Federal Employee Members
Welcome Federal Government Employee Member-Owners
Getting the most out of your health plan starts with understanding all the benefits included with your coverage. Keep reading to learn about your coverage details and how to get the most out of your health plan!
Reference Documents & Materials
If you are a FEHB provider or member, access the necessary documents for expedited contraceptives for the contraceptive exceptions process by visiting the Prescriber Portal on the Navitus website.
2025 Coverage Changes for Postal Service Health Benefits
FAQ Regarding Coverage Changes
GHC-SCW explored participation in the new PSHBP but did not meet any of the three criteria established by the PSHBP. These criteria included having 1,500 or more Postal Service enrollees in our FEHB plan in 2023, providing geographic coverage where current FEHB options are limited or utilizing a specialized health care delivery system. Unfortunately, our cooperative structure and care model did not meet the criteria for a specialized delivery system.
No, GHC-SCW will not be part of the PSHBP in 2025, so you will need to select a new health insurance provider that is offered under the PSHBP.
Your current coverage with GHC-SCW will remain in effect until the PSHBP takes effect in 2025. You will need to select a new provider under the PSHBP before the changeover occurs.
GHC-SCW’s unique staff-model cooperative approach to care delivery did not align with the criteria set by the PSHBP for a specialized delivery system. We provided detailed information about our model, but it was determined that it did not meet the threshold.
Yes, GHC-SCW will continue to evaluate our involvement in the future and monitor whether the participation criteria for the PSHBP evolve over time.
You should stay informed about the upcoming transition and review the health plan options that will be available under the PSHBP. GHC-SCW will provide any additional updates or information as it becomes available.
The new PSHBP legislation allows postal retirees who haven’t yet enrolled in Medicare Part B to sign up without a penalty. This change aims to reduce costs for both retirees and providers by making Medicare Part B the primary payer for medical services
If you do not select a new plan under the PSHBP by the required deadline, you may be automatically enrolled in a default plan, which could affect your coverage and costs. It is important to review and choose a plan that best meets your needs before any auto-enrollments happen.
Contraceptive Coverage for Federal Employees
As a federal employee, you have exclusive access to comprehensive benefits designed to meet your diverse needs. Below is a table highlighting contraceptive coverage for your plan, affirming our commitment to your reproductive health and wellness.
To explore the full range of contraceptive options covered under your plan, including detailed eligibility information and how to access these benefits, please review the 2024 Federal Employee GHC-SCW Brochure.
We want to ensure you have the resources and support necessary to make informed decisions about your reproductive and sexual health care. Should you have any questions or require assistance, our Member Services Team is here to help. You can contact them at (608) 828-4853 or (800) 605-4327 during our regular business hours Monday through Friday from 8 a.m. to 5 p.m.
Benefit Description |
You Pay |
| Preventive Care, Adult
Preventive care benefits for women such as Pap smears, gonorrhea prophylactic medication to protect newborns, annual counseling for sexually transmitted infections, contraceptive methods, and screening for interpersonal and domestic violence. For a complete list of preventive care benefits for women go to the Health and Human Services (HHS) website at https://www.healthcare.gov/preventive-care-women/ |
*Please review the 2024 Federal Employee GHC-SCW Brochure for coverage details. |
Family Planning
Note: We cover oral contraceptives under the prescription drug benefit.
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*Please review the 2024 Federal Employee GHC-SCW Brochure for coverage details. |
| Covered Medications and Supplies
Contraceptive drugs and devices prescribed by a health care professional and obtained from a Plan pharmacy or through our mail order program. Contraceptive drugs and devices as listed in the ACA/HRSA site. Contraceptive coverage is available at no cost to FEHB members. The contraceptive benefit includes at least one option in all methods of contraception (as well as the screening, education, counseling, and follow-up care). Any contraceptive that is not already available without cost sharing on the formulary can be accessed through the Contraceptive Exceptions Process described below.
The “morning after pill” is considered preventive service under contraceptives, with no cost to the member if prescribed by a physician and purchased at a network pharmacy. The “morning after pill” should be addressed under the pharmacy benefit as an over-the counter (OTC) emergency contraceptive drug |
*Please review the 2024 Federal Employee GHC-SCW Brochure for coverage details. |
