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Medical Mutual of Ohio, Standard Option: 2027 PSHB premiums and benefits

Updated October 30, 2026 · How we check facts
Not a government website. Educational information only, not official advice. StandWatch is independent, is not affiliated with the U.S. Postal Service, and does not act for OPM or any agency. For any decision, the official source is the final authority: your plan's brochure and the Postal Service's HR Shared Service Center. Full disclosures
Open Season: plan year 2027

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
PREMIUMS, 2027
EnrollmentEmployee, biweeklyEmployee, monthlyAnnuitant, monthlyChange in your share vs 2026Employee, per year (26 periods)
Self Only
code D3D
$428.74
gov $318.23
$928.94$928.94$-16.48 biweekly (-3.7%)$11,147
Self Plus One
code D3F
$954.00
gov $689.34
$2,067.00$2,067.00$-38.17 biweekly (-3.8%)$24,804
Self and Family
code D3E
$1,044.18
gov $748.55
$2,262.39$2,262.39$-43.18 biweekly (-4.0%)$27,149

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.

WHAT A YEAR COULD COST, ESTIMATED
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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.

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Deductibles and limits

Self OnlySelf Plus OneSelf and Family
DeductibleNone
out of network Not applicable
None
out of network Not applicable
None
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

ServiceIn networkOut of network
VISITS
Preventive careMember Pays Nothing
N/A
Member Pays All Charges
N/A
Primary care visit$25 Copayment
N/A
Member Pays All Charges
N/A
Specialist visit$45 Copayment
N/A
Member Pays All Charges
N/A
Urgent care$35 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-raysMember Pays Nothing
N/A
Member Pays All Charges
N/A
CT, MRI, PETMember Pays Nothing
N/A
Member Pays All Charges
N/A
Hospital stay, per admission$850 Copayment
N/A
Member Pays All Charges
N/A
Hospital roomMember Pays Nothing
N/A
Member Pays All Charges
N/A
Surgeon, inpatientMember Pays Nothing
N/A
Member Pays All Charges
N/A
Outpatient surgery$500 Copayment
per outpatient surgery
Member Pays All Charges
N/A
Mental health, office$25 Copayment
Your cost-sharing responsibilities are no greater than for other illnesses or conditions
Member Pays All Charges
N/A
Mental health, inpatient$650 Copayment
Your cost-sharing responsibilities are no greater than for other illnesses or conditions
Member Pays All Charges
N/A
Physical therapy$25 Copayment
60 visits per calendar year (combined benefit for Physical and Occupational Therapy
Member Pays All Charges
N/A
Chiropractic$25 Copayment
Up to 20 Chiropractivc visits per calendar year
Member Pays All Charges
N/A
AcupunctureMember Pays All Charges
N/A
Member Pays All Charges
N/A
Maternity careMember Pays Nothing
N/A
Member Pays All Charges
N/A
Maternity hospital stayMember Pays Nothing
$850 per adminssion hospital copayment applies for any inpatient hospitalization
Member Pays All Charges
N/A
Infertility diagnosis and treatment30% Coinsurance
30% of the Plan allowance
Member Pays All Charges
N/A
IVF and assisted reproductionMember Pays All Charges
N/A
Member Pays All Charges
N/A
Hearing aidsCovered
One hearing aide every 48 months, limit $2,500/each hearing impaired ear for children >age 21
Not Covered
N/A
Durable medical equipment25% Coinsurance
of the Plan allowance
Member Pays All Charges
N/A
Home healthMember Pays Nothing
N/A
Member Pays All Charges
N/A
Adult dental examsNot Covered
N/A
Not Covered
N/A
Children's dental examsNot Covered
N/A
Not Covered
N/A
Routine eye examCovered
$45 per specialty care office visit, $25 per primary care office visit
Not Covered
N/A
EyeglassesNot Covered
N/A
Not Covered
N/A
PRESCRIPTIONS
Tier 1 (usually generic)Generic - $15 CopaymentGeneric - Not applicable
Tier 2Preferred Brand - $75 CopaymentPreferred Brand - Not applicable
Tier 3Non-Preferred Brand - $180 CopaymentNon-Preferred Brand - Not applicable
Tier 4Non-Preferred Drugs - 50% CoinsuranceNon-Preferred Drugs - Not applicable
Mail orderYesYes
Prescription out-of-pocket maximum, SelfNone
N/A
Not listed
Prescription out-of-pocket maximum, familyNone
N/A
Not listed
WITH MEDICARE
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 BNot applicable
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$25 Copayment
Max copayment after Medicare Payment
Not applicable
N/A
Specialist with Parts A and B$45 Copayment
Max copayment after Medicare Payment
Not applicable
N/A
Hospital stay with Parts A and B$850 Copayment
Max copayment after Medicare Payment
Not applicable
N/A
Part B reimbursement with Parts A and BNot 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.

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

WHAT THIS PAGE IS, AND IS NOT

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.

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Larry Cannon
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Larry Cannon · Founder, StandWatch

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