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Frequently Asked Questions
Federal and postal retirees and their dependents who are retired, with Medicare A and B, and enrolled in the APWU Health Plan High Option plan.
- FEHB Participating plan codes include: 471, 472, 473.
- PSHB Participating plan codes include: 23A, 23B, 23C.
There is no additional premium to enroll in the Medicare Advantage plan. You must continue to pay your APWU Health Plan High Option premium and your Medicare premiums.
Yes. You must be enrolled in Medicare Part A and Part B to be eligible for our Medicare Advantage plan and you must continue to pay your Medicare premiums to the government. This is a requirement for Medicare Advantage plans. If you stop paying your Medicare premiums, you may be disenrolled from your plan.
APWU Health Plan High Option retirees with Medicare Part A and B who elect the Medicare Advantage plan will have the opportunity for reduced out-of-pocket costs with no additional premium added to their current High Option premiums and a monthly part B premium reduction of $100 per enrolled member.
Yes, you must remain enrolled in the APWU Health Plan High Option plan code with OPM to be eligible for the Medicare Advantage plan. Do not suspend or terminate your coverage with OPM or you will be terminated from the Medicare Advantage plan.
This Medicare Advantage plan is approved by OPM as a part of the FEHB and PSHB programs. This is why you must first enroll in the APWU Health Plan High Option Plan code with OPM and remain enrolled in that plan code – it keeps you within the FEHB or PSHB program. Do not suspend or terminate your coverage with OPM or you will also be terminated from the Medicare Advantage plan.
No, while you will remain an APWU Health Plan member in the FEHB or PSHB program, once enrolling in the Medicare Advantage plan it will take over as the primary and only payor. You will no longer need to coordinate between two plans.
Thank you for your service!
While VA Providers cannot submit claims to a Medicare Advantage plan, Veterans can request reimbursement when all of the following are true:
- You are a Medicare Advantage member or were at the time of the service
- You received Medicare-covered services from a VA Provider or facility
- You paid a higher copayment or coinsurance for the Medicare-covered services (including prescription drugs) through the VA than you would have using your Medicare Advantage plan
You can submit a request for reimbursement, by completing the VA 10-583 Form and mailing it to the address on your ID card.
No, you only need to contact OPM to enroll in the APWU Health Plan High Option plan code.
IRMAA is an amount Social Security determines you may need to pay in addition to your monthly Part B and D premium if your modified adjusted gross income on your IRS tax return from 2 years ago is above a certain limit. The Medicare Advantage plan for APWU Health Plan retirees includes prescription drug coverage and is considered a Part D plan, therefore if you currently have a Part B IRMAA then you may incur an additional Part D IRMAA when enrolling in this plan.
Your monthly Medicare part B premium subsidy will be automatically applied to your Medicare part B premium in the form of a reduced part B premium charge.
The method in which you pay your part B premium will be the method in which you will receive the subsidy. Your reduced part B premium will be applied on your Social Security benefit, direct bill from Medicare, or Annuity benefit depending on how you pay your premium.
You will not see a line-item credit on your statement, you will see a reduced premium amount. For example, in 2024 the part B premium is $174.70 and the subsidy amount is $85, therefore the charge you will see on your statement will be $89.70. The amount on your statement could vary should you have a part B Late Enrollment Penalty or a part B IRMAA. *Please note, the subsidy amount will increase from $85 to $100 in 2025.
No, this is a custom, OPM-approved, Medicare Advantage plan designed specifically for retirees in the FEHB and PSHB programs. The Medicare Advantage plans advertised on TV are Individual plans and are unrelated to the FEHB or PSHB programs, and may require you to suspend your FEHB or PSHB coverage.
Starting 1/1/2025, yes the APWU Health Plan’s Medicare Advantage plan includes an eyewear allowance.
Click on the Coverage and benefits tab for more information.
Each year that you are a member of a UnitedHealthcare Medicare Advantage or Medicare Part D Prescription Drug plan, you will receive an Annual Notice of Changes (ANOC) about six weeks before your plan's effective date. The ANOC explains any changes in coverage, costs, and benefits that will be effective for the upcoming year. You may also call the customer service number listed on your member ID card with any questions.
As a member of the APWU Health Plan High Option plan you may enroll in the enhanced level of benefits (UnitedHealthcare Group Medicare Advantage (PPO)) at any time. If you are not yet a member of APWU Health Plan, you must first enroll in the APWU Health Plan High Option plan during Open Season or during a Qualifying Life Event (QLE). You must remain enrolled in the APWU Health Plan High Option plan in order to be eligible for the enhanced level of benefits.