Review the 2026 Consumer Driven Option Preferred Formulary prescription drugs.
Open Season 2025
OptumRx provides pharmacy benefits for the Consumer Driven Option. The network features more than 67,000 pharmacies, including large national chains, local community pharmacies, home delivery, and specialty.
Consumer Driven Option prescription coverage
Network retail
Tier 1/Tier 2
Lower cost/Mid-range cost
Tier 3
Highest cost
In-network you pay
25% ($15 min/$200 max) for a 30-day supply per Rx
$400 for a 60-day supply per Rx
$600 for a 90-day supply per Rx
40% ($15 min/$300 max) for a 30-day supply per Rx
$600 for a 60-day supply per Rx
$900 for a 90-day supply per Rx
Network home delivery
Tier 1/Tier 2
Lower cost/Mid-range cost
Tier 3
Highest cost
25% ($10 min/$200 max) for a 30-day supply per Rx
$400 for a 60-day supply per Rx
$600 for a 90-day supply per Rx
40% ($10 min/$300 max) for a 30-day supply per Rx
$600 for a 60-day supply per Rx
$900 for a 90-day supply per Rx
Visit the OptumRX drug pricing tool.
During your deductible phase, members are responsible for the total cost of medication.
Your Personal Care Account (PCA) covers 100% of eligible expenses, including prescription drugs. If you fill a prescription when you have benefit dollars available in your PCA, the funds will be applied, and you’ll pay nothing.
Receive a discount when you use OptumRx Home Delivery. When you order or refill a prescription by mail, the discounted cost of the medication will be subtracted from your PCA.
Review the 2026 Consumer Driven Option Preferred Formulary prescription drugs.
Review the 2026 APWU Health Plan FEHB brochure detailing federal employee benefits.
High Option Members: See clarification for Section 5(c)- Services provided by a hospital or other facility, and ambulance services.
For most services in this section, a deductible is not required. The calendar year deductible only applies to outpatient hospital or ambulatory surgical center. If you have additional questions or would like to verify your benefits, please contact the Health Plan at 1-800-222-2798.