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.

Personal Care Account (PCA)

As a member of APWU Health Plan’s Consumer Driven Option plan, you may be eligible to get reimbursed for your MedicareRx Part D Prescription Drug plan (PDP) out-of-pocket costs through your Personal Care Account (PCA). The amount in your PCA can vary based on your enrollment status with APWU Health Plan and the rewards you’ve earned by taking certain health actions as part of the Consumer Driven Option medical plan. For instructions on how to access your PCA please visit the FAQ page.