Benefits and coverage for your Consumer Driven Option postal plan
The Consumer Driven Option is a proactive alternative to conventional healthcare, paired with a Health Plan-funded Personal Care Account (PCA) that helps pay for medical expenses.
Use your PCA to pay for
- Medical care
- Prescription drugs and supplies
- Dental and vision, including eyeglasses and contact lenses (up to $400 for Self coverage, and $800 for Self Plus One or Self & Family coverage)
- Surgery and hospital services
- Mental health and substance use treatment
- Emergency care
- Medicare Part B premium
100% coverage for many in-network services
- Preventive care and screenings
- Maternity care and support
- Breast cancer screenings
- Quit for Life® tobacco cessation program
- One Pass Select fitness and gym discounts
- Maven maternity program
- Receive $25 wellness incentives for completing an annual physical exam, mammogram, cervical cancer screening, or colonoscopy/Cologuard
Your PCA covers 100% of all covered healthcare expenses
In January each year, APWU Health Plan funds a PCA you can use for covered medical services. You’re covered 100% until your PCA is exhausted.
Get to know how your PCA works and how it can decrease your plan deductible and out-of-pocket expenses.
Self
$1,200 — APWU Health Plan contribution
Self Plus One / Self & Family
$2,400 — APWU Health Plan contribution
2026 Consumer Driven Option coverage
2026 BENEFITS
In-network you pay
| Preventive care | |
|---|---|
| Well-child care, immunizations, adult routine exams, preventive screenings | $0 — No PCA used |
| Receive a $25 wellness incentive for each family member who completes an annual physical exam, mammogram, cervical cancer screening, or colonoscopy/Cologuard | |
| Medical visits | |
| Office, specialist, & virtual visits | 15% of Plan allowance (Plan allowance: The maximum amount a plan will pay for a covered healthcare service |
| Dental care | |
| Save 20% – 50% on most procedures at dentists in the Careington Dental Discount Network | |
| Maternity | |
| Complete maternity care, including prenatal, delivery, postnatal and initial exam of newborn covered under family enrollment | $0 — No PCA used |
| Hospital/facility care | |
| Diagnostic tests or imaging | 15% of Plan allowance |
| Outpatient surgery | 15% of Plan allowance |
| Inpatient surgery | 15% of Plan allowance |
| Cancer Center of Excellence | 10% of Plan allowance |
| Infertility treatment | |
| Diagnostic and treatment services | 15% of Plan allowance |
| Emergency care | |
| Accidental injury (within 72 hours) | 15% of Plan allowance |
| Urgent care | 15% of Plan allowance |
| Emergency room | 15% of Plan allowance |
| Ambulance | 15% of Plan allowance |
| Air Ambulance | 15% of Plan allowance |
| Hearing services | |
| Diagnostic hearing tests | 15% every 2 years |
| Hearing aids | All charges in excess of $1,500 (every 3 years, no deductible applied) |
| Mental health/substance use | |
| Office visits | 15% of Plan allowance |
| Outpatient treatment | 15% of Plan allowance |
| Diagnostics, inpatient and outpatient services | 15% of Plan allowance |
| Virtual behavioral health care | 15% of Plan allowance |
| Alternative care | |
| Chiropractic care | 15% of Plan allowance (24 visits per year) |
| Acupuncture | 15% of Plan allowance (26 visits per year) |
| Physical, occupational and speech therapy | 15% of Plan allowance (60 visits per year) |
| Prescription coverage | |
|
Network retail Tier 1/Tier 2 Lower cost/Mid-range cost |
Per Rx: 25% with a min of $15 and a max of $200 for a 30-day supply, $400 for a 60-day supply, and $600 for a 90-day supply |
|
Tier 3 Highest cost |
Per Rx: 40% min of $15 and max of $300 for a 30-day supply, $600 for a 60-day supply, and $900 for a 90-day supply |
|
Network home delivery Tier 1/Tier 2 Lower cost/Mid-range cost |
Per Rx: 25% with a min of $10 and a max of $200 for a 30-day supply, $400 for a 60-day supply, and $600 for a 90-day supply |
|
Tier 3 Highest cost |
Per Rx: 40% min of $10 and max of $300 for a 30-day supply, $600 for a 60-day supply, and $900 for a 90-day supply |
Take advantage of added benefits for Consumer Driven Option members
Download and access Health Plan resources
