Actives and annuitants with Medicare

HMSA Plan for Postal Service Employees is the plan for employees who are eligible to participate in the Postal Service Health Benefits (PSHB) Program.

 Postal Service annuitants and eligible dependents

Benefits

Learn more about the services your plan pays for.

2025 Plan Changes document thumbnail

2025 Plan Rates [PDF]
See a summary of rates for the 2025 plan year.

2025 Member Booklet document thumbnail

2025 Member Booklet [PDF]
Member booklet for open season.

2025 Plan Brochure document thumbnail

2025 Plan Brochure [PDF]
View benefits and services included in your plan.
View on opm.gov

2025 plan summary

High Option Plan Standard Option Plan
Plan Documents
Plan Documents

Annual Medical Out-of-pocket Maximum

$3,000 per person
(Some costs can’t be applied to your maximum.)

Annual Medical Out-of-pocket Maximum

$5,000 per person
(Some costs can’t be applied to your maximum.)

Medical Benefits


Physician visit
$15

No charge
  • Lab and pathology services
  • Diagnostic, psychological, and lab tests
  • Partial hospitalization and outpatient facility
20% of eligible charges
  • X-rays
  • Outpatient hospital services
  • Emergency room facility copayment and other emergency services
$15 copayment
  • Professional services and medication management
$200 copayment
  • Inpatient hospital services
  • Inpatient admission

Medical Benefits


Physician visit*
$20

30% of eligible charges
  • Lab and pathology services*
  • X-rays
  • Inpatient hospital services
  • Outpatient hospital services
  • Emergency room facility copayment and other emergency services
  • Diagnostic, psychological, and lab tests
  • Inpatient admission
  • Partial hospitalization and outpatient facility
$20 copayment
  • Professional services and medication management*

HMSA Medicare Postal Prescription Drug Plan

HMSA Medicare Postal Prescription Drug Plan

Annual Drug Out-of-pocket Maximum

$2,000 per person
(The annual drug out-of-pocket maximum is maximum accumulates towards the medical out-of-pocket maximum.)

Annual Drug Out-of-pocket Maximum

$2,000 per person
(The annual drug out-of-pocket maximum is maximum accumulates towards the medical out-of-pocket maximum.)

Drug Benefits

  • Tier 1 (preferred generic drugs)
    $7 copayment
  • Tier 2 (generic drugs)
    $20 copayment
  • Tier 3 (preferred brand drugs)
    $20 copayment
  • Tier 4 (non-preferred drugs)
    $70 copayment
  • Tier 5 (specialty drugs)
    $80 copayment

Drug Benefits

  • Tier 1 (preferred generic drugs)*
    $7 copayment
  • Tier 2 (generic drugs)
    25% of eligible charge up to $100
  • Tier 3 (preferred brand drugs)
    25% of eligible charge up to $100
  • Tier 4 (non-preferred drugs)
    40% of eligible charge up to $600
  • Tier 5 (specialty drugs)
    $200 copayment

Dental Benefits


No charge
  • Annual exam
  • Annual cleaning
30% of eligible charges
  • Fillings
  • Extractions
  • Root canal
  • Anesthesia
  • X-rays

Dental Benefits


30% of eligible charges for Accidental Injury benefits only.

Vision Benefits2


20% of eligible charges
  • Annual exam

Vision Benefits2


30% of eligible charges
  • Annual exam

Infertility Benefits


20% of eligible charges

Infertility Benefits


30% of eligible charges

Infertility definition

Infertility is the failure to achieve a successful pregnancy after regular, unprotected intercourse or artificial insemination for 12 months or more (6 months for individuals over age 35). Infertility may also be established through an evaluation based on medical history and diagnostic testing.

Diagnosis and treatment of infertility specific to:

  • Artificial Insemination (AO)
  • Assisted Reproductive Technology Procedures
  • In Vitro Fertilization (IVF)

More resources

High Option Plan

Plan Documents

Annual Medical Out-of-pocket Maximum

$3,000 per person
(Some costs can’t be applied to your maximum.)

Medical Benefits


Physician visit
$15

No charge
  • Lab and pathology services
  • Diagnostic, psychological, and lab tests
  • Partial hospitalization and outpatient facility
20% of eligible charges
  • X-rays
  • Outpatient hospital services
  • Emergency room facility copay and other emergency services
$15 copayment
  • Professional services and medication management
$200 copayment
  • Inpatient hospital services
  • Inpatient admission

HMSA Medicare Postal Prescription Drug Plan


Drug Benefits


  • Tier 1 (preferred generic drugs)
    $7 copayment
  • Tier 2 (generic drugs)
    $20 copayment
  • Tier 3 (preferred brand drugs)
    $20 copayment
  • Tier 4 (non-preferred drugs)
    $70 copayment
  • Tier 5 (specialty drugs)
    $80 copayment


Annual Drug Out-of-pocket Maximum

$2,000 per person
(The annual drug out-of-pocket maximum is maximum accumulates towards the medical out-of-pocket maximum.)

Dental Benefits


No charge
  • Annual exam
  • Annual cleaning
30% of eligible charges
  • Fillings
  • Extractions
  • Root canal
  • Anesthesia
  • X-rays

Vision Benefits2


20% of eligible charges
  • Annual exam

Infertility Benefits


20% of eligible charges

Standard Option Plan

Plan Documents

Annual Medical Out-of-pocket Maximum

$5,000 per person
(Some costs can’t be applied to your maximum.)

Medical Benefits


Physician visit*
$20

30% of eligible charges
  • Lab and pathology services*
  • X-rays
  • Inpatient hospital services
  • Outpatient hospital services
  • Emergency room facility copayment and other emergency services
  • Diagnostic, psychological, and lab tests
  • Inpatient admission
  • Partial hospitalization and outpatient facility
$20 copayment
  • Professional services and medication management*

HMSA Medicare Postal Prescription Drug Plan


Drug Benefits


  • Tier 1 (preferred generic drugs)*
    $7 copayment
  • Tier 2 (generic drugs)
    25% of eligible charge up to $100
  • Tier 3 (preferred brand drugs)
    25% of eligible charge up to $100
  • Tier 4 (non-preferred drugs)
    40% of eligible charge up to $600
  • Tier 5 (specialty drugs)
    $200 copayment


Annual Drug Out-of-pocket Maximum

$2,000 per person
(The annual drug out-of-pocket maximum is maximum accumulates towards the medical out-of-pocket maximum.)

Dental Benefits


30% of eligible charges for Accidental Injury benefits only.

Vision Benefits2


30% of eligible charges
  • Annual exam

Infertility Benefits


30% of eligible charges

Infertility defintion

Infertility is the failure to achieve a successful pregnancy after regular, unprotected intercourse or artificial insemination for 12 months or more (6 months for individuals over age 35). Infertility may also be established through an evaluation based on medical history and diagnostic testing.

Diagnosis and treatment of infertility specific to:

  • Artificial Insemination (AO)
  • Assisted Reproductive Technology Procedures
  • In Vitro Fertilization (IVF)

*Deductible doesn’t apply

1These dental products are separate and distinct from FEDVIP and therefore premiums for these products cannot be deducted on a pre-tax basis. These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are available to all enrollees and family members who become members of HMSA.

2New Vision Plan Administrator HMSA routine vision benefits will be administered by EyeMed Vision Care. You’ll have access to a large network of vision care, new member tools and more. This doesn’t impact medical vision benefits, such as Medicare-covered glaucoma screenings and eyeglasses after cataract surgery. HMSA administers those benefits.

This is a summary of the features of the HMSA Postal Service Plan. Before making a final decision, please read the Postal Service Plan Brochure (RI 73-916). All benefits subject to the definitions, limitations, and exclusions in the brochure.

Show me an example

Compare plans based on estimated benefits. Choose from three examples.

Simple fracture Example

In-network emergency room visit and follow up care

Services included in example event

  • Emergency room care (including medical supplies)
  • Diagnostic test (x-ray)
  • Durable medical equipment (crutches)
  • Rehabilitation services (physical therapy)

EXAMPLE Simple fracture cost: $2,800

PlanHigh PlanStandard Plan
You pay deductible:$0$150
Copayments:$80$100
Coinsurance:$200$600
What isn’t covered (Limits or exclusions): $0$0
Your total out-of-pocket:$280$850
High Plan
PlanHigh Plan
You pay deductible:$0
Copayments:$80
Coinsurance:$200
What isn't covered (Limits or exclusions): $0
Your total out-of-pocket:$280
Standard Plan
PlanStandard Plan
You pay deductible:$150
Copayments:$100
Coinsurance:$600
What isn't covered (Limits or exclusions): $0
Your total out-of-pocket:$850

This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending on the actual care you receive, the prices your providers charge, and many other factors.

Managing type 2 diabetes Example

A year of routine in-network care of a well-controlled condition

Services included in example event

  • Primary care physician office visits (including disease management)
  • Diagnostic tests (blood work)
  • Prescription drugs
  • Durable medical equipment (glucose meter)

EXAMPLE Managing type 2 diabetes cost: $5,600

PlanHigh PlanStandard Plan
You pay deductible:$0$150
Copayments:$400$400
Coinsurance:$200$200
What isn’t covered (Limits or exclusions): $20$20
Your total out-of-pocket:$620$770
High Plan
PlanHigh Plan
You pay deductible:$0
Copayments:$400
Coinsurance:$200
What isn't covered (Limits or exclusions): $20
Your total out-of-pocket:$620
Standard Plan
PlanStandard Plan
You pay deductible:$150
Copayments:$400
Coinsurance:$200
What isn't covered (Limits or exclusions): $20
Your total out-of-pocket:$770

This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending on the actual care you receive, the prices your providers charge, and many other factors.

Maternity Care Example

9 months of in-network pre-natal care and a routine hospital delivery

Services included in example event

  • Specialist office visits (prenatal care)
  • Childbirth/delivery professional services
  • Childbirth/delivery facility services
  • Diagnostic tests (ultrasounds and blood work)
  • Specialist visit (anesthesia)

EXAMPLE Maternity Care cost: $12,700

PlanHigh PlanStandard Plan
You pay deductible:$0$150
Copayments:$200$30
Coinsurance:$70$2,500
What isn’t covered (Limits or exclusions): $60$60
Your total out-of-pocket:$330$2,740
High Plan
PlanHigh Plan
You pay deductible:$0
Copayments:$200
Coinsurance:$70
What isn't covered (Limits or exclusions): $60
Your total out-of-pocket:$330
Standard Plan
PlanStandard Plan
You pay deductible:$150
Copayments:$30
Coinsurance:$2,500
What isn't covered (Limits or exclusions): $60
Your total out-of-pocket:$2,740

This is not a cost estimator. Treatments shown are just examples of how this plan might cover medical care. Your actual costs will be different depending on the actual care you receive, the prices your providers charge, and many other factors.

Annual deductible

A deductible is the fixed dollar amount you must pay each calendar year for certain services and products before your health plan pays.

Out-of-pocket maximum

The out-of-pocket maximum is the most you'll have to pay per calendar year for covered health care services. Once you reach this amount, your plan pays 100 percent of the allowed amount for covered services excluding taxes.

There's a maximum for each person on the plan and a maximum for everyone on the plan.

P000608

By phone:

Monday–Friday: 8 a.m. to 5 p.m.
808-948-6499
1-800-776-4672

In person:

Visit us at an HMSA Center
See locations and hours