Open Season 2025
APWU Health Plan offers a fee-for-service High Option and a Consumer Driven Option paired with a Personal Care Account. Explore coverage details and health benefits for employees and retirees covered under the Postal Service Health Benefits (PSHB) Program.
| PSHB enrollment code | Biweekly | Monthly / Retiree |
|---|---|---|
| Self - 23A | $107.15 | $232.16 |
| Self + One - 23C | $216.18 | $468.38 |
| Self & Family - 23B | $275.94 | $597.87 |
| PSHB Enrollment code | PSE & APWU career < 1 year in FEHB/PSHB | APWU career > 1 year in FEHB/PSHB |
|---|---|---|
| Self - 23D | $91.10 | $18.22 |
| Self + One - 23F | $198.00 | $39.60 |
| Self & Family - 23E | $216.01 | $43.20 |
| PSHB enrollment code | Biweekly | Monthly / Retiree |
|---|---|---|
| Self - 23D | $91.10 | $197.39 |
| Self + One - 23F | $198.00 | $429.01 |
| Self & Family - 23E | $216.01 | $468.02 |
In-network
In-network (after deductible is met)
| BENEFITS |
HIGH OPTION In-network |
CONSUMER DRIVEN OPTION
In-network (after deductible is met) |
|---|---|---|
| Medical visits | ||
| Office and specialists visits | $25 copay (no deductible applied) | 15% of Plan allowance (Plan allowance: The maximum amount a plan will pay for a covered healthcare service) |
| Virtual visits |
$0 copay for first 2 visits $10 copay (no deductible applied) |
|
| Preventive care | ||
| Well-child | $0 | $0 — No PCA used. Receive a $25 wellness incentive for each family member who completes an annual physical exam, mammogram, cervical cancer screening, or colonoscopy/Cologuard |
| Childhood immunizations | ||
| Annual adult routine exams | ||
| Adult immunizations | ||
| Preventive screenings | ||
| Dental care | ||
| Routine dental | 30% of Plan allowance (no deductible applied) | See Careington Dental Discount Network for savings information |
| Diabetes care | ||
| Generic oral medication, formulary blood glucose test strips and lancets (used to reduce blood sugar) | $0 through mail-order | See prescription coverage details |
| Maternity | ||
| Complete maternity care, including prenatal, delivery, postnatal and initial exam of newborn covered under family enrollment | $0 | $0 — No PCA used |
| Hospital/facility care | ||
| Diagnostic tests or imaging | 15% ($0 for covered blood work performed at LabCorp and Quest Diagnostics) | 15% of Plan allowance |
| Outpatient surgery | 15% | 15% of Plan allowance |
| Inpatient surgery | 15% | 15% of Plan allowance |
| Cancer Center of Excellence | 5% | 10% of Plan allowance |
| Infertility treatment | ||
| Diagnostic and treatment services | 15% | 15% of Plan allowance |
| Emergency care | ||
| Accidental injury (within 72 hours) | $0 | 15% of Plan allowance |
| Urgent care | $30 copay (no deductible applied) | |
| Emergency room | 15% | |
| Ambulance | 15% (no deductible applied) | |
| Hearing services | ||
| Diagnostic hearing tests | 15% every 2 years | 15% every 2 years |
| Hearing aids | All charges in excess of $1,500 (every 3 years, no deductible applied) | All charges in excess of $1,500 (every 3 years) |
| Mental health/substance use | ||
| Office visits | $25 copay (no deductible applied) | 15% of Plan allowance |
| Outpatient treatment | 15% | |
| Diagnostics, inpatient and outpatient service | 15% | |
| Alternative care | ||
| Chiropractic care | $25 copay (24 visits per year, no deductible applied) | 15% of Plan allowance (24 visits per year, no deductible applied) |
| Acupuncture | $25 copay (26 visits per year, no deductible applied) | 15% of Plan allowance |
| Physical, occupational and speech therapy | 15% (60 visits per year, no deductible applied) | 15% of Plan allowance (up to 60 visits per year) |
| Prescription drugs | ||
| Retail prescription (30-day supply) | Per Rx: $10 for Tier 1 drugs, 25% for Tier 2 drugs – max $200, 45% for Tier 3 drugs – max $300 | Per Rx: 25% with a min of $15 and a max of $200 for Tier 1 or Tier 2 drugs, 40% with a min $15 and a max of $300 for Tier 3 drugs |
| Mail-order prescription (90-day supply) | Per Rx: 20% for Tier 1 drugs, 25% for Tier 2 drugs – max $300, 40% for Tier 3 drugs – max $500 | Per Rx: 25% with a min $10 and a max of $200 for Tier 1 or Tier 2 drugs, 40% with a min $10 and a max of $300 for Tier 3 drugs |
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.