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Value Plan Summary of Benefits

Medical Coverage  
You Pay

 

PPO

Non-PPO

Calendar Year Deductible

$500 per person, limited to $1,000 per family

$800 per person, limited to $1,600 per family

We added "(No deductible)" to show when the calendar year deductible does not apply

Adult Preventive Care
Annual Physical Exam, Screening and Immunizations

Nothing (No deductible)

Not Covered

Well-Child Care
Well-child visits, Screenings and Immunizations

Nothing (No deductible)

Not Covered

Maternity Care

Nothing (No deductible)

40% of the Plan's allowance and any difference between our allowance and the billed amount

Doctor's Office Visits

20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Lab, X-ray and Diagnostic Tests

20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Lab Savings Program

Nothing for covered lab tests with the Lab Savings Program with Quest Diagnostics (No deductible)

Chiropractic Care

20% of the Plan's allowance and all charges after the Plan has paid the $2,500 combined alternative, chiropractic and rehabilitative therapies maximum

Not Covered

Hospitalization

20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Outpatient Surgical Facility

$200 copayment per occurrence (No deductible)

40% of the Plan's allowance and any difference between our allowance and the billed amount

Surgery (Professional Fee)
   Outpatient Hospital/ASC
   Inpatient


Nothing (No deductible)
20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Anesthesia

20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Emergency Treatment

20% of the Plan's allowance

40% of the Plan's allowance and any difference between our allowance and the billed amount

Overseas Medical Expenses

PPO-level benefits for covered care received outside the United States

Catastrophic protection
(Some costs do not count toward this protection)

Nothing after your out-of-pocket expenses for covered services from PPO providers totals $4,000 per calendar year

Nothing after your out-of-pocket expenses for covered services from PPO providers and non-PPO providers combined totals $6,000 per calendar year

Prescription Drug Coverage  
You Pay

 

Network Pharmacy and Electronic Claims

Non-Network Pharmacies and Paper Claims
Retail Pharmacy - Up to a 30-day supply  
No deductible

Generic

$10 copayment

Not Covered

Non-Generic

50% of the Plan's allowance

Not Covered
Mail Order Pharmacy - Up to a 90-day supply  
No deductible

Generic

$30 copayment

Not Covered

Non-Generic

50% of the Plan's allowance

Not Covered

Special Member Benefits*

Vision care discounts and savings from EyeMed Vision Care providers, laser vision correction savings from the U.S. Laser Network and QualSight, and a hearing aid discount program from HearPO.

*These benefits are neither offered nor guaranteed under contract with the FEHBP, but are made available to all FEHBP participants and their covered family members. You cannot file a FEHBP disputed claim about them. The fees you pay for these services do not count toward FEHBP deductibles or out-of-pocket maximums.

The Mail Handlers Benefit Plan 2008 Value Plan Rates

   

Federal Employees
(Biweekly)

Postal Employees
(Category 1 Biweekly)

Postal Employees
(Category 2 Biweekly)

Annuitants
(Monthly)

Self Only: 414

$20.50

$10.25

$9.23

$44.43

Self & Family :415

$48.89

$24.44

$22.00

$105.92

These rates do not apply to all enrollees. If you are in a special enrollment category, please refer to your FEHBP Guide or contact the agency that maintains your health benefits enrollment.

A single annual $42 Mail Handlers Benefit Plan associate membership fee makes MHBP Value Plan available to you.

This is a summary of the Mail Handlers Benefit Plan Value Plan. Before making a final decision, please read the 2008 Official Plan Brochure (RI71-007). All benefits are subject to the definitions, limitations and exclusions set forth in the 2008 Official Plan Brochure.