Medical Mutual of Ohio, Basic 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 D3A | $64.26 gov $192.77 | $139.22 | $139.22 | +$2.72 biweekly (+4.4%) | $1,671 |
| Self Plus One code D3C | $141.36 gov $424.09 | $306.28 | $306.28 | +$5.96 biweekly (+4.4%) | $3,675 |
| Self and Family code D3B | $154.22 gov $462.65 | $334.14 | $334.14 | +$6.51 biweekly (+4.4%) | $4,010 |
Traditional, HMO network. Offered in Ohio (30 counties). A regional plan: open to anyone eligible for PSHB who lives in its service area (some plans also take people who work there). The county list is on the comparison page. 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 | $1,100 out of network Not applicable | $2,200 out of network Not applicable | $2,200 out of network Not applicable |
| Out-of-pocket maximum | $8,000 out of network Not applicable | $16,000 out of network Not applicable | $16,000 out of network Not applicable |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing N/A | Member Pays All Charges N/A |
| Primary care visit | $30 Copayment N/A | Member Pays All Charges N/A |
| Specialist visit | $60 Copayment N/A | Member Pays All Charges N/A |
| Urgent care | $45 Copayment N/A | Member Pays All Charges N/A |
| Emergency room | $500 Copayment Medical/Accidental Emergency waives to Network level ER copay waived if admitted | $500 Copayment Medical/Accidental Emergency waives to Network level ER copay waived if admitted |
| Labs and X-rays | 30% Coinsurance 30% of the Plan allowance (deductible applies) | Member Pays All Charges N/A |
| CT, MRI, PET | 30% Coinsurance 30% of the Plan allowance (deductible applies) | Member Pays All Charges N/A |
| Hospital stay, per admission | 30% Coinsurance of the Plan Allowance (deductible applies) | Member Pays All Charges N/A |
| Hospital room | 30% Coinsurance of the plan allowance (deductible applies) | Member Pays All Charges N/A |
| Surgeon, inpatient | 30% Coinsurance of the Plan allowance (deductible applies) | Member Pays All Charges N/A |
| Outpatient surgery | 30% Coinsurance 30% of the Plan allowance (deductible applies) | Member Pays All Charges N/A |
| Mental health, office | 30% Coinsurance Your cost-sharing responsibilities are no greater than for other illnesses or conditions | Member Pays All Charges N/A |
| Mental health, inpatient | 30% Coinsurance Your cost-sharing responsibilities are no greater than for other illnesses or conditions | Member Pays All Charges N/A |
| Physical therapy | $30 Copayment 60 visits per calendar year (combined for Physical and Occupational Therapy) | Member Pays All Charges N/A |
| Chiropractic | $30 Copayment Up to 20 chiropractic visits per calendar year | Member Pays All Charges N/A |
| Acupuncture | Member Pays All Charges N/A | Member Pays All Charges N/A |
| Maternity care | Member Pays Nothing N/A | Member Pays All Charges N/A |
| Maternity hospital stay | Member Pays Nothing N/A | Member Pays All Charges N/A |
| Infertility diagnosis and treatment | 50% Coinsurance Plan covers Artificial Insemination: Intrauterine (IUI), Intracervical (ICI) and Intravaginal (IVI) | Member Pays All Charges N/A |
| IVF and assisted reproduction | Member Pays All Charges N/A | Member Pays All Charges N/A |
| Hearing aids | Covered One hearing aide every 48 months, limit $2,500/each hearing impaired ear for children >age 21 | Not Covered N/A |
| Durable medical equipment | 30% Coinsurance 30% of the Plan allowance (deductible applies) | Member Pays All Charges N/A |
| Home health | 30% Coinsurance 30% of Plan allowance (deductible applies) | Member Pays All Charges N/A |
| Adult dental exams | Not Covered N/A | Not Covered N/A |
| Children's dental exams | Not Covered N/A | Not Covered N/A |
| Routine eye exam | Covered $60 Copay per specialty care visit Office | Not Covered N/A |
| Eyeglasses | Not Covered N/A | Not Covered N/A |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Generic - $10 Copayment | Generic - Not applicable |
| Tier 2 | Preferred Brand - 40% Coinsurance | Preferred Brand - Not applicable |
| Tier 3 | Non-Preferred Brand - 60% Coinsurance | Non-Preferred Brand - Not applicable |
| Tier 4 | Non-Preferred Drugs - 50% Coinsurance | Non-Preferred Drugs - Not applicable |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | None Not Applicable | Not listed |
| Prescription out-of-pocket maximum, family | None Not Applicable | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (Medicare Advantage option) | None N/A | Not listed |
| Part B premium reimbursement (prescription drug plan) | None N/A | Not listed |
| Part D drug plan: most you pay in a year | $2,400 N/A | Not listed |
| Deductible with Parts A and B | $1,000 N/A | Not applicable N/A |
| Out-of-pocket maximum with Parts A and B | $8,000 N/A | Not applicable N/A |
| Primary care with Parts A and B | $30 Copayment Max copayment after Medicare Payment | Not applicable N/A |
| Specialist with Parts A and B | $60 Copayment Max copayment after Medicare Payment | Not applicable N/A |
| Hospital stay with Parts A and B | 30% Coinsurance Of the plan allowance after Medicare payment | Not applicable N/A |
| Part B reimbursement with Parts A and B | Not applicable N/A | Not applicable N/A |
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
Medical Mutual of Ohio plan site · Summary of Benefits and Coverage · Brochure RI 73-928 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · (800) 315-3144
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.
