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

Benefits and costs

Plan options 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.