TakeCare Insurance Company, Inc., Standard Option: 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 JK4 | $41.37 gov $124.11 | $89.63 | $89.63 | $-4.98 biweekly | $1,076 |
| Self Plus One code JK6 | $82.89 gov $248.69 | $179.60 | $179.60 | $-9.98 biweekly | $2,155 |
| Self and Family code JK5 | $136.54 gov $409.64 | $295.85 | $295.85 | $-16.43 biweekly | $3,550 |
Traditional, HMO/POS network. Offered in Guam (statewide); Northern Mariana Islands (statewide); Palau (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 | None out of network None | None out of network None | None out of network None |
| Out-of-pocket maximum | $3,000 out of network $3,000 | $6,000 out of network $6,000 | $6,000 out of network $6,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Primary care visit | $25 Copayment $5 FHP / $15 Preferred | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Specialist visit | $40 Copayment PCP Referral Required | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Urgent care | $15 Copayment In area at FHP Health Center, otherwise, $25 primary/$40 specialist. Out of area: 20% coinsurance | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Emergency room | $100 Copayment in area / 20% coinsurance out of area | $100 Copayment in area / 20% coinsurance out of area |
| Labs and X-rays | Member Pays Nothing $5 FHP /$25 Preferred for X-rays | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| CT, MRI, PET | $40 Copayment $30 FHP | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Hospital stay, per admission | $150 Copayment per day, up to $750 per admission | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Hospital room | Member Pays Nothing | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Surgeon, inpatient | Member Pays Nothing | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Outpatient surgery | Member Pays Nothing | 30% Coinsurance of our allowance plus any difference between our allowance and billed charges. |
| Mental health, office | $40 Copayment Specialist office visit. Same as any other covered condition | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Mental health, inpatient | $150 Copayment per day, up to $750 per admission | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Physical therapy | $15 Copayment per office visit, $0 for home or hospital visits. Up to 2 consecutive months. | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Chiropractic | Member Pays All Charges Any Amount Over $25 - 20 Visit/Year Limit | Member Pays All Charges |
| Acupuncture | Member Pays All Charges Any Amount Over $25 - 20 Visit/Year Limit | Member Pays All Charges |
| Maternity care | Member Pays Nothing | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Maternity hospital stay | $150 Copayment per day, up to $750 per admission | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Infertility diagnosis and treatment | 50% Coinsurance of our allowance | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Covered Up to $300 per ear, every two years. Adults only. | Not Covered |
| Durable medical equipment | 15% Coinsurance toward rental or purchase | Member Pays All Charges |
| Home health | Member Pays Nothing | 30% Coinsurance of our allowance plus difference between our allowance and billed charges |
| Adult dental exams | Covered 100% of allowance | Covered 70% of allowance |
| Children's dental exams | Covered 100% of allowance | Covered 70% of allowance |
| Routine eye exam | Covered 100% of allowance | Covered 70% of allowance |
| Eyeglasses | Covered for prescription eyeglasses, up to $100/year. Benefit combined with contact lenses | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $15 Copayment | 100% Coinsurance |
| Tier 2 | $40 Copayment | 100% Coinsurance |
| Tier 3 | $100 Copayment | 100% Coinsurance |
| Tier 4 | $100 Copayment | 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $3,000 | Not listed |
| Prescription out-of-pocket maximum, family | $6,000 | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | None | Not listed |
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
TakeCare Insurance Company, Inc. plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 73-776 · 1-671-647-3526
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.
