery (mail order through express scripts pharmacy or smart 90 retail (up to 90-day supply) |
|---|---|---|
| Tier 1 - Generic | $10 copay | $15 copay |
| Tier II - Preferred | 25% ($30 min, $100 max) | $60 copay |
| Tier III - Non Preferred Brand | 35% ($60 min, $200 max) | 35% ($80 min, $500 max) |
| Tier IV - Generic Specialty | 25% ($150 max) | 25% ($150 max) |
| Tier V - Preferred Specialty | 25% ($200 max) | 25% ($200 max) |
| Tier VI - Non-Preferred Specialty | 35% ($300 max) | 35% ($300 max) |
| YOU PAY |
|---|
| Chiropractic & Alternative Services | In-Network (Including Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Massage therapy, chiropractic, and acupuncture - limited to 50 visits for each service , per person, per calendar year | The difference between the billed amount and plan maximum benefit of $75 per visit , per service, per calendar year | The difference between the billed amount and plan maximum benefit of $75 per visit , per service, per calendar year | The difference between the billed amount and plan maximum benefit of $75 per visit , per service, per calendar year |
| YOU PAY |
|---|
| Dental Care | In-Network | Out-of-network | Outside the 50 U.S. |
|---|---|---|---|
| Routine preventive care and surgical procedures | The difference between our scheduled allowances and the actual billed amounts | The difference between our scheduled allowances and the actual billed amounts | The difference between our scheduled allowances and the actual billed amounts |
| Orthodontics | 50% of our allowance up to our maximum payment of $1,000 per course of treatment and 100% after our maximum payment of $1,000 | 50% of our allowance up to our maximum payment of $1,000 per course of treatment and 100% after our maximum payment of $1,000 | 50% of our allowance up to our maximum payment of $1,000 per course of treatment and 100% after our maximum payment of $1,000 |
| Annual Calendar Year Deductible |
|---|
| Enrollment Type | In-Network (including Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Self Only (401) | $300 | $400 | $300 |
| Self Plus One (403) | $600 | $800 | $600 |
| Self & Family (402) | $600 | $800 | $600 |
| Catastrophic Protection Out-of-pocket maximum |
|---|
| Enrollment Type | In-Network (including Guam) | Out-of-network (Including Guam) | Outside the 50 U.S. |
|---|---|---|---|
| Self Only (401) | $5,000 | $7,000 | $5,000 |
| Self Plus One (403) | $7,000 | $9,000 | $7,000 |
| Self & Family (402) | $7,000 | $9,000 | $7,000 |
*Subject to the calendar year deductible. In-network deductibles: $300 for Self Only, $600 for Self Plus One or Self and Family | Out of network deductibles: $400 for Self Only, $800 for Self Plus One or Self and Family
This is a summary of the features of the Foreign Service Benefit Plan. Before making a final decision, please read the Plan’s Federal brochure. All benefits are subject to the definitions, limitations, and exclusions in the Foreign Service Benefit Plan Brochure (RI 72-001).
