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APWU Health Plan FAQ

APWU Health Plan has been offering affordable, comprehensive coverage to postal workers, federal employees, and retirees since 1960. We’re here to help you choose a plan that’s right for you and make the most of your benefits.

If you can’t find an answer to your question, contact us to speak with a customer service representative:

1-800-222-2798 | 1-800-622-2511 (TTY)

Monday – Friday, 8:30 am – 6:30 pm ET

Displaying FAQs for High Option

What happens to my spouse’s coverage if my spouse is under 65 and/or not eligible for Medicare?

Dependents who are not Medicare eligible or Medicare primary will remain on the APWU Health Plan High Option plan.

How do I enroll in the Medicare Advantage plan?

If you are already enrolled in the APWU Health Plan, please call UnitedHealthcare to enroll in the UnitedHealthcare Medicare Advantage (PPO) plan for APWU Health Plan toll-free at 1-855-383-8793, TTY 711, 8 am – 8 pm CT, Monday – Friday.

If you are not yet a member of the APWU Health Plan, you’ll need to enroll during Open Season with the Office of Personnel Management (OPM). Once your enrollment into APWU Health Plan has been processed and confirmed by OPM, you can call UnitedHealthcare to enroll in the UnitedHealthcare Medicare Advantage (PPO) plan for APWU Health Plan toll-free at 1-855-383-8793, TTY 711, 8 am – 8 pm CT, Monday – Friday.

Enrollment in Medicare Advantage is voluntary. Retirees may opt in or out of the enhanced level of benefits at any time throughout the year

How much does it cost to enroll in this plan?

There is no additional cost to enroll in the Medicare Advantage plan. You will continue to pay your APWU Health Plan High Option premium as well as your Medicare Part B premium. You will receive a Medicare Part B subsidy of $100 per month when enrolled in the Medicare Advantage plan.

Should I suspend my APWU Health Plan coverage through PSHB or FEHB?

No, you must remain enrolled in the APWU Health Plan to be eligible for the Medicare Advantage plan. If you suspend your APWU Health Plan coverage, you will also be terminated from the Medicare Advantage plan.

Will I lose my coverage through the PSHB Program or FEHB Program if I enroll in a Medicare Advantage plan?

Typically, enrollment in a Medicare Advantage plan would cause a suspension or termination of Postal Service Health Benefits (PSHB) Program or Federal Employee Health Benefit (FEHB) Program coverage. However, the Medicare Advantage for APWU Health Plan was designed for PSHB Program and FEHB Program retirees to allow you to retain your status in these programs.

Is this the Medicare Advantage plan that’s advertised on TV?

This is a custom Group Medicare Advantage (PPO) plan designed exclusively for APWU Health Plan’s High Option members. This plan is different and should not be confused with individual UnitedHealthcare Medicare Advantage plans that might be available in the area.

What does the Medicare Advantage for APWU Health Plan cover?

The UnitedHealthcare Medicare Advantage for APWU Health Plan offers all the benefits of Original Medicare Part A and Part B, plus prescription drug coverage (Part D) and additional benefits, such as a $100 monthly Medicare Part B subsidy, a Renew Active® fitness benefit, UnitedHealthcare® HouseCalls, and much more.

Why is APWU Health Plan offering a Medicare Advantage plan?

APWU Health Plan has been serving retirees since 1960. Retirees make up a big portion of our plan population, and they are very important to us. We thank you for your service to our country and now it’s our turn to take care of you. APWU Health Plan designed this Medicare Advantage plan in collaboration with UnitedHealthcare to provide an enhanced level of benefits that focus more closely on senior health and well-being.

What is Medicare Advantage and how does it work with Original Medicare?

Medicare Advantage plans are Part C plans that are offered by private insurers like UnitedHealthcare. They offer all the benefits of Original Medicare Part A and Part B. Many Medicare Advantage plans include prescription drug coverage (Part D) and typically include additional benefits, features, and programs. You must remain enrolled in Medicare Part A and Part B to be eligible for a Medicare Advantage plan.

Does APWU Health Plan have a Medicare Advantage plan?

Yes, the UnitedHealthcare® Medicare Advantage (PPO) for APWU Health Plan enhances your coverage under the Postal Service Health Benefits (PSHB) Program or Federal Employees Health Benefits (FEHB) Program by reducing or eliminating cost-sharing for services.

To qualify for enhanced Medicare Advantage benefits you must be retired, enrolled in APWU Health Plan High Option, and enrolled in Medicare Parts A and B.

Benefits of our Medicare Advantage plan include:

No copays for covered medical services
A $100 monthly Part B premium subsidy
Eyewear allowance offered every 24 months: $130 for glasses or $175 for contacts
$60 quarterly over-the-counter item allowance
$1,500 hearing aid allowance
Dental coverage
Prescription drug coverage (Part D)
Nationwide provider network
One plan with no need to coordinate primary and secondary payers

To find out if you’re eligible to enroll in the Medicare Advantage plan, call 1-855-383-8793, or 711 (TTY), 8 am – 8 pm CT, Monday – Friday.

Does the High Option provide Part D pharmacy benefits if I’m enrolled in Medicare?

As a High Option member, you can receive Medicare Part D coverage at no extra cost through the Express Scripts Medicare Prescription Drug Plan (PDP) Employer Group Waiver Plan (EGWP).

If you are enrolled in Medicare and are not enrolled in a Medicare Advantage plan (Part C), you will be automatically enrolled in the Medicare PDP for APWU Health Plan.

The plan is a prescription drug benefit for Medicare-eligible annuitants and family members covered under the Postal Service Health Benefits (PSHB) Program or Federal Employees Health Benefits (FEHB) Program.

With this Medicare Part D coverage, you have access to:

Low copays/coinsurance
$2,000 out-of-pocket maximum
Home delivery service

For details about the Medicare PDP, contact Express Scripts Medicare at 1-844-818-8790, 24 hours a day, 7 days a week.

Does the High Option provide worldwide coverage when I travel abroad?

Medicare generally doesn’t pay for hospital or medical services outside the United States, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands.

However, the High Option covers you around the world. When you have services outside of the U.S., you’ll probably have to pay the bill at the time of service and submit the bill to APWU Health Plan for reimbursement.

APWU Health Plan FAQ

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