Manage your Consumer Driven Option federal health plan
Get to know how your PCA works
- $1,200 for Self
- $2,400 for Self Plus One or Self & Family
You're covered 100% until your PCA is exhausted
- 1. Use your PCA for all eligible expenses.
- 2. If you use up your PCA funds, you need to satisfy your annual net deductible.
- 3. After you satisfy the annual Plan deductible, you pay coinsurance—a percentage of the cost of covered healthcare—and the Plan pays the rest.
- 4. If you reach the out-of-pocket maximum, the Plan pays 100% of your healthcare costs for the rest of the year.
Save money by staying in the network
Your PCA covers both in-network and out-of-network services. However, you can save money by staying in the network because network providers discount their fees.
APWU Health Plan covers most out-of-network services at 50% of the Plan allowance, while members pay 50%.
Earn rewards by taking steps to protect your health
Receive a $25 wellness incentive—added to your PCA—for each family member who completes:
- An annual physical exam
- Mammogram
- Cervical cancer screening
Choose how you pay for medical claims
If you have funds available in your PCA, claims will be paid out of your PCA first. If you want to use a different pre-tax benefit account to pay your medical bills, you can turn off your PCA online. In some cases, you may have to pay the cost of the services upfront.
Pharmacy claims will always be paid out of your PCA, as long as you have funds available.
Access Consumer Driven Option tools, resources, and benefit details
Prescription coverage
OptumRx manages your pharmacy benefits and offers home delivery.
Health management programs
Protect your well-being and live a healthier life, usually with no out-of-pocket costs.
Benefits & coverage
Your plan covers preventive care, medical visits, dental care, mental health, and more.
Download and access Health Plan resources
2025 Federal Brochure
2025 FEHB Consumer Driven Option Summary of Benefits and Coverage (SBC)
Consumer Driven Option Preferred Formulary
See a list of generic and brand-name prescription drugs covered by your health plan.
