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Coverage and benefits
Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.
Important Information about your Part D Vaccine and Insulin Coverage
What You Pay for Vaccines – Our plan covers most adult Part D vaccines at no cost to you.
What You Pay for Insulin – You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan. Refer to your plan materials.
MedicareRx Part D Prescription Drug plan (PDP) for APWU Health Plan Postal Retirees
2025 materials
- Summary of benefits (pdf)
-
Plan basics - coming soon
Benefits and costs
| Benefit |
2024: Consumer Driven Option 2024 pharmacy benefits |
2025: Medicare Part D Prescription Drug plan (PDP) for APWU Health Plan Postal Retirees |
|---|---|---|
|
2024: Consumer Driven Option 2024 pharmacy benefits |
2025: Medicare Part D Prescription Drug plan (PDP) for APWU Health Plan Postal Retirees |
|
| Deductible |
$2,200 – self only $4,400 – self +1 or more |
$0 * |
| Deductible | ||
|
$2,200 – self only $4,400 – self +1 or more |
$0 * |
|
| Out-of-pocket maximum |
$6,500 – self only $13,000 – self + 1 or more |
$2,000 * |
| Out-of-pocket maximum | ||
|
$6,500 – self only $13,000 – self + 1 or more |
$2,000 * |
|
| Prescription drug coverage | ||
| Prescription drug coverage | ||
| Retail: 30-day supply Note: 90 – day retail supply is available for 3x 30 – day retail price |
Tier 1: 25% coinsurance - $15 minimum, $200 maximum Tier 2: 25% coinsurance - $15 minimum, $200 maximum Tier 3: 40% coinsurance - $15 minimum, $300 maximum Tier 4: N/A |
Tier 1: 25% coinsurance - $20 maximum Tier 2: 25% coinsurance - $45 maximum Tier 3: 40% coinsurance - $100 maximum Tier 4: 40% coinsurance - $100 maximum |
| Retail: 30-day supply Note: 90 – day retail supply is available for 3x 30 – day retail price | ||
|
Tier 1: 25% coinsurance - $15 minimum, $200 maximum Tier 2: 25% coinsurance - $15 minimum, $200 maximum Tier 3: 40% coinsurance - $15 minimum, $300 maximum Tier 4: N/A |
Tier 1: 25% coinsurance - $20 maximum Tier 2: 25% coinsurance - $45 maximum Tier 3: 40% coinsurance - $100 maximum Tier 4: 40% coinsurance - $100 maximum |
|
| Mail Order: 90-day supply |
Tier 1: 25% coinsurance - $10 minimum, $200 maximum Tier 2: 25% coinsurance - $10 minimum, $200 maximum Tier 3: 40% coinsurance - $10 minimum, $300 maximum Tier 4: N/A |
Tier 1: 25% coinsurance - $40 maximum Tier 2: 25% coinsurance - $90 maximum Tier 3: 40% coinsurance - $200 maximum Tier 4: 40% coinsurance - $200 maximum |
| Mail Order: 90-day supply | ||
|
Tier 1: 25% coinsurance - $10 minimum, $200 maximum Tier 2: 25% coinsurance - $10 minimum, $200 maximum Tier 3: 40% coinsurance - $10 minimum, $300 maximum Tier 4: N/A |
Tier 1: 25% coinsurance - $40 maximum Tier 2: 25% coinsurance - $90 maximum Tier 3: 40% coinsurance - $200 maximum Tier 4: 40% coinsurance - $200 maximum |
|
* MedicareRx Part D Prescription Drug plan (PDP) deductible and out-of-pocket maximum applies separately for each enrolled individual. This means there is no combined deductible or out-of-pocket maximum for families.
Important 2025 changes explained
For 2025, all stand-alone Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage will be impacted by changes made by the federal government. This video provides an overview of those changes.