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2004 Premiums | FAQ | Glossary

You are here: OPM Home > Insurance > FEHB > Choose a Plan and Enroll > Additional Plan Information > Preferred Care Changes

Preferred Care Changes for 2004

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 9.8% for Self Only or 9.8% for Self and Family.
Your copayment for adult influenza shots has been reduced from $15 to $0.
Your Primary Care Physician (PCP) copayment for sick child visits for children ages 5 through 18 has been reduced from $15 to $10.
You will be required to pay a $15 copayment for provider administered prescription medications if a separate charge is made by the provider for that medication. This copayment will be in addition to any copayment applied for that day.
For approved medications purchased through the mail order program, you will be responsible for a $25 tier 1 generic prescription or refill, or a $50 tier 2 brand name prescription or refill, or a $87.50 tier 3 brand name prescription or refill, for each 90 day supply that you purchase.
Your benefit for durable medical equipment will be subject to a $15,000 annual maximum.
You are not covered for smoking cessation deterrents such as Zyban, Nicotrol, and Habitrol, which may be purchased over the counter without a prescription from your doctor.

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