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 decrease by 11.2% for Self Only or 15.5% for Self and Family.

• For medications purchased at a retail pharmacy, or through the mail order program, you will be responsible for a $5 copayment per generic prescription or refill, $20 copayment per preferred brand name prescription or refill, or a $35 copayment per non-preferred brand name prescription or refill, for each 30 day supply you purchase.

• Your copayment for all pre-and post-natal care visits will be $5 for the first 10 visits: remaining visits covered in full

• Your copay for primary care physician visits for children under the age of 5 will be $5 per visit

• Your copay for the following services will be $15 per visit:

  • Professional services rendered in a physician's office, medical consultations and second surgical opinions.

  • Periodic adult physicals and Bi-annual pelvic exams

  • Routine Immunizations for Tetanus-diphtheria, influenza(annually) and pneumococcal vaccines (annually age 65 and older

  • X-rays, Mammograms, Cat Scans/MRI, Ultrasounds

  • Eye exams for routine refraction and disease of the eye

  • Family planning services limited to voluntary sterilization, surgically implanted contraceptives, Injectable contraceptive devices, intrauterine devices and diaphragms

  • Infertility services including intravaginal insemination, intracervical insemination, and intrauterine insemination

  • Allergy care testing and treatment

  • Respiratory and growth hormone therapy

  • Physical, occupational, speech and cardiac therapy

  • Hearing testing and exams

  • Routine hearing tests and exams

  • Chiropractic care

  • Surgical procedures performed in a physician's office

  • Emergency care at a doctor's office

  • Accidental injury benefit covering services and supplies necessary to promptly repair sound and natural teeth.

  • Professional services, including individual or group therapy by providers such as psychiatrists, psychologists or clinical social workers and medication management

  • Sigmoidoscopy screenings

  • Colonoscopy screenings