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 1.6% for Self Only or decrease by -10.3% for Self and Family.

• The copayment for Durable Medical Equipment has changed from $20 per office visit to 20% coinsurance per item or per rental period. See page 21.

• The Prescription drug benefit is changed as follows:
  • The dispensing limitation has changed from a 34 day supply to a 30 day supply. See page 34.
  • A limited number of drugs will be available in a 90-day supply subject to three copayments. This changed from a 100 day supply for three copayments. See page 34.
  • Injectable medications administered in a clinic setting will be subject to the prescription drug copayments. See page 34.
  • A patient will be able to purchase a formulary brand drug when a formulary generic drug is prescribed when the name brand copayment and the difference between the generic and name brand are paid. See page 34.

• Physical and Occupational therapies will be limited to 40 visits (combined) per year. Previously the benefit limit was 60 consecutive days per condition. See page 19.

• Hospice Care: GHC will continue to cover in-home services only. If a member chooses in-patient services, the member will be responsible for the difference in GHC’s daily in-home allowance and the actual cost billed by the hospice organization. See page 27.