APWU Health Plan, Consumer Driven Option: 2027 PSHB premiums and benefits
Federal Benefits Open Season for plan year 2027 runs November 9 to December 14, 2026.
* Three PSHB options end after 2026: GEHA High, MHBP Consumer, and UnitedHealthcare Postal East. If you are in one, choose a plan by December 14. See what ends| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code 23D | $100.21 gov $300.65 | $217.13 | $217.13 | +$9.11 biweekly (+10.0%) | $2,605 |
| Self Plus One code 23F | $217.81 gov $653.42 | $471.92 | $471.92 | +$19.81 biweekly (+10.0%) | $5,663 |
| Self and Family code 23E | $237.61 gov $712.83 | $514.82 | $514.82 | +$21.60 biweekly (+10.0%) | $6,178 |
CDHP, PPO network. Offered nationwide. Open to postal employees and annuitants eligible for PSHB, but you must be or become an APWU member or associate member: associate members are billed a $35 annual membership fee, and regular APWU dues vary. Source. The government share is the lesser of 72% of the PSHB program-wide average premium or 75% of this plan's premium (OPM). Employee figures are OPM's rate for active postal employees; USPS non-career employees and some union contracts differ.
Educational information only; StandWatch is not acting for OPM or the Postal Service, and the brochure and the HR Shared Service Center 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 | $2,200 out of network $2,700 | $4,400 out of network $5,400 | $4,400 out of network $5,400 |
| Out-of-pocket maximum | $6,500 out of network $15,000 | $13,000 out of network $30,000 | $13,000 out of network $30,000 |
| Health Reimbursement Arrangement contribution How it works, who can have one | $1,200 | $2,400 | $2,400 |
| Deductible after the account | $1,000 | $2,000 | $2,000 |
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 (Uses PCA while funds are available) |
| Primary care visit | 15% Coinsurance | 50% Coinsurance |
| Specialist visit | 15% Coinsurance | 50% Coinsurance |
| Urgent care | 15% Coinsurance | 50% Coinsurance |
| Emergency room | 15% Coinsurance | 15% Coinsurance |
| Labs and X-rays | 15% Coinsurance | 50% Coinsurance |
| CT, MRI, PET | 15% Coinsurance | 50% Coinsurance |
| Hospital stay, per admission | 15% Coinsurance | 50% Coinsurance |
| Hospital room | 15% Coinsurance | 50% Coinsurance |
| Surgeon, inpatient | 15% Coinsurance | 50% Coinsurance |
| Outpatient surgery | 15% Coinsurance | 50% Coinsurance |
| Mental health, office | 15% Coinsurance | 50% Coinsurance |
| Mental health, inpatient | 15% Coinsurance | 50% Coinsurance |
| Physical therapy | 15% Coinsurance (Up to a combined 60 visits per calendar year) | 50% Coinsurance (Up to a combined 60 visits per calendar year) |
| Chiropractic | 15% Coinsurance (Up to 24 visits per calendar year) | 50% Coinsurance (Up to 24 visits per calendar year) |
| Acupuncture | 15% Coinsurance | 50% Coinsurance |
| Maternity care | Member Pays Nothing | 50% Coinsurance |
| Maternity hospital stay | Member Pays Nothing | 50% Coinsurance |
| Infertility diagnosis and treatment | 15% Coinsurance | 50% Coinsurance |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Covered (Covered every 3 years limited to $1500) | Covered (Covered every 3 years limited to $1500) |
| Durable medical equipment | 15% Coinsurance | 50% Coinsurance |
| Home health | 15% Coinsurance (Up to 50 visits per calendar year) | 50% Coinsurance (Up to 50 visits per calendar year) |
| Adult dental exams | Not Covered Members can use a portion of their PCA while funds are available | Not Covered Members can use a portion of their PCA while funds are available |
| Children's dental exams | Not Covered Members can use a portion of their PCA while funds are available | Not Covered Members can use a portion of their PCA while funds are available |
| Routine eye exam | Not Covered Members can use a portion of their PCA while funds are available | Not Covered Members can use a portion of their PCA while funds are available |
| Eyeglasses | Not Covered Members can use a portion of their PCA while funds are available | Not Covered Members can use a portion of their PCA while funds are available |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Generic - 25% Coinsurance | Generic - 100% Coinsurance |
| Tier 2 | Preferred Brand - 25% Coinsurance | Preferred Brand - 100% Coinsurance |
| Tier 3 | Non-Preferred Drugs - 40% Coinsurance | Non-Preferred Drugs - 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $6,500 Medical and prescription is combined | Not listed |
| Prescription out-of-pocket maximum, family | $13,000 Medical and prescription is combined | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | $1,200 | Not listed |
| Part D drug plan: most you pay in a year | $2,400 | Not listed |
| Deductible with Parts A and B | No | No |
| Out-of-pocket maximum with Parts A and B | $6,500 | $15,000 |
| Primary care with Parts A and B | 15% Coinsurance | 50% Coinsurance |
| Specialist with Parts A and B | 15% Coinsurance | 50% Coinsurance |
| Hospital stay with Parts A and B | 15% Coinsurance | 50% Coinsurance |
| Part B reimbursement with Parts A and B | $1,200 Maximum | $1,200 Maximum |
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
APWU Health Plan plan site · Summary of Benefits and Coverage · Brochure RI 71-019 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · (410) 424-1500
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 U.S. Postal Service, 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 PSHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM PSHB premium charts for the change from 2026.
