Health Alliance Plan of Michigan, 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 J5A | $210.28 gov $318.23 | $455.61 | $455.61 | $-1.93 biweekly (-0.9%) | $5,467 |
| Self Plus One code J5C | $526.23 gov $689.34 | $1,140.17 | $1,140.17 | $-5.01 biweekly (-0.9%) | $13,682 |
| Self and Family code J5B | $541.01 gov $748.55 | $1,172.19 | $1,172.19 | $-7.79 biweekly (-1.4%) | $14,066 |
Traditional, HMO network. Offered in Michigan (62 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 | $6,350 out of network Not applicable | $12,700 out of network Not applicable | $12,700 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 No out of network benefits |
| Primary care visit | $20 Copayment | Member Pays All Charges No out of network benefits |
| Specialist visit | $40 Copayment | Member Pays All Charges No out of network benefits |
| Urgent care | $50 Copayment | $50 Copayment |
| Emergency room | $150 Copayment | $150 Copayment |
| Labs and X-rays | Member Pays Nothing | Member Pays All Charges No out of network benefits |
| CT, MRI, PET | $150 Copayment Per test | Member Pays All Charges No out of network benefits |
| Hospital stay, per admission | $100 Copayment Maximum Copay: $500 per admission. | Member Pays All Charges No out of network benefits |
| Hospital room | $100 Copayment Maximum Copay: $500 per admission. | Member Pays All Charges No out of network benefits |
| Surgeon, inpatient | Member Pays Nothing | Member Pays All Charges No out of network benefits |
| Outpatient surgery | $250 Copayment | Member Pays All Charges No out of network benefits |
| Mental health, office | $20 Copayment | Member Pays All Charges |
| Mental health, inpatient | $100 Copayment Maximum Copay: $500 per admission. | Member Pays All Charges |
| Physical therapy | $40 Copayment Up to 60 combined visits for PTOTST and habilitation per benefit period. | Member Pays All Charges |
| Chiropractic | Member Pays All Charges | Member Pays All Charges |
| Acupuncture | Member Pays All Charges | Member Pays All Charges |
| Maternity care | Member Pays Nothing | Member Pays All Charges |
| Maternity hospital stay | $100 Copayment Maximum Copay: $500 per admission. | Member Pays All Charges |
| Infertility diagnosis and treatment | Member Pays Nothing | Member Pays All Charges |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Covered Please refer to our 2027 PSHB Brochure for more details on cost share | Not Covered |
| Durable medical equipment | 50% Coinsurance | Member Pays All Charges |
| Home health | Member Pays Nothing | Member Pays All Charges |
| Adult dental exams | Not Covered | Not Covered |
| Children's dental exams | Not Covered | Not Covered |
| Routine eye exam | Covered | Not Covered |
| Eyeglasses | Not Covered | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Generic - $4 Copayment | Generic - Not applicable |
| Tier 2 | Preferred Brand - $10 Copayment | Preferred Brand - Not applicable |
| Tier 3 | Non-Preferred Brand - $40 Copayment | Non-Preferred Brand - Not applicable |
| Tier 4 | Non-Preferred Drugs - $60 Copayment | Non-Preferred Drugs - Not applicable |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $6,350 includes Medical OOPM | Not listed |
| Prescription out-of-pocket maximum, family | $12,700 Includes medical OOPM | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (Medicare Advantage option) | $1,800 | Not listed |
| Part B premium reimbursement (prescription drug plan) | $800 | Not listed |
| Part D drug plan: most you pay in a year | $2,000 | Not listed |
| Deductible with Parts A and B | Not applicable | Not applicable |
| Out-of-pocket maximum with Parts A and B | $6,350 or less | Not applicable |
| Primary care with Parts A and B | $20 Copayment or less | Not applicable |
| Specialist with Parts A and B | $40 or less | Not applicable |
| Hospital stay with Parts A and B | $100 Copayment per day max 500 per stay or less | Not applicable |
| Part B reimbursement with Parts A and B | $800 Maximum annually | 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
Health Alliance Plan of Michigan plan site · Summary of Benefits and Coverage · Brochure RI 73-914 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · 800-556-9765
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.
