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FOR ALL
FEDERAL WORKERS
AND RETIREESAll federal and postal employees and retirees who are eligible to enroll in the FEHB Program may become members of APWU Health Plan.
Check EligibilityELIGIBILITY CHECK
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SHOPPING FOR A PLAN?
START HERE.APWU Health Plan is a National Preferred Provider Organization (PPO) offering both a fee-for-service High Option Health Plan and a Consumer Driven Option Health Plan. We have been proudly serving America's workforce since 1960.
HIGH OPTION
CONSUMER DRIVEN OPTION
CONVERSION OPTION
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KEY ENROLLMENT
DATESNew members can enroll during Open Season in the fall, or within 60 days of new employment, or for a qualifying life event.
How to Enroll -
TIPS AND TOOLS FOR
A HEALTHIER YOUFind health and wellness information
and tips for getting the most out of
your benefits.HEALTH NEWS
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APWU HEALTH
PLAN IS PROUD
TO SERVE YOU.YOU CAN CONTACT US AT
1-800-222-APWU (2798)
1-800-622-2511 (TDD)
8:30 am – 6:30 pm ET
Monday - FridayFOR HIGH OPTION MEMBERS
FOR CONSUMER DRIVEN
OPTION MEMBERSFOR ALL MEMBERS
- Change Your Address
- Order Claim Forms
- Form 1095-B
- Conversion Option
- Health Risk Assessments
- Health Management Programs
- Drug Interaction Checker
- Medical Encyclopedia
- Symptom Checker
- HIPAA Privacy Forms
- Notice of Privacy Practices
- (file download link)Advance Directives
- (file download link)Complaints and Grievances
- (file download link)Member Rights and Responsibilities Statement
- (file download link)Surprise Billing Notice
- Healthier at Home(external link)
- APW-ABA(external link)
- FSA Feds(external link)
- OPM.gov(external link)
- PostalEase(external link)
- NAIC.org(external link)
The High Option has contracted with 70,432 retail pharmacies throughout the country. These pharmacies belong to the Express Scripts® Health Prescription Solutions network, and the pharmacies discount their charges and bill the Health Plan automatically for you.
The High Option Plan also offers a convenient mail order program for our members with long-term prescription needs. Both programs offer no deductible and low copayments.
Diabetes medications available through mail-order
- $0 copay for generic oral medication, formulary blood glucose test strips and lancets (used to reduce blood sugar)
- $25 copay for a 30-day supply of certain insulin and non-insulin drugs to treat diabetes
- $75 copay for a 90-day supply of certain insulin
| In-network you pay | Out-of-network you pay | |
|---|---|---|
| Retail prescription drugs - non-specialty (30-day supply) |
$10 for Tier 1 drugs, 25% for Tier 2 drugs, maximum $200 per Rx, 45% for Tier 3 drugs, maximum $300 per Rx, (no deductible) |
50% ($10 minimum coinsurance), (no deductible) |
| Mail order prescription drugs - non-specialty (90-day supply) |
$20 for Tier 1 drugs, 25% for Tier 2 drugs, maximum $300 per Rx, 45% for Tier 3 drugs, maximum of $500 per Rx, (no deductible) |
N/A |
| Retail prescription drugs - specialty | 25% for Tier 1 drugs, maximum of $300 per Rx, 25% for Tier 2 drugs, maximum $600 per Rx, 45% for Tier 3 drugs, maximum $1,000 per Rx, (no deductible) |
50% ($10 minimum coinsurance), (no deductible) |
| Mail order prescription drugs - specialty | 25% for Tier 1 drugs, maximum $150 per Rx, 25% for Tier 2 drugs, maximum $300 per Rx, 45% for Tier 3 drugs, maximum $500 per Rx, (no deductible) |
N/A |
With both the mail order and the retail drug programs, there is no paperwork for the member to file. The pharmacy does the work for you.
