UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)), HDHP: 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 V41 | $98.60 gov $295.81 | $213.64 | $213.64 | +$11.45 biweekly | $2,564 |
| Self Plus One code V43 | $211.39 gov $634.19 | $458.02 | $458.02 | +$24.29 biweekly | $5,496 |
| Self and Family code V42 | $225.10 gov $675.29 | $487.71 | $487.71 | +$26.00 biweekly | $5,853 |
HDHP, HMO/POS network. Offered in District of Columbia (statewide); Maryland (statewide); Pennsylvania (statewide); Virginia (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 | $2,000 out of network $4,000 | $4,000 out of network $8,000 | $4,000 out of network $8,000 |
| Out-of-pocket maximum | $6,000 out of network $12,000 | $12,000 out of network $24,000 | $12,000 out of network $24,000 |
| Health Savings Account contribution | $750 | $1,500 | $1,500 |
| Deductible after the account | $1,250 | $2,500 | $2,500 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | Member Pays All Charges |
| Primary care visit | $30 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Specialist visit | $50 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Urgent care | $50 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Emergency room | $350 Copayment Waived if Admitted | $350 Copayment Waived if Admitted |
| Labs and X-rays | $50 Copayment | Member Pays All Charges |
| CT, MRI, PET | $150 Copayment | Member Pays All Charges |
| Hospital stay, per admission | $500 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Hospital room | Member Pays Nothing | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Surgeon, inpatient | 20% Coinsurance | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Outpatient surgery | $250 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Mental health, office | $50 Copayment Office Visit | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Mental health, inpatient | $500 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Physical therapy | $50 Copayment Limited to 60 Visits Per Calendar Year Combined With Occupational Therapy | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Chiropractic | 20% Coinsurance | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Acupuncture | 20% Coinsurance | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Maternity care | $50 Copayment $30 PCP Visit; $50 Specialist Visit | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Maternity hospital stay | $500 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Infertility diagnosis and treatment | $50 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| IVF and assisted reproduction | 50% Coinsurance | 50% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Hearing aids | Not Covered | Not Covered |
| Durable medical equipment | 20% Coinsurance | Member Pays All Charges |
| Home health | $50 Copayment | 30% Coinsurance + Difference Between Plan Allowance and Billed Amount |
| Adult dental exams | Covered | Covered |
| Children's dental exams | Covered | Covered |
| Routine eye exam | Covered Limited to 1 Exams Per 24 Months | Covered |
| Eyeglasses | Not Covered | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $15 Copayment | Not applicable |
| Tier 2 | $60 Copayment | Not applicable |
| Tier 3 | $150 Copayment | Not applicable |
| Tier 4 | $300 Copayment | Not applicable |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $6,000 Prescription (Rx) copays count toward the plan catastrophic protection out-of-pocket maximum | Not listed |
| Prescription out-of-pocket maximum, family | $12,000 Prescription (Rx) copays count toward the plan catastrophic protection out-of-pocket maximum | 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
UnitedHealthcare Insurance Company, Inc. (A HDHP with a Health Savings Account (HSA)) plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 73-891 · 877-835-9861
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.
