Welcome FEHB members
Discover a HAP plan that’s easy and affordable
Get the care you need with great benefits, features and savings.
| High Option | Standard Option | |||
|---|---|---|---|---|
| Deductible | $0 | $350 Self Only /$700 Family |
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| Coinsurance | None | 10% | ||
| Coinsurance Max | $0 | $0 | ||
| Out of Pocket Max | $6,350/$12,700 | $6,350/$12,700 | ||
| Office Visit | $20 copay | $20 copay | ||
| Specialist | $40 copay |
$50 copay |
||
| Emergency Room | $150 copay | $200 copay | ||
| Urgent Care | $50 copay | $50 copay | ||
| Telehealth | $0 copay | $0 copay | ||
| Ambulance | $150 copay | 10% after deductible | ||
| Inpatient Hospital | $100 copay per day up to $500 max per stay | 10% after deductible | ||
| Physical Therapy/Occupational Therapy/Speech Therapy | $40 per visit (60 visits combined) | $25 copay per visit (60 combined per year) | ||
| Prescription Drugs* | $4 Tier 1 - Generic $10 Tier 2 - Generic and select brand $40 Tier 3 - Preferred brand $60 Tier 4 - Non-preferred brand and non-preferred generic 20% coinsurance ($200 max) Tier 5 – Preferred specialty 20% coinsurance ($200 max) Tier 6 – Non-preferred specialty |
$15 Tier 1 - Generic $25 Tier 2 - Generic and select brand names $40 Tier 3 - Preferred brand $80 Tier 4 - Non-preferred brand and non-preferred generic 20% coinsurance ($200 max) Tier 5 - Preferred specialty 20% coinsurance ($200 max) Tier 6 - Non-preferred specialty /td> |
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| Vision | One routine visit covered per year $40 copay per exam | One routine visit covered per year $50 copay per exam | ||
| Imaging CT/PET/MRI Scans | $150 copay | 10% after deductible | ||
| Outpatient Surgery | $250 | 10% after deductible | ||
*For more information on contraceptives, please click here.
High Option and Standard Option health benefits summary
*For more information on 2025 plan specifics, please review the FEHB HAP plan brochure.
High Option Benefits
In a high option benefit, there’s a $0 deductible with no coinsurance
Standard Option Benefits
In a standard option benefits, there’s a $350 self only/$700 family deductible with 10% coinsurance
High Option and Standard Option Rates
| Premium Rate | |||||||
|---|---|---|---|---|---|---|---|
| Bi Weekly | Monthly | ||||||
| Enrollment Type |
Enrollment Code | Gov’t Share |
Your Share | Gov’t Share |
Your Share | ||
| Michigan | |||||||
| High Option Self Only | 521 | $298.08 | $313.01 | $645.84 | $678.19 | ||
| High Option Self Plus One | 523 | $650.00 | $755.52 | $1,408.33 | $1,636.96 | ||
| High Option Family | 522 | $714.23 |
$776.84 | $1,547.50 | $1,683.15 | ||
| Michigan | |||||||
| Standard Option Self Only | GY4 | $273.80 | $91.27 | $593.24 | $197.75 | ||
| Standard Option Self Plus One | GY6 | $629.75 | $209.91 | $1,364.45 | $454.81 | ||
| Standard Option Family | GY5 | $668.08 | $222.69 | $1,447.50 | $482.50 | ||
To compare your FEHB health plan option, go to www.opm.gov/fehbcompare.
To review premium rates for all FEHB health pan options please go to www.opm.gov/FEHBpremiums or www.opm.gov/Tribalpremium.
Premiums for Tribal employees are shown under the monthly Premium Rate column. The amount shown under employee contribution is the maximum you will pay. Your Tribal employer may choose to contribute a higher portion of your premium.
Please contact your Tribal Benefits Officer for exact rates.