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- Am I Eligible?
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 Eligibility- ELIGIBILITY CHECK
- Open Season
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.
Compare Plan Options See Premiums See Provider Networks See 2020 Federal Brochure- HIGH OPTION
- CONSUMER DRIVEN OPTION
- CONVERSION OPTION
- Enroll
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- ENROLLMENT FACTS
- HOW TO ENROLL
- Healthy Living
TIPS AND TOOLS FOR
A HEALTHIER YOUFind health and wellness information
and tips for getting the most out of
your benefits.- HEALTH NEWS
- APWU Health
Plan MembersAPWU 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 - 7 pm EST
Monday - Friday- FOR HIGH OPTION MEMBERS
- Manage your benefits
- Service dates as of January 1, 2018
- eHealthRecord PLUS
- Service dates prior to January 1, 2018
- eHealthRecord
- My Tools
- Customer Service
- 2019 Benefits at a Glance
- Precertification
- Premiums
- Pharmacy
- Dental
- Behavioral Health
- Health Management Programs
- Hearing
- Cancer Centers of Excellence
- Retirees/Medicare
- FAQ
- FOR CONSUMER DRIVEN
OPTION MEMBERS - FOR ALL MEMBERS
- Change Your Address
- Order Claim Forms
- Conversion Option
- Drug Interaction Checker
- Medical Encyclopedia
- Symptom Checker
- HIPAA Privacy Forms
- Notice of Privacy Practices
- Advance Directives
- Complaints and Grievances
- Member Rights and Responsibilities Statement
- Beacon Health Options
- APW-ABA
- FSA Feds
- OPM.gov
- PostalEase
- Health Vault
- NAIC.org
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.
New for 2019
Members can obtain maintenance drugs at an in-network Smart90 retail pharmacy, which includes CVS and Walgreens.
| 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.
