Aetna HealthFund CDHP and Aetna Value Plan, Aetna HealthFund CDHP: 2027 FEHB premiums and benefits
| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code H41 | $365.60 gov $352.04 | $792.14 | $792.14 | +$47.24 biweekly | $9,506 |
| Self Plus One code H43 | $852.43 gov $767.53 | $1,846.93 | $1,846.93 | +$111.87 biweekly | $22,163 |
| Self and Family code H42 | $791.98 gov $843.82 | $1,715.95 | $1,715.95 | +$104.08 biweekly | $20,591 |
CDHP, PPO network. Offered in Idaho (38 counties); Illinois (102 counties); Iowa (statewide); Kentucky (110 counties); Minnesota (87 counties); Mississippi (72 counties); Montana (56 counties); Nebraska (statewide); North Dakota (41 counties); Oregon (29 counties); Pennsylvania (statewide); Wyoming (statewide). The county list is on the comparison page. The government share is the lesser of 72% of the program-wide average premium or 75% of this plan's premium (5 U.S.C. 8906).
Educational information only; StandWatch is not acting for OPM, and the brochure and your agency's benefits office are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $1,000 out of network $1,500 | $2,000 out of network $3,000 | $2,000 out of network $3,000 |
| Out-of-pocket maximum | $5,000 out of network $6,000 | $10,000 out of network $12,000 | $10,000 out of network $12,000 |
| Health Reimbursement Arrangement contribution | $1,000 | $2,000 | $2,000 |
| Deductible after the account | $0 | $0 | $0 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Primary care visit | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Specialist visit | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Urgent care | 15% Coinsurance of our Plan Allowance | 15% Coinsurance |
| Emergency room | 15% Coinsurance of our Plan Allowance | 15% Coinsurance |
| Labs and X-rays | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| CT, MRI, PET | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Hospital stay, per admission | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Hospital room | 15% Coinsurance of our Plan Allowance. If a private room rate is requested when it is not medically necessary, members pay the additional charge above the semiprivate room rate. | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount. If a private room rate is requested when it is not medically necessary, members pay the additional charge above the semiprivate room rate. |
| Surgeon, inpatient | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Outpatient surgery | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Mental health, office | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Mental health, inpatient | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Physical therapy | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Chiropractic | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Acupuncture | 15% Coinsurance of our Plan Allowance; 10 visits per member per calendar year | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Maternity care | Member Pays Nothing of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Maternity hospital stay | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Infertility diagnosis and treatment | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| IVF and assisted reproduction | 15% Coinsurance of our Plan allowance, up to 3 cycles per calendar year (combined limit with Ovulation Induction and Advanced Reproductive Technology) | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount, up to 3 cycles per calendar year (combined limit with Ovulation Induction and Advanced Reproductive Technology) |
| Hearing aids | Not Covered of our Plan Allowance | Not Covered |
| Durable medical equipment | 15% Coinsurance of our Plan Allowance | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount |
| Home health | 15% Coinsurance of our Plan allowance, 60 visits per member per calendar year | 40% Coinsurance of our Plan allowance and any difference between our allowance and the billed amount, 60 visits per member per calendar year |
| Adult dental exams | Covered Dental Fund ($300 for Self Only, $600 for Self Plus One, or $600 for Self and Family) | Covered Dental Fund ($300 for Self Only, $600 for Self Plus One, or $600 for Self and Family) |
| Children's dental exams | Covered Dental Fund ($300 for Self Only, $600 for Self Plus One, or $600 for Self and Family) | Covered Dental Fund ($300 for Self Only, $600 for Self Plus One, or $600 for Self and Family) |
| Routine eye exam | Covered | Covered |
| Eyeglasses | Covered Medical Fund (HRA) | Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $10 Copayment | 40% Coinsurance |
| Tier 2 | 50% Coinsurance | 40% Coinsurance |
| Tier 3 | 50% Coinsurance | 40% Coinsurance |
| Tier 4 | 50% Coinsurance | 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | None | Not listed |
| Prescription out-of-pocket maximum, family | None | Not listed |
| WITH MEDICARE | ||
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
Aetna HealthFund CDHP and Aetna Value Plan plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 73-879 · 888-238-6240
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the Office of Personnel Management or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM FEHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM premium charts for the change from 2026.
