Coverage and benefits

Get a quick overview of your plan benefits and costs and find more detailed information about additional benefits and programs.

UHC Feds PSHB 2026 Plan Options

2027 materials

Retiree Advantage and Choice Plus Primary Medical with MedicareRx Part D plan comparison flyer (pdf)

Option 1: Retiree Advantage Plan (PPO)

Plan guide - Coming soon
Summary of benefits - Coming soon
Part B premium subsidy (pdf)
Foreign Travel brochure (pdf)

Option 2: Choice Plus Medical with MedicareRx PDP

Benefits and costs

Plan options and costs
Benefits	Option 1: Retiree Advantage Plan (PPO)	Option 2: Choice Plus Medical with MedicareRx PDP
Option 1: Retiree Advantage Plan (PPO)	Option 2: Choice Plus Medical with MedicareRx PDP
Medical coverage overview*
Medical coverage overview*

Deductible	$0	$750
Deductible
$0	$750
Annual out-of-pocket maximum	$0	$7,350**
Annual out-of-pocket maximum
$0	$7,350**
Office and clinic visits	$0 copay primary care office visit $0 copay specialist office visit	$0 copay primary care office visit $60 copay specialist office visit
Office and clinic visits
$0 copay primary care office visit $0 copay specialist office visit	$0 copay primary care office visit $60 copay specialist office visit
Emergency room and ambulance	$0 copay	20% coinsurance after deductible
Emergency room and ambulance
$0 copay	20% coinsurance after deductible
Hospital services (inpatient)	$0 copay	20% coinsurance after deductible
Hospital services (inpatient)
$0 copay	20% coinsurance after deductible
Hearing aid allowance	$0 copay up to $1,500 allowance	20% coinsurance after deductible up to $2,500
Hearing aid allowance
$0 copay up to $1,500 allowance	20% coinsurance after deductible up to $2,500
Part D prescriptions***	Yes	Yes
Part D prescriptions***
Yes	Yes
Rx Deductible	$0	$0
Rx Deductible
$0	$0
Rx annual out-of-pocket maximum	$2,100	$2,100
Rx annual out-of-pocket maximum
$2,100	$2,100
Prescription drug coverage	Retail Tier 1: $5 copay Tier 2: $25 copay Tier 3: $60 copay Tier 4: $90 copay Mail Order – 90-day supply Tier 1: $10 copay Tier 2: $50 copay Tier 3: $120 copay Tier 4: $180 copay Once your True Out of Pocket (TROOP) reaches $2,400 you enter the Catastrophic Coverage level and will have no copay for all covered medications.	Retail Tier 1: $10 copay Tier 2: $45 copay Tier 3: $100 copay Tier 4: $100 copay Mail Order – 90-day supply Tier 1: $25 copay Tier 2: $112.50 copay Tier 3: $250 copay Tier 4: $250 copay Once your True Out of Pocket (TROOP) reaches $2,400 you enter the Catastrophic Coverage level and will have no copay for all covered medications.
Prescription drug coverage
Retail Tier 1: $5 copay Tier 2: $25 copay Tier 3: $60 copay Tier 4: $90 copay Mail Order – 90-day supply Tier 1: $10 copay Tier 2: $50 copay Tier 3: $120 copay Tier 4: $180 copay Once your True Out of Pocket (TROOP) reaches $2,400 you enter the Catastrophic Coverage level and will have no copay for all covered medications.	Retail Tier 1: $10 copay Tier 2: $45 copay Tier 3: $100 copay Tier 4: $100 copay Mail Order – 90-day supply Tier 1: $25 copay Tier 2: $112.50 copay Tier 3: $250 copay Tier 4: $250 copay Once your True Out of Pocket (TROOP) reaches $2,400 you enter the Catastrophic Coverage level and will have no copay for all covered medications.
Extras
Extras

Part B premium reduction	$150 per month	$0
Part B premium reduction
$150 per month	$0
Nationwide network	Yes	Yes
Nationwide network
Yes	Yes
Referrals required	No	No
Referrals required
No	No
Worldwide emergent and routine coverage	Yes	No
Worldwide emergent and routine coverage
Yes	No
Free gym memberships	Yes	No
Free gym memberships
Yes	No
$40 quarterly over-the-counter item credit	Yes	No
$40 quarterly over-the-counter item credit
Yes	No
One plan – no need to coordinate benefits	Yes	No
One plan – no need to coordinate benefits
Yes	No

* This list is an overview and does not include all benefits. Please refer to your plan materials for full plan benefits.

** Coupons and copay assistance programs cannot be used under either the Retiree Advantage plan or the Part D prescription.

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.

Preventive services

The following preventive services are covered under your plan for a $0 copay when you visit your primary care provider:

Annual Wellness Exam
Annual Routine Physical
Screenings for certain Cancers (Prostate, colorectal, breast cancer)
Screening for diabetes
Smoking and Tobacco Use Cessation

For more information about these preventive services, please call the Customer Service number on your UCard.