FAQs - Consumer Option

The MHBP Consumer Option is a high-deductible health plan (HDHP) with a Health Savings Account (HSA).

The Plan deposits up to $2,400 per year for a Self and Family or Self Plus One enrollment or up to $1,200 per year for a Self Only into your HSA. You can use the funds to pay for health expenses, or watch your savings grow as they roll over. Plus Network preventive care is covered at 100% with no deductible. After you meet your deductible, you pay low copayments — or nothing at all — for covered care.

Preventive care is covered at a $0 copay with an in-network provider and does not apply to the deductible.
You are responsible for meeting your deductible for all other medical services:

• $2,000 for Self Only
• $4,000 for Self Plus One or Self and Family

Note: Self Plus One or Self and Family have to meet the family deductible before the cost share applies.

Once the deductible has been satisfied, you pay a copay depending on which type of medical service you use:

• Primary care physician (PCP): $15 copay
• Specialist visits: $15 copay

Prescriptions (30-day supply):

• $10 per generic formulary drug
• Preferred Brand: 30% of Plan allowance, limited to $200 per prescription
• Non-Preferred brand: 50% of Plan allowance, limited to $200 per prescription
• 90-day supply of maintenance medications are available through mail order or CVS Retail pharmacies.

The Consumer Option is a high deductible health plan with a Health Savings Account (HSA) that you can use for qualified health care expenses now or in the future and provides nationwide coverage, MHBP Consumer Option plan could be right for you.

MHBP provides:

• A large, nationwide network of over 2 million providers and hospitals. When you need care, it’s never too far.
• Worldwide coverage
• No referrals required to see specialists.
• Outstanding plan satisfaction, per OPM.gov Consumer Satisfaction Survey Results

No. However you can save money by visiting in-network providers, you have in-network and non-network coverage.

Use our provider directory. You can access information about our extensive network of providers, including board certification, education, specialty and languages spoken, etc.

You pay nothing for in-network preventive care. When you visit a Primary Care Provider (PCP) or a Specialist, you'll pay a $15 copay (deductible applies to all services other than preventive care).

No. You do not need a referral to see a specialist.

A copay is a fixed amount of money you pay to the provider, facility, pharmacy when you received covered services. The copay will vary, depending on where the services are delivered and by whom (e.g., PCP, specialist and pharmacy). Please review the Official Plan brochure for copay amounts.

Members usually do not need to file claim forms except in some non-network emergency care situations.

Should you need to submit a claim form , you can do so at these addresses.

For a disputed claim, follow the Postal Service Health Benefits Program disputed claims process if you disagree with our decision on your claim or request for services, drugs, or supplies, including a request for preauthorization/prior approval. View the appeals and disputed claims processes.

If you are actively employed for a 30-day supply after deductible:

• Generic: $10 copyament per prescription
• Preferred Brand: 30% of Plan allowance, limited to $200 per prescription
• Non-Preferred brand: 50% of Plan allowance, limited to $200 per prescription
• 90-day supply of maintenance medications are available through mail order or CVS Retail pharmacies.

If you are retired, view our SilverScript Employer PDP for MHBP Plans

Yes, mail-order pharmacy is available for maintenance medications. You can also get your 90-day prescription at a CVS retail pharmacy for the same cost as mail order.
Go to your member website and select "Prescriptions" for details and forms.

Yes. Your calendar year in-network deductible is $2,000 for Self Only coverage and $4,000 for Self Plus One or Self and Family Coverage. Preventive services are not subject to the deductible.

Once you pay your deductible, you pay a copay or coinsurance for medical services. Copay and coinsurance amounts are listed in the Official Plan brochure. They will apply until you meet your out-of-pocket maximum.

MHBP plans do not include preventive dental coverage. The MHBP Dental plan is available as a standalone option.

MHBP plans do not include preventative vision coverage. The MHBP Vision plan is available as a standalone option.

Detailed instructions and information on the Postal Service Health Benefits (PSHB) Program enrollment process is available at Enroll Now. You will need to know the enrollment code for the MHBP plan. Please refer to the rate calculator for the plans available in your area and the associated enrollment codes.

Benefits start on January 1, 2026 for active employees and annuitants. If you are enrolling outside of Open Enrollment, for most people, benefits will begin on the first day of the first full pay period. New hires have 60 days to enroll for health coverage. Verify your effective date with the agency or retirement system that maintains your health benefits enrollment.

If you do not receive your ID card by your effective date and are enrolled in our system, you may register on your member website and print an ID card. After you register, simply select "ID cards" and follow the instructions. You may use this printable version of your personal ID card if you need medical care.

Your member ID card is always available on your member website. When you log in, you can:

• Pull up your digital ID card and print it or email it. Your digital ID card is the same as your plastic ID card.
• Request a new ID card and we can send a new plastic ID card to your home.

Members have access to Teladoc Health (Teladoc), a convenient, lower-cost alternative to urgent care or the emergency room. Teladoc lets you access board-certified physicians by web, phone or mobile app. It's perfect for when you're traveling or when your physicians isn't available. Simply visit Teladoc.com/Aetna or call 1-855-835-2362 (855-Teladoc) to get started.

Teladoc physicians prescribe medical treatment for a wide range of conditions including cold & flu symptoms, pink eye, skin rash conditions and stress and anxiety. Teladoc physicians prescribe a medication when necessary. All Teladoc physicians are U.S. board certified internists, state-licensed family practitioners or pediatricians licensed to practice medicine in the U.S.

You must tell us if you or a covered family member has coverage under any other health plan or has automobile insurance that pays health care expenses without regard to fault. This is called “double coverage”. When you have double coverage, one plan normally pays its benefits in full as the primary payor. The other plan pays a reduced benefit as the secondary payor. We, like other insurers, determine which coverage is primary according to the National Association of Insurance Commissioners’ (NAIC) guidelines. For more information on NAIC rules regarding the coordinating of benefits, visit https://content.naic.org/sites/default/files/inline-files/MDL-120.pdf.
For complete details about how we coordinate with other health plans and a Primary Payor Chart, see Section 9 of the Official Plan brochure under Coordinating Benefits with Medicare and Other Coverage.

Certain health care services, such as hospitalization or outpatient surgery, require precertification to ensure coverage for those services. In most cases, your network provider will take care of getting precertification. You’re still responsible for ensuring that your care is precertified. This means you should always ask your provider whether they’ve contacted us and that we’ve approved the request. If you see an out-of-network provider or you’re admitted to an out-of-network hospital you must get prior approval or precertification by calling 1-833-497-2415 (TTY: 711). For additional information, see Section 3 of the Official Plan brochure.

Our network has doctors, hospitals and facilities across the country. Your benefits are accepted by the doctors and hospitals that participate with the Aetna Choice® POS II network in all states. Be sure to present your MHBP ID card at the time of service.

Overseas providers (those outside the continental United States, Alaska and Hawaii) will be paid at the Network level of benefits for covered services.

To update any personal information, update dependents, or make plan changes, visit The Postal Service Health Benefits System.

Generally, your HSA is effective on the first day of the month following the effective date of the health plan coverage. For the 2026 plan year, your plan is effective January 1, 2026. With a health plan effective date of January 1, 2026, the HSA is effective February 1, 2026, the first Plan contribution will be applied in February. However, we will apply 12 deposits for members joining the plan at Open Season by making two deposits in December.

Yes. The first Plan deposit will be applied in February and monthly thereafter. The Plan will apply two deposits in December to compete the $1,200 premium pass through.

An HSA is a tax-advantaged account that you own. You can contribute to it with pre-tax funds. It’s not taxed when you use your funds for qualified medical care. Plus, it even earns interest tax-free.

• The plan makes contributions to your HSA each month.
• You may also make voluntary contributions to your HSA.
• Your HSA dollars earn interest, tax-free.
• At the end of the year, any money remaining in your HSA rolls over to the next year.
• You own your HSA, so you keep the money even if you change jobs or health plans.
  You can pay for qualified expenses with money withdrawn directly from your HSA using your Inspira® debit card. Or use the online payment features to pay your provider directly from your account. You can also allow the account to grow over time and use it to help pay for future health-related expenses — like long-term care insurance premiums, TCC/COBRA premiums and certain retiree expenses.

Yes, the Consumer Option meets all of the requirements to be considered qualified by the IRS.

To be eligible for an HSA, you must meet certain requirements:

• You must not be covered by a High Deductible Health Plan (HDHP).
• You cannot have other health coverage that pays for out-of-pocket health care expenses before you meet your plan deductible.
• You or your spouse cannot have a regular health care flexible spending account (FSA)* or regular health reimbursement arrangement (HRA)* in the same year.
• You cannot have Medicare or TRICARE.
• You cannot have received certain Veterans Administration (VA) health benefits in the previous three months.
• You cannot be claimed as a dependent on another person's tax return.

*You can have a Limited Purpose FSA (LPFSA) or Limited HRA. Generally, you can use an LPFSA or LHRA for eligible dental and vision expenses. This can help you save your HSA funds for other eligible expenses.

No, you cannot continue to contribute to your HSA. But you may keep using the funds in your account. If you no longer qualify for an HSA, you are responsible for notifying us. Then, we will enroll you in our Consumer Option with a health reimbursement arrangement (HRA).

You can check your HSA balance on your member website, or ask to receive a monthly paper statement. Or you can call Customer Service as directed on your Inspira Card®.
You may check the status of your deductible on your member website.

At the end of the year, any money remaining in your HSA stays in your HSA for the next year.

The money in your HSA is always yours, even if you change jobs or health plans. You can use your HSA to pay for qualified expenses today. Or let it grow and earn interest for the future.

Yes, the money in your HSA earns interest. Interest earned on your HSA is not included in your income for federal tax purposes. There is no minimum balance required to earn interest. Interest is earned at a higher level as your balance grows. Interest rates are calculated per account balance ranges and the associated interest rates per tier each day, stored, and credited to your account on the second banking day of the next month. If you close your account mid-month, you won't receive interest for that month.
For HSA balances of $1,000 or more, you'll be able to invest in a variety of mutual funds. Participation in the investment options is entirely optional. You can view these funds in the Financial Center of your online Inspira account. See the Official Plan brochure for more details.

You have three options.

Option 1: Keep your HSA at Inspira

• You can use your remaining balance to pay for your eligible health care expenses.
• You have until the tax filing deadline to contribute for the months that you were eligible. You'll need to divide the IRS contribution limit by the number of months you were eligible. This will help you know how much you're eligible to contribute.
• You'll use the same Inspira Card®.
• You'll have to pay a monthly maintenance fee. This fee will be paid from your HSA on the first of each month. You'll need to log in to your Inspira account to view the HSA Fee Schedule.
• You'll continue to use the Inspira member website to manage your HSA.

Option 2: Move your HSA balance to another HSA administrator

• You may move your HSA funds to your new HSA administrator. Just ask them for a Trustee Transfer form. Then, complete the form and send it to Inspira.

Option 3: Return your HSA balance to yourself and roll over to a new HSA

• You may request to withdraw your balance from Inspira and have the funds sent directly to you.
• To help avoid taxes and penalties on these funds, you'll need to roll over those funds into a new HSA. You must complete this process within 60 days of receiving the funds.
• You're only allowed one rollover into another HSA per calendar year. This is an IRS rule.
• The funds you roll over don't count toward the IRS annual maximum contribution amount.

Employees are able to make pre-tax allotments to HSAs straight from your paychecks. Please contact your payroll office to determine whether this feature is available for your agency. You may also have funds direct deposited to your HSA on a post-tax basis from your personal checking or savings account by completing an EFT form, which can be found in HSA resources.

You have until April 15 of the following year to make HSA contributions for the current plan year.

Once you have funds in your HSA, you can use your Inspira® debit card to pay for eligible health care expenses. If you paid out of your pocket, you can go online and reimburse yourself.

When you reimburse yourself, you can do so through a linked bank account. This will withdraw funds from your HSA and deposit them into your personal account. It can take up to 48 hours for you to see the funds in your account.

To link a bank account, log in to your Inspira account and go to your account settings to get started.

If you prefer to receive a check, use the online tool to request funds and pay yourself back. The online "connected claims" feature is another fast and easy way to pay out-of-pocket health expenses from your HSA, without having to use your Inspira® debit card. You can go online, view your claims and choose how to pay them. You can pay the provider, pay yourself back or you can archive the claim for future use.

You can use your HSA to pay for qualified medical expenses . This includes qualified expenses for you, your spouse and your tax dependents. This is true even if they aren’t covered by your Consumer Option. You can view a list of common eligible expenses online. You can also use your HSA funds to pay for some OTC products. To use your HSA funds, you must have received the care on or after the effective date of your HSA. You can find more information IRS.gov. Refer to IRS Publications 969 and 502.

Remember to keep receipts for your HSA purchases to show that you used your HSA funds for qualified expenses. Under HSA regulations, you are responsible for determining which expenses are considered "qualified expenses." Please consult your tax advisor for guidance.

You may withdraw money from your HSA for items other than qualified expenses; however, taxes and penalties may apply. Please consult your tax advisor for guidance.

The administrative fee to maintain your HSA is included in your premium. If you leave our Consumer Option, you’ll have to pay a monthly maintenance fee. This fee will be deducted from your Inspira HSA on the first of each month.

No, there are no fees associated with using the Inspira debit card.

The plan makes deposits to the HSA monthly. The monthly deposit is $100 per month for Self Only coverage and $200 per month for Self Plus One or Self and Family coverage. Deposits can total up to $1,200 per year for Self Only coverage or $2,400 per year for Self Plus One or Self and Family coverage, depending on the date that coverage commences.

Each year, the Internal Revenue Service (IRS) sets annual contribution limits for HSAs. These limits are based on your Consumer Option coverage level (Self Only, Self plus One, or Self and Family).

You can contribute in a lump sum or multiple times throughout the year. You can change how much you contribute at any time during the year; you don’t need a life event change. If you’re age 55 or older, you can contribute an additional $1,000 per year. This is a “catch-up” contribution.

This means the amount you can contribute is based on a few things:

Do you have Self Only or Self and Family coverage?

Did you have coverage under the plan for the entire year? If not, you may have to prorate how much you can contribute. Proration means you only contribute for the number of months you have the Consumer Option .

Are you 55 or older?

You may want to speak with your tax advisor. They can help you understand how much you can contribute to your HSA. You might also find it helpful to review IRS Publication 969 at IRS.gov.

If the amount of your eligible medical expense exceeds the amount in your HSA, you would be responsible for paying that expense out of pocket. You can reimburse yourself using online payment options as additional funds become available.

You can use funds from your HSA to pay for LTC insurance premiums. The amount you withdraw from your HSA to pay LTC premiums would NOT count toward your catastrophic limit, nor toward your deductible, because it is not a covered expense under the Consumer Option.

Yes. The OPM website has extensive information about HSAs including FAQs, worksheets, comparison charts, etc. Go to OPM.gov/insure/health/hsa/index.asp.

Inspira® will send a Form 5498-SA that will list your contributions to your HSA and a Form 1099-SA that will list the distributions from your HSA. You will need to complete a Form 8889 to report HSA contributions. See the IRS website or your tax advisor for more information.