Aetna: Open Access HMO and Aetna Saver, Aetna Open Access - High 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 G8A | $488.31 gov $318.23 | $1,058.00 | $1,058.00 | +$53.74 biweekly (+12.4%) | $12,696 |
| Self Plus One code G8C | $1,105.92 gov $689.34 | $2,396.16 | $2,396.16 | +$118.04 biweekly (+11.9%) | $28,754 |
| Self and Family code G8B | $1,064.70 gov $748.55 | $2,306.85 | $2,306.85 | +$115.13 biweekly (+12.1%) | $27,682 |
Traditional, HMO network. Offered in District of Columbia (statewide); Maryland (statewide); Virginia (21 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 | None out of network Not applicable | None out of network Not applicable | None out of network Not applicable |
| Out-of-pocket maximum | $5,000 out of network Not applicable | $10,000 out of network Not applicable | $10,000 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 | Member Pays All Charges |
| Primary care visit | $15 Copayment per visit | Member Pays All Charges |
| Specialist visit | $30 Copayment per visit | Member Pays All Charges |
| Urgent care | $50 Copayment per visit | Member Pays All Charges |
| Emergency room | $150 Copayment per visit | Member Pays All Charges |
| Labs and X-rays | $15 Copayment PCP/ $30 Specialist cost share | Member Pays All Charges |
| CT, MRI, PET | $75 Copayment per test | Member Pays All Charges |
| Hospital stay, per admission | $150 Copayment per day up to $450 per admission | Member Pays All Charges |
| Hospital room | Member Pays Nothing (see Inpatient Admission) If a private room rate is requested when it is not medically necessary, members pay the additional charge above the semiprivate room rate. | Member Pays All Charges |
| Surgeon, inpatient | Member Pays Nothing (see Inpatient addmission) | Member Pays All Charges |
| Outpatient surgery | $150 Copayment per visit | Member Pays All Charges |
| Mental health, office | $30 Copayment | Member Pays All Charges |
| Mental health, inpatient | $150 Copayment per day up to a maximum of $450 per admission | Member Pays All Charges |
| Physical therapy | $30 Copayment 60 visits per person, per calendar year for physical or occupational therapy or a combination of both. | Member Pays All Charges |
| Chiropractic | $30 Copayment 20 visits per member per calendar year | Member Pays All Charges |
| Acupuncture | $15 Copayment 10 visits per member per calendar year | Member Pays All Charges |
| Maternity care | Member Pays Nothing | Member Pays All Charges |
| Maternity hospital stay | $150 Copayment $150 per day up to a maximum of $450 per admission | Member Pays All Charges |
| Infertility diagnosis and treatment | $150 Copayment per visit | Member Pays All Charges |
| IVF and assisted reproduction | $150 Copayment of our Plan allowance, up to 3 cycles per calendar year (combined limit with Ovulation Induction and Advanced Reproductive Technology) | Member Pays All Charges |
| Hearing aids | Covered $1,400/ear/every 36-month period | Not Covered |
| Durable medical equipment | 30% Coinsurance of our plan allowance | Member Pays All Charges |
| Home health | $90 Copayment per visit, 60 visits per member per calendar year | Member Pays All Charges |
| Adult dental exams | Covered | Covered 50% of our negotiated rate and any difference between our allowance and the billed amount. |
| Children's dental exams | Covered | Covered 50% of our negotiated rate and any difference between our allowance and the billed amount. |
| Routine eye exam | Covered | Not Covered |
| Eyeglasses | Covered Up to $100 per 24 months | Covered Up to $100 per 24 months |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Preferred Generic - $3 Copayment | Preferred Generic - 100% Coinsurance |
| Tier 2 | Preferred Brand - $35 Copayment | Preferred Brand - 100% Coinsurance |
| Tier 3 | Non-Preferred Drugs - 50% Coinsurance | Non-Preferred Drugs - 100% Coinsurance |
| Tier 4 | Preferred Specialty Tier - 50% Coinsurance | Preferred Specialty Tier - 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | None | Not listed |
| Prescription out-of-pocket maximum, family | None | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | None | Not listed |
| Part D drug plan: most you pay in a year | $2,400 | Not listed |
| Deductible with Parts A and B | Not applicable | Not applicable |
| Out-of-pocket maximum with Parts A and B | $5,000 for self-only enrollment | Not applicable |
| Primary care with Parts A and B | $15 Copayment per visit | Not applicable |
| Specialist with Parts A and B | $30 Copayment per visit | Not applicable |
| Hospital stay with Parts A and B | $150 Copayment per day up to $450 per admission | Not applicable |
| Part B reimbursement with Parts A and B | No | Not applicable |
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
Aetna: Open Access HMO and Aetna Saver plan site · Summary of Benefits and Coverage · Brochure RI 73-435 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · (833) 497-2413
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.
