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Welcome FEHB Members

HAP is here, with a 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
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 preferred generic
$10 Non-Preferred generic
$40 preferred brand
$60 Non-Preferred brand
20% up to a $200 max preferred Specialty/20% up to a $200 max on non-preferred Specialty
$15 preferred generic
$25 Non-Preferred generic
$40 preferred brand 
$80 Non-Preferred brand
20% up to a $200 max preferred Specialty/20% up to a $200 max on non-preferred Specialty
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 copay 10% after deductible  10% after deductible 

High Option and Standard Option Health Benefits Summary

*For more information on 2022 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 & 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  $244.86 $175.19 $530.53 $379.58
High Option Self Plus One 523  $524.63 $441.47 $1,136.70 $956.52
High Option Family  522  $574.13
$450.77 $1,243.95 $976.67
Michigan
Standard Option Self Only GY4 $183.52 $61.17 $397.62 $132.54
Standard Option Self Plus One    GY6   $422.09

$140.70

$914.54 $304.84
Standard Option Family   GY5   $447.77 $149.26 $970.18 $323.39

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.