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 non-Postal premium will increase by 5.8% for Self Only or 5.8% for Self and Family.

• The copay for Abortion has changed from $150 to $200.

• The copay for Ambulance has changed from $0 to $50 per trip.

• The copay for Home visits by physicians has changed from $0 to $10.

• Durable Medical Equipment, Orthopedic and Prosthetic devices have a maximum benefit of $2,500 per calendar year.

• The copay for Emergency Care at an urgent care center, within the service area has changed from $25 to $50.

• The copay for Emergency care outside the service area has changed from $25 to $50.

• The copay for Inpatient Hospital has changed from $100 per day up to $300 per person to $300 per admission

• The copay for Skilled Nursing Facility has changed from $100 per day up to $300 per person to $300 per admission

• The limit on Skilled Nursing Facility is 30 days per calendar year

• The copay for Maternity Care has changed from $0 to $10.

• The copay for Tubal Ligation has changed from $100 to $200.

• Medically necessary drugs to treat sexual dysfunction, including, but not limited to, Viagra, Yocon, Muse and Caverjet are limited to eight (8) pills per member per month, with a 50% copay and must be prior authorized by the Contracting Medical Group.

• Your catastrophic protection out-of-pocket maximum for copay is $2,000 per person and $4,000 per family in any calendar year.

• Hearing testing for children is through age 17.

• We addded a prescription drug mail order benefit.