Review the 2026 Consumer Driven Option Preferred Formulary prescription drugs.
Open Season 2025
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.
As a retired Consumer Driven Option member, you’ll automatically receive Medicare prescription drug program (PDP) coverage.
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. If you’re enrolled in Medicare PDP, your prescription drugs will not automatically be paid out of your PCA. If you have funds in your PCA, you can submit a claim for reimbursement.
Consumer Driven Option postal retirees automatically receive Medicare PDP coverage through UnitedHealthcare MedicareRx Part D. While you can’t use your PCA at the pharmacy for these prescriptions, you can pay out of pocket and request reimbursement, allowing you to keep using your PCA benefits.
Review the 2026 Consumer Driven Option Preferred Formulary prescription drugs.
Review the 2026 APWU Health Plan PSHB brochure detailing postal 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.
Discover the APWU Health Plan’s 2026 offerings, including the High Option and Consumer Driven Option plans. Learn more about benefits, coverage, and how these plans can meet your health care needs.
Visit our Virtual Health Fairs page to see the full schedule and register for upcoming sessions.