We’re here to help you choose a plan that’s right for you and understand your coverage options. If you can’t find an answer to your question, contact APWU Health Plan to speak with a customer service representative:
Monday – Friday, 8:30 am – 6:30 pm ET
U.S. Postal Service employees and annuitants are no longer eligible for FEHB coverage as of January 1, 2025, and will need to enroll in a PSHB plan. In addition, certain Postal Service annuitants and their Medicare-eligible family members are required to be enrolled in Medicare Part B after January 1, 2025, in order to maintain PSHB coverage.
Yes, all active and retired Postal Service employees who elect federal health insurance coverage must now get it through the new PSHB Program. Postal Service employees and annuitants are no longer eligible for FEHB coverage as of January 1, 2025, and will need to enroll in a PSHB plan.
However, if a Postal Service employee or annuitant is covered under a family member’s FEHB plan, they may remain in their family member’s FEHB plan.
If Postal Service employees and annuitants are not currently covered under a family member’s FEHB plan but wish to be, they may be enrolled in their family member’s FEHB plan during 2024 Open Season.
If you do not select a plan, you will be automatically enrolled in a plan offered by your current carrier.
If your current carrier does not offer a plan in the PSHB program, you will be enrolled in the lowest cost nationwide plan option that is not a high deductible plan and does not charge a membership fee.
All annuitants who participate in FEHB who do not make an active plan selection will be automatically enrolled in the same or similar PSHB plan during the 2024 Open Season period.
You can also compare and shop for a different plan, if you choose.
As an active employee, you are not required to enroll in Medicare while employed. However, you can select a new health insurance plan under the PSHB program to continue coverage beyond 2024.
If you are currently enrolled in FEHB coverage, you will be automatically enrolled in the same or similar plan PSHB plan as your current FEHB plan during the 2024 Open Season period, which will run from November 11, 2024, to December 9, 2024.
Depending on your age and whether you are an annuitant on or before January 1, 2025, you may be required to also enroll in Medicare Part B to continue PSHB coverage in retirement.
No. If you are an annuitant on or before January 1, 2025, and are not enrolled in Medicare Part B on that date, you are not required to enroll in Medicare Part B to retain your PSHB health insurance coverage, regardless of your age.
No. If you are an active Postal Service employee age 64 or older on or before January 1, 2025, you are not required to enroll in Medicare Part B to continue your PSHB health insurance coverage in retirement. This is because you are eligible for an exception to the Medicare Part B enrollment requirement. This exception will also apply to your covered family members.
While you are not required to enroll in Medicare Part B, you may choose to enroll in Medicare Part B. If you qualify for an exception as an active employee aged 64 or older on or before January 1, 2025, if you enroll in Medicare Part B, you are not required to maintain Part B enrollment to continue your PSHB insurance coverage.
Yes, you may qualify for an exception if you:
Covered family members may have their own exception, even if you do not, if they can demonstrate meeting any of these exceptions. Individuals will be responsible for providing proof of eligibility for the applicant exception(s) to the designated agency.
Maybe. If you are an annuitant on or before January 1, 2025, and you are enrolled in Medicare Part B on January 1, 2025, you are required to remain enrolled in Medicare Part B to continue coverage under PSHB, unless you are eligible for an exception.
Also, if you are the spouse of an annuitant who is already enrolled in Medicare Part B, you are required to enroll in Medicare Part B when you become entitled to Medicare Part A, unless you are eligible for an exception.
Maybe. If you are an active employee under the age of 64 as of January 1, 2025, you are required to enroll in Medicare Part B after you retire and become entitled to Medicare Part A, typically at age 65, unless you qualify for an exception.
Yes, there are a few exceptions to the requirements to enroll in Medicare Part B. As a Postal Service annuitant, these exceptions will also apply to your covered family members.
Family members may also be eligible for their own exception, even if the annuitant is required to enroll in Medicare Part B. Postal Service annuitants and family members may be responsible for providing proof of eligibility for the applicable exceptions. These exceptions are:
Medicare coordination requires certain Medicare-eligible Postal Service annuitants to enroll in Medicare Part B in order to maintain their PSHB coverage in retirement. Enrollment in Medicare Part B does not cancel your PSHB coverage or reduce the benefits that are available to you under your federal health insurance plan. The idea is to coordinate your PSHB and Medicare coverage when you become eligible for Medicare.
Yes. For Medicare-eligible annuitants and your Medicare-eligible family members, Medicare would become the primary payer for your medical claims, with your PSHB plan becoming your secondary payer.
As an annuitant, enrolling in PSHB and Medicare may reduce your out-of-pocket costs for healthcare. Though there is a premium cost for Medicare Part B, it is important to consider your long-term health care needs. As you get older you may realize a greater benefit from having PSHB and Medicare coverage.
While annuitants will have an additional cost associated with Medicare Part B coverage, many PSHB plans may eliminate cost-sharing and reimburse part of the Part B premium for Medicare enrollees. Also, annuitants may be able to select a lower cost PSHB plan when enrolling in Medicare. These savings may offset the costs of Medicare Part B coverage.
Postal Service employees and annuitants’ eligibility determines spousal and family PSHB coverage. If the enrollee is not required to enroll in Medicare Part B, neither will dependent family members.
Yes. As a national preferred provider organization (PPO), APWU Health Plan offers both a fee-for-service High Option plan and a Consumer Driven Option plan. Both options are open to all employees and retirees covered under the Postal Service Health Benefits (PSHB) Program.
APWU Health Plan is open to all eligible postal employees and retirees. If an employee, retiree, surviving spouse, or child is eligible to enroll in the PSHB Program, that person is eligible to join APWU Health Plan.
High Option
For questions about the High Option, contact APWU Health Plan to speak with a customer service representative:
1-800-PIC-APWU (Open Season) | 1-800-222-APWU (2798) | 1-800-622-2511 (TTY)
8:30 am – 6:30 pm ET, Monday – Friday
If the Health Plan is experiencing a high call volume, you can schedule a call back, 9 am – 6:30 pm ET, Monday – Friday.
Consumer Driven Option
For questions about the Consumer Driven Option, contact UnitedHealthcare:
Medicare Advantage
To find out if you’re eligible to enroll in the Medicare Advantage plan, call:
1-855-383-8793 | 711 (TTY)
8 am – 8 pm CT, Monday – Friday
Medicare
For questions about Medicare, contact the OPM Postal Enrollment Retirement Call Center:
As a member, APWU Health Plan provides you with access to a comprehensive network of doctors, hospitals, and healthcare providers.
You can choose between two smart medical plans—the High Option and Consumer Driven Option—that feature a nationwide UnitedHealthcare network of 1.7+ million providers and 7,000 hospitals and care facilities—with no need for referrals.
You also have access to:
Use these PSHB codes when you enroll in APWU Health Plan:
High Option
Self — PSHB enrollment code 23A
Self Plus One — PSHB enrollment code 23C
Self & Family — PSHB enrollment code 23B
Consumer Driven Option
Self — PSHB enrollment code 23D
Self Plus One — PSHB enrollment code 23F
Self & Family — PSHB enrollment code 23E
Yes, as a member of the High Option or Consumer Driven Option, you’ll enjoy 100% coverage for in-network preventive care:
Wellness checkups
Recommended screenings
Care and support
See the postal brochure for complete details.
To help you feel better and more in control of your emotional well-being, APWU Health Plan offers mental health and substance use services through Behavioral Health Solutions. If you or a loved one are facing emotional struggles or substance use issues, you’re not alone. Behavioral Health Solutions offers confidential assistance to help you find the support you need to do all of this and more:
With Virtual Behavioral Health Care, you can talk to a behavioral health professional without leaving home. Help is completely confidential.
See the postal brochure for complete details.
APWU Health Plan covers diagnostic hearing tests every two years and hearing aids every three years. For hearing tests, members pay 15% of the Plan allowance, while hearing aids are covered up to $1,500.
High Option and Consumer Driven Option members can access more than 2,000 name-brand models and styles of hearing aids at significant savings through UnitedHealthcare Hearing. Choose virtual care with hearing aid home delivery or in-person care at more than 7,000 hearing providers nationwide. Plus, get in-person or virtual support for every stage or your hearing health journey.
See the postal brochure for complete details.
As an APWU Health Plan High Option or Consumer Driven Option member, you have access to a number of programs that can help you protect your health and well-being:
Rally® is a digital health experience that offers personalized recommendations to help you move more, eat better, and feel great. It even rewards your progress with Rally Coins, which you can use to contribute to a charity.
One Pass Select is a fitness and well-being subscription-based network that provides access to over 16,000 gyms and studios. Members can use multiple locations during the same month and change locations at any time. Choose from five membership tiers, with the option to change tiers monthly.
Maven provides free, 24/7 virtual support for pregnancy, postpartum, and returning to work after parental leave.
Quit For Life® helps you move beyond tobacco and take control of your health. The program includes counseling by phone, group therapy sessions, or educational sessions with a doctor. FDA-approved prescription drugs and over-the-counter drugs to treat tobacco dependence are also available for those age 18 or older.
See the postal brochure for complete details.
Infertility is a struggle. When you want to start or expand your family but have been unable to conceive within a reasonable period of time, it can affect your emotional health.
For members who are ready to seek medical help on the journey to becoming a parent, the APWU Health Plan High Option and Consumer Driven Option cover a range of services to diagnosis and treat infertility.
See the postal brochure for complete details.
APWU Health Plan recognizes that transgender, non-binary, and other gender-diverse members require healthcare delivered by providers experienced in gender-affirming health.
Gender-affirming services include therapy to address feelings of gender dysphoria and medical treatments that help you achieve physical characteristics that better align with your gender identity.
Gender affirming surgery requires prior approval. Under the High Option and Consumer Driven Option, members need to call UnitedHealthcare before receiving gender-affirming surgery. Failure to do so will result in a minimum $500 penalty for an inpatient hospital stay.
See the postal brochure for complete details.
When you enroll in the APWU Health Plan, you will have access to designated Cancer Centers of Excellence around the country.
High Option: With pre-approval, you pay only 5% of the treatment costs at these in-network designated centers.
Consumer Driven Option: If you decide to use a designated Cancer Center of Excellence, you may receive prior approval for travel and lodging costs. With pre-approval and in the network, you pay 10% of the Plan allowance.
Yes, as an APWU Health Plan member your member portal and member app give you the tools you need to manage your health plan benefits, access your claims and health records, and get on the path to healthier living.
High Option member portal
Your member portal at myapwuhp.com features resources to keep you healthy and tools to help you get the most from your plan. Log in to your portal to:
High Option mobile app
The myapwuhp member app helps you manage your health plan. See your claims, year-to-date information, prescriptions, and more.
Consumer Driven Option member portal
Access your Health Plan 24/7 with myuhc.com. After you’re signed in, you’ll have easy access to tools and resources that can help you understand your benefits and make informed decisions about your care:
Consumer Driven Option mobile app
The UnitedHealthcare app® helps you find care, price medications, review and manage claims, view and share your digital Health Plan ID card and more—all from your mobile device.
APWU Health Plan is committed to safeguarding your privacy online. In general, you can visit our website without revealing any personal information about yourself. At times, we may ask you for personal information if it is necessary to help you in selecting appropriate services offered by APWU Health Plan. All information is provided voluntarily and explicitly by visitors to the site.
The Health Plan’s online access to membership details and claims history for High Option members—myapwuhp.com—is secure and protected and meets all federal requirements for privacy and security. Access is available only when you register and enter your user ID and password.
The email facilities at our site do not provide a means for completely secure and private communication between us. Your email, like most non-encrypted internet email communications, may be accessed and viewed without your knowledge or permission while in transit to us. If you consider the information you are communicating to be confidential and you wish to keep it private, please do not use email. Instead, call us at 1-800-222-APWU (2798) or, if you are a current member, at the number listed on the back of your identification card.
Please note that email sent to us will be shared with our customer service representatives or the staff members who are best able to address your questions. Once we have responded to your communication, it may be discarded or archived, depending on the nature of the inquiry.
The APWU Health Plan website gathers routine usage information, such as how many people visit the site, the pages visited, and the length of time a visitor spends on the site. This information is collected on an anonymous basis, which means no personal identifiable information is associated with the data. This data helps us to improve the site content and overall usefulness for visitors.
The site contains hypertext links to other websites. APWU Health Plan has no control over the content or the availability of these sites and assumes no responsibility for the privacy practices of such websites. These links are provided for convenience and reference purposes only. Therefore, we are not liable for any information or materials contained in them.
You do not need a referral to see a specialist when you are a member of APWU Health Plan. You are free to choose your covered providers without seeking our permission.
Precertification—sometimes called prior authorization—is a process that requires physicians and healthcare providers to obtain advanced approval from the Health Plan before delivering a specific service to the patient to qualify for payment coverage.
APWU Health Plan’s contract requires precertification for:
See section 3 of the postal brochure to determine if a service you are about to receive needs precertification or prior authorization.
Inpatient hospital stays
Unless a hospital stay takes place outside of the United States or Puerto Rico, or unless you have other insurance, including Medicare Part A as your primary health insurer, all inpatient hospital stays must be precertified.
If a hospital stay is not precertified, a $500 penalty will be assessed when the claim is paid.
Planned admission into the hospital must be precertified as least two business days prior to the admission to avoid the precertification penalty.
If you have an emergency admission or an unscheduled maternity admission, you must certify the stay within two business days of the admission, even if you have already been discharged.
For a maternity admission, the newborn’s stay does not have to be precertified unless the child stays in the hospital after the mother has been discharged. At the time of the mother’s discharge, the newborn’s stay becomes a separate admission.
Home nursing care and physical, speech, or occupational therapy
If these services are not preauthorized, the Health Plan may deny services, even if they are considered medically necessary and appropriate. These benefits are covered when prescribed by a doctor, and the doctor submits a treatment plan for the services.
CAT/CT/MRI/PET scans
Prior approval of these procedures is required. Failure to obtain required precertification can result in a $100 penalty and/or denial of the claim pending review. Have your provider call prior to delivering these procedures.
The catastrophic out-of-pocket maximum or limitation does not indicate any single illness or condition. The catastrophic limitation is the maximum amount of coinsurance that a member has to pay out of their own pocket before the Health Plan pays covered charges at 100% for the balance of the calendar year.
Most conditions that the Health Plan pays on your behalf for the High Option, at a percentage amount, will have your portion of the fee (the coinsurance) apply toward a maximum out-of-pocket amount. Once a member meets the maximum amount (the catastrophic limit), the Plan pays covered charges for the remainder of the calendar year at 100% of the Plan allowance, or the PPO negotiated rate if you us a preferred provider.
See the postal brochure for complete details.
Yes. The amounts that are accrued toward the catastrophic limitation are coinsurance or copayments for medical, prescription, and deductible covered services.
See the postal brochure for complete details.
When you select the High Option as your health plan, you are always covered no matter where you are. Your coverage always goes with you, whether you are in another state or another country. When you have services outside the U.S., you will probably have to pay the bill at the time of service, and then submit a bill directly for reimbursement.
This is a summary of benefits and features offered by the APWU Health Plan. All benefits are subject to the definitions, limitations, and exclusions set forth in the Plan’s Brochure (RI 71-004).
The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs and to determine whether making a lifestyle change or decision based on this information is appropriate for you. Some treatments mentioned may not be covered by your health plan. Please refer to your benefit plan documents for information about coverage.
Health plan coverage provided by or through UnitedHealthcare Insurance Company, UHC of California and UnitedHealthcare Benefits Plan of California. Administrative services provided by United Healthcare Services, Inc., Optum Rx or OptumHealth Care Solutions, Inc. Behavioral health products are provided by U.S. Behavioral Health Plan, California (USBHPC).
Administrative services provided by United HealthCare Services, Inc. or their affiliates.
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