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APWU Health Plan FAQ

APWU Health Plan has been offering affordable, comprehensive coverage to postal workers, federal employees, and retirees since 1960. We’re here to help you choose a plan that’s right for you and make the most of your benefits.

If you can’t find an answer to your question, contact us to speak with a customer service representative:

1-800-222-2798 | 1-800-622-2511 (TTY)

Monday – Friday, 8:30 am – 6:30 pm ET

Displaying FAQs for Medicare

What is Medicare Part B?

Medicare Part B (medical insurance) helps cover the outpatient services you receive from doctors and other healthcare providers:

Doctor visits
Outpatient hospital care
Home health care not covered by Part A
Durable medical equipment (including wheelchairs, walkers, and hospital beds)

Part B covers medically necessary services and supplies that meet accepted standards of medical practice to diagnose or treat a medical condition. In addition, it covers preventive services, like screenings, flu shots, vaccines, and yearly wellness visits.

Your premium is deducted from your Social Security check each month, and you must meet a deductible. You’ll also need to pay a percentage for most doctor services, usually 20%.

For many retirees, Part B is a critical component of an overall health package. If you don’t sign up for Part B when you’re first eligible, you may be penalized by paying a much higher monthly premium.

What is Medicare Part A?

Medicare Part A (hospital insurance) helps pay for inpatient care you get in hospitals, skilled nursing facilities, and some home health care. It also helps cover hospice care.

Most postal and federal employees and retirees are entitled to premium-free Part A.

What is Original Medicare?

Original Medicare is a fee-for-service health insurance program that has two parts: Part A and Part B. You typically pay a portion of the costs for the covered services you receive. Under Original Medicare, you don’t have coverage through a Medicare Advantage plan or another type of Medicare health plan.

Original Medicare (Parts A and B) covers most medically necessary services and supplies in hospitals, doctors’ offices, and other healthcare facilities. In general, Original Medicare does not cover most vision, dental, and hearing services.

What is Medicare?

Medicare is federal health insurance for anyone age 65 and older and some people under 65 with certain disabilities or conditions, including end-stage renal disease (ESRD). It’s made up of four parts—Part A, Part B, Part C, and Part D. Each part helps pay for certain services and also includes specific costs you may need to pay.

How do I locate a Cancer Center of Excellence?

When you enroll in the APWU Health Plan, you will have access to designated Cancer Centers of Excellence around the country.

High Option: With pre-approval, you pay only 5% of the treatment costs at these in-network designated centers.

Consumer Driven Option: If you decide to use a designated Cancer Center of Excellence, you may receive prior approval for travel and lodging costs. With pre-approval and in the network, you pay 10% of the Plan allowance.

Locate Cancer Centers of Excellence

Does APWU Health Plan provide gender-affirming care?

APWU Health Plan recognizes that transgender, non-binary, and other gender-diverse members require healthcare delivered by providers experienced in gender-affirming health.

Gender-affirming services include therapy to address feelings of gender dysphoria and medical treatments that help you achieve physical characteristics that better align with your gender identity.

Gender affirming surgery requires prior approval. Under the High Option and Consumer Driven Option, members need to call UnitedHealthcare before receiving gender-affirming surgery. Failure to do so will result in a minimum $500 penalty for an inpatient hospital stay.

See the postal or federal brochure for complete details.

How can I contact APWU Health Plan for enrollment support?

High Option

For questions about the High Option, contact APWU Health Plan to speak with a customer service representative:

1-800-PIC-APWU (Open Season)

1-800-222-APWU (2798)

1-800-622-2511 (TTY)

8:30 am – 6:30 pm ET, Monday – Friday

If the Health Plan is experiencing a high call volume, you can schedule a call back, 9 am – 6:30 pm ET, Monday – Friday.

Consumer Driven Option

For questions about the Consumer Driven Option, contact UnitedHealthcare:

1-855-808-3003

whyuhc.com/apwuhp

Medicare Advantage

To find out if you’re eligible to enroll in the Medicare Advantage plan, call:

1-855-383-8793

711 (TTY)

8 a.m. – 8 p.m. CT, Monday – Friday

Medicare

For questions about Medicare, contact the OPM Postal Enrollment Retirement Call Center:

1-844-451-1261

OPM Retirement Center

What does Medicare coordination to my PHSB plan mean for my spouse and family?

Postal Service employees and annuitants’ eligibility determines spousal and family PSHB coverage. If the enrollee is not required to enroll in Medicare Part B, neither will dependent family members.

Would I be able to save money by coordinating my PSHB coverage with Medicare? How does PSHB and Medicare coordination add value to my healthcare coverage?

As an annuitant, enrolling in PSHB and Medicare may reduce your out-of-pocket costs for healthcare. Though there is a premium cost for Medicare Part B, it is important to consider your long-term health care needs. As you get older you may realize a greater benefit from having PSHB and Medicare coverage.

While annuitants will have an additional cost associated with Medicare Part B coverage, many PSHB plans may eliminate cost-sharing and reimburse part of the Part B premium for Medicare enrollees. Also, annuitants may be able to select a lower cost PSHB plan when enrolling in Medicare. These savings may offset the costs of Medicare Part B coverage.

APWU Health Plan FAQ

High Option

Consumer Driven Option

Medicare Advantage

Medicare

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