HMSA Plan, 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 M6A | $101.63 gov $304.90 | $220.20 | $220.20 | +$4.84 biweekly (+5.0%) | $2,642 |
| Self Plus One code M6C | $222.68 gov $668.05 | $482.48 | $482.48 | +$10.60 biweekly (+5.0%) | $5,790 |
| Self and Family code M6B | $228.47 gov $685.40 | $495.01 | $495.01 | +$10.88 biweekly (+5.0%) | $5,940 |
Traditional, HMO/POS network. Offered in Hawaii (statewide). 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 None | None out of network None | None out of network None |
| Out-of-pocket maximum | $3,000 out of network $3,000 | $6,000 out of network $6,000 | $9,000 out of network $9,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Primary care visit | $15 Copayment | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge.to eligible charge; member pays difference between actual charge and eligible charge. |
| Specialist visit | $15 Copayment | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge.to eligible charge; member pays difference between actual charge and eligible charge. |
| Urgent care | $20 Copayment | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge.to eligible charge; member pays difference between actual charge and eligible charge. |
| Emergency room | 20% Coinsurance ER facility; coinsurance applies to eligible charge. | 20% Coinsurance ER facility; coinsurance applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Labs and X-rays | $0 Copayment | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| CT, MRI, PET | 20% Coinsurance pplies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Hospital stay, per admission | $200 Copayment Based on semi-private room rate; per admission. | 30% Coinsurance Based on semi-private room rate; coinsurance applies to eligible; member pays difference between actual charge and eligible charge. |
| Hospital room | $200 Copayment Based on semi-private room rate; per admission. | 30% Coinsurance Based on semi-private room rate; coinsurance applies to eligible; member pays difference between actual charge and eligible charge. |
| Surgeon, inpatient | Member Pays Nothing Benefits may vary depending on services rendered. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge; benefits may vary depending on services rendered. |
| Outpatient surgery | Member Pays Nothing | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Mental health, office | $15 Copayment | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Mental health, inpatient | $200 Copayment Per admission. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Physical therapy | 20% Coinsurance Applies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Chiropractic | 20% Coinsurance Applies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Acupuncture | Member Pays All Charges Not a covered benefit | Member Pays All Charges Not a covered benefit |
| Maternity care | Member Pays Nothing | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Maternity hospital stay | $200 Copayment Per admission. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Infertility diagnosis and treatment | 20% Coinsurance Applies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| IVF and assisted reproduction | 20% Coinsurance Coinsurance applies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Hearing aids | Covered One per ear per 60 months; coinsurance applies to eligible charge. | Covered One per ear per 60 months; coinsurance applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Durable medical equipment | 20% Coinsurance Applies to eligible charge. | 30% Coinsurance Applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Home health | 20% Coinsurance 150 visits per calendar year; coinsurance applies to eligible charge. | 30% Coinsurance 150 visits per calendar year; coinsurance applies to eligible charge; member pays difference between actual charge and eligible charge. |
| Adult dental exams | Covered Adult dental care does not count toward max OOP. | Covered Adult dental care does not count toward max OOP. |
| Children's dental exams | Covered | Covered |
| Routine eye exam | Covered Adult vision care does not count toward max OOP. | Covered Adult vision care does not count toward max OOP. |
| Eyeglasses | Covered For certain medical conditions; adult vision care does not count toward max OOP. | Covered For certain medical conditions; adult vision care does not count toward max OOP. |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | Preferred Generic - $7 Copayment | Preferred Generic - $7 Copayment |
| Tier 2 | Preferred Brand - $35 Copayment | Preferred Brand - $35 Copayment |
| Tier 3 | Non-Preferred Brand - $70 Copayment | Non-Preferred Brand - $70 Copayment |
| Tier 4 | Preferred Specialty Tier - $160 Copayment | Preferred Specialty Tier - Not applicable |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | $3,000 Combined with medical | Not listed |
| Prescription out-of-pocket maximum, family | $9,000 Combined with medical | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | $0 | Not listed |
| Part D drug plan: most you pay in a year | $2,400 TrOOP is not applicable to secondary, but once the Primary Medicare plan $2400 MOOP has been met, claims on both the Primary and Secondary plan shall have $0 Catastrophic copays | Not listed |
| Deductible with Parts A and B | Not applicable | Not applicable |
| Out-of-pocket maximum with Parts A and B | $3,000 Self; $6,000 self plus one; $9,000 self plus family | $3,000 Self; $6,000 self plus one; $9,000 self plus family |
| Primary care with Parts A and B | $15 | 30% Coinsurance applies to eliglble charge; member pays difference between actual charge and eligible charge |
| Specialist with Parts A and B | $15 | 30% Coinsurance applies to eliglble charge; member pays difference between actual charge and eligible charge |
| Hospital stay with Parts A and B | $200 Based on semiprivate room rate; per admission | 30% Based on semiprivate room rate; coinsurance applies to elgible charge; member pays difference between actual charge and eligible charge |
| Part B reimbursement with Parts A and B | Not applicable | 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
HMSA Plan plan site · Summary of Benefits and Coverage · Brochure RI 73-916 (the official statement of benefits) · Every PSHB brochure · OPM premiums · What this brochure says about GLP-1 drugs · (808) 948-6499
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.
