FEHBRA Retirees – Review plan benefits
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Review plan benefits & costs

Get a quick overview of your plan benefits and costs, and find more detailed information about additional coverage and benefit services.

UnitedHealthcare Retiree Advantage Plan (PPO) 

Benefits and costs UnitedHealthcare Retiree Advantage Plan (PPO) 
Annual medical deductible None
Annual out-of-pocket maximum None
Office and clinic visits $0 copay 
Hospital services (inpatient) $0 copay 
Hospital services (outpatient) $0 copay
Prescription drug coverage Retail 
Tier 1: $7 copay
Tier 2: $35 copay
Tier 3: $65 copay
Tier 4: $100 copay

Mail Order 
Tier 1: $14 copay
Tier 2: $70 copay
Tier 3: $130 copay
Tier 4: $200 copay

The UnitedHealthcare Retiree Advantage Plan PPO offers additional coverage for the coverage gap (donut hole).  You will continue to pay your normal copays once you enter the donut hole.  Once your True Out of Pocket (TROOP) reaches $6,350 you enter the Catastrophic Coverage level and will pay $3.60 for a 30-day supply of generic medications or $8.95 for a 30-day supply of all other medications.

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Group retiree benefits for the FEHBP

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2021 Open Enrollment Period

Began: 11/9/2020
Ended: 12/14/2020


Virtual Education Center 

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Last updated: 09.03.2021 at 12:01 AM CT  H2001_021021BMR