The NALC Consumer Driven Health Plan gives postal members a low-cost, flexible option with a built-in Personal Care Account (PCA) to help cover everyday care and preventive services.
For postal members who want low monthly premiums, a savings account, and digital tools to manage care—this plan delivers.
The NALC CDHP puts you in control with an annual PCA to help pay for medical costs first. You’ll then pay the rest of your deductible, after which the plan begins sharing costs; ensuring that your out-of-pocket costs never go beyond a set maximum.
This plan isn’t one-size-fits-all—it’s built for postal members and retirees who want reliable, full-coverage care. See if this plan fits your needs:
This plan is a great choice if you don’t visit the doctor often and want to save on monthly premiums. You’ll still get 100% coverage on preventive care and have a Plan-funded Personal Care Account (PCA) to cover early expenses.
With a $2,400 annual PCA for Self Plus One or Self and Family enrollments, you can cover everyday costs while managing your budget. Unused PCA funds roll over each year (up to $10,000), giving families room to plan long-term.
Prefer lower premiums? This plan keeps your monthly costs low and lets you use PCA funds first—before you start paying out of pocket. It’s a smart way to protect yourself without overpaying.
From the myCigna app to wellness programs like Hello Heart® and Hinge Health®, this plan gives you tools to manage your care from anywhere—and earn rewards for staying healthy.
While Medicare pays first, this plan still lets you use PCA funds toward remaining costs. And you’ll get access to our SilverScript® prescription drug plan.
The NALC CDHP offers competitive premiums for Postal employees and retirees. Below are the 2025 & 2026 biweekly and monthly rates
The NALC Consumer Driven Health Plan partners with the Cigna OAP network to ensure you have trusted, in-network care nationwide. No referrals are needed to see specialists. International care is also available under our Out-of-Network standard benefits of the plan.
Get quick access to what you'll pay for common care under the NALC Consumer Driven Health Plan.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Annual Routine Physical Exam (age 3 or older) |
Nothing |
50% after deductible is met* |
|
Adult Routine Immunizations & Tests |
Nothing |
50% after deductible is met* |
|
Well Child Care (through age 2) |
Nothing |
50% after deductible is met* |
|
Nothing |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Maternity |
20% after deductible is met |
50% after deductible is met* |
|
Maternity related hospital services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Medical/surgical |
20% after deductible is met |
50% after deductible is met* |
|
Emergency Medical |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Initial office visit and 12 office visits per calendar year when rendered on the same day as covered manipulations |
20% after deductible is met |
50% after deductible is met* |
|
Manipulations (12 per calendar year) |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Office or virtual visits |
20% after deductible is met |
50% after deductible is met* |
|
Telehealth professional services for minor acute conditions |
10% after deductible is met |
All charges |
|
X-rays, other diagnostic services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Lab Services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Office visit |
20% after deductible is met |
50% after deductible is met* |
|
Outpatient telemental or virtual visits |
10% after deductible is met |
50% after deductible is met* |
|
Other diagnostic services |
20% after deductible is met |
50% after deductible is met* |
|
Laboratory Services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
PRESCRIPTION DRUGS THIS IS A MANDATORY GENERIC PROGRAM |
NETWORK |
NON-NETWORK |
|---|---|---|
|
Retail Pharmacy |
1st and 2nd fill: $10 for generic (after deductible is met) $40 for Formulary brand (after deductible is met) $60 for Non-Formulary brand (after deductible is met) Note: You may purchase up to a 90-day supply (84-day minimum) of covered drugs and supplies at a CVS Caremark® Pharmacy through our Maintenance Choice Program. You will pay the applicable mail order copayment for each prescription purchased. |
50% of the Plan allowance after deductible is met* |
|
Mail Order Program |
90-day supply: $20 generic / $90 Formulary brand / $125 Non-Formulary brand (after deductible is met) |
|
|
Specialty drugs (requires prior approval) |
Caremark Specialty Mail Order: 30-day supply: $250 / 90-day supply: $450 |
|
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT |
NETWORK |
NON-NETWORK |
|---|---|---|
|
CDHP |
|
|
|
Medical/Surgical/Mental health and substance abuse care |
In-Network providers/facilities, preferred network pharmacies or mail order pharmacy out-of-pocket maximum: • Per person: $6,600 • Per family: $12,000 Out-of-Network providers/facilities out-of-pocket maximum: • Per person: $12,000 • Per family: $24,000 |
|
|---|---|---|
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Annual Routine Physical Exam (age 3 or older) |
Nothing |
50% after deductible is met* |
|
Adult Routine Immunizations & Tests |
Nothing |
50% after deductible is met* |
|
Well Child Care (through age 2) |
Nothing |
50% after deductible is met* |
|
Nothing |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Maternity |
20% after deductible is met |
50% after deductible is met* |
|
Maternity related hospital services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Medical/surgical |
20% after deductible is met |
50% after deductible is met* |
|
Emergency Medical |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Initial office visit and 12 office visits per calendar year when rendered on the same day as covered manipulations |
20% after deductible is met |
50% after deductible is met* |
|
Manipulations (12 per calendar year) |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Office or virtual visits |
20% after deductible is met |
50% after deductible is met* |
|
Telehealth professional services for minor acute conditions |
10% after deductible is met |
All charges |
|
X-rays, other diagnostic services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Lab Services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT DESCRIPTION |
YOU PAY (IN-NETWORK) |
YOU PAY (OUT-OF-NETWORK) |
|---|---|---|
|
Office visit |
20% after deductible is met |
50% after deductible is met* |
|
Outpatient telemental or virtual visits |
10% after deductible is met |
50% after deductible is met* |
|
Other diagnostic services |
20% after deductible is met |
50% after deductible is met* |
|
Laboratory Services |
20% after deductible is met |
50% after deductible is met* |
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
PRESCRIPTION DRUGS THIS IS A MANDATORY GENERIC PROGRAM |
NETWORK |
NON-NETWORK |
|---|---|---|
|
Retail Pharmacy |
1st and 2nd fill: Generic = 20% of Plan allowance (after deductible is met) Formulary brand = 30% of Plan allowance (after deductible is met) Non-Formulary brand = 50% of Plan allowance (after deductible is met) Note : You may purchase up to a 90-day supply (84-day minimum) of covered drugs and supplies at a CVS Caremark® Pharmacy through our Maintenance Choice Program. You will pay the applicable mail order copayment for each prescription purchased. |
50% of the Plan allowance after deductible is met and any difference between our allowance and the billed amount |
|
Mail Order Program |
90-day supply: (after deductible is met) Generic = 20% of Plan allowance, maximum of $450 per prescription Formulary brand = 30% of the Plan allowance, maximum of $450 per prescription Non-Formulary brand = 50 % of Plan allowance |
|
|
Specialty drugs (requires prior approval) |
Caremark Specialty Mail Order: 30-day supply: $250 / 60-day supply: $450 / 90-day supply: $650 |
|
*in addition, for out of network services you are responsible for the difference, if any, between the Plan allowance and the billed amount.
|
BENEFIT |
NETWORK |
NON-NETWORK |
|---|---|---|
|
CDHP |
|
|
|
Medical/Surgical/Mental health and substance abuse care |
In-Network providers/facilities, preferred network pharmacies or mail order pharmacy out-of-pocket maximum: • Per person: $6,600 • Per family: $12,000 Out-of-Network providers/facilities out-of-pocket maximum: • Per person: $12,000 • Per family: $24,000 |
|
|---|---|---|
Explore coverage, benefits, and costs in the official NALC PSHB Plan Brochure.
The NALC Postal Consumer Driven Health Plan includes powerful tools and programs to help you take control of your health—from managing prescriptions to getting vaccines, support, and savings on the go.
The NALC Consumer Driven Health Plan helps you take charge of your health—whether you’re staying fit or managing a condition.
Feel supported, anytime. Cigna® gives you access to mental health professionals, coaching, and 24/7 resources.
If you're enrolled in Medicare Parts A and B, the NALC Postal Consumer Driven Health Plan works with your Medicare benefits to help you lower your health care costs and get added value.
SilverScript® Prescription Drug Plan (PDP)
Travel confidently—your plan goes wherever you do.
Not sure if the Consumer Driven Health Plan is right for you? Let’s talk.
Funds from the Personal Care Account (PCA) are automatically deducted to pay for eligible out-of-pocket medical expenses. When you receive care, your PCA pays first—before you pay anything out-of-pocket—until the funds are used up. You can track your PCA balance and usage through the myCigna® app or Member Portal.
Any unused PCA funds roll over year to year - as long as you remain enrolled in the CDHP - up to a maximum of $5,000 for self only policies, and $10,000 for self plus one and self and family policies. That means you can build a safety net for future healthcare expenses.
Yes. You can switch plans during Open Season or if you experience a qualifying life event (like marriage, birth, or a job change). Use the PSHB enrollment system to make updates.
Preventive services—including annual checkups, immunizations, and screenings—are covered at 100% when you use in-network providers. These do not count toward your deductible or PCA.
