U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

This is a general description of the plan changes. This page is not an official statement of benefits. For that, go to the Benefits descriptions in the Plan Brochure. Also, we edited and clarified language throughout the brochure; any language change not shown here is a clarification that does not change benefits.

• Your share of the Postal premium will increase by 8.2% for Self Only or 8.0% for Self & Family.

• Your share of the non-Postal premium will increase by 9.3% for Self Only or 9.3% for Self and Family.

• You now pay an $18 copay per visit to a PPO physician. Previously, you paid $15.

• You now pay an $18 copay per in-network visit for mental conditions and substance abuse. Previously, you paid $15.

• The non-PPO calendar year deductible is now $500 per person with a maximum of $1,000 per family. Previously, this annual deductible was $350 per person with a maximum of $700 per family.

• If you are using non-PPO providers, your catastrophic protection out-of-pocket maximum is $10,000 for either a Self Only or a Self and Family enrollment. The limit was previously $8,000.

• For prescription drugs, you now pay an $8 copay for generic drugs obtained from a network pharmacy for either Medicare or non-Medicare. Last year, you paid $7.

• For prescription drugs, there is now an $8 minimum for brand name drugs obtained from a network pharmacy for either Medicare or non-Medicare. Last year, the minimum was $5.

• For prescription drugs, you now pay 50% with an $8 minimum for prescription drugs obtained from a non-network pharmacy for either Medicare or non-Medicare. Last year, you paid 45% and there was no minimum.

• For prescription drugs, you now pay a $12 copay for generic drugs obtained through Network Mail Order for either Medicare or non-Medicare. Last year, you paid $10.

• For prescription drugs, you now pay 25% for brand name drugs obtained through Network Mail Order for either Medicare or non-Medicare. Last year, you paid 20%.

• For prescription drugs, there is now a $12 minimum for brand name drugs obtained through Network Mail Order for either Medicare or non-Medicare. Last year, the minimum was $5.

• We now cover Osteoporosis screening, once every two years, for women age 65 or older under Preventive Care, adult.

• If you don't use a Plan-designated transplant facility, covered benefits for kidney transplants is now limited to $50,000. Previously, a $100,000 maximum was allowed.

• We now require prior approval of certain outpatient radiological procedures, specifically CAT/CT/MRI/MRA/NC/PET scans.

• For Inpatient hospital benefits, the non-PPO per admission deductible is now $300. Previously, it was $200 per admission.

• We have changed PPO networks in the following states: Alabama, Arizona, Arkansas, Colorado, Connecticut, Delaware, Georgia, Illinois, Indiana, Kentucky, Louisiana, Michigan, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, Pennsylvania, South Carolina, Tennessee, Texas and Wisconsin.

• Your share of the Postal premium will increase by 5.8% for Self Only or decrease by 1.0% for Self & Family.

• Your share of the non-Postal premium will increase by 6.9% for Self Only or 5.1% for Self and Family.

• We now cover Osteoporosis screening, once every two years, for women age 65 or over under In-network Preventive Care.

• We have changed or added PPO networks in the following states: Illinois, Iowa, Nebraska, Ohio, Oklahoma, Wisconsin and Wyoming.