Frequently Asked Questions
We define emergency as those health care services provided on a 24-hour/365-days-a-year basis to evaluate and treat medical conditions of a recent onset and severity, leading a prudent lay person, possessing an average knowledge of medicine and health, to believe his or her condition, sickness, or injury is of such a nature where failure to seek immediate medical care could result in: placing the patient's health in serious jeopardy; serious impairment to bodily functions; or serious dysfunction of any bodily organ or part.
If you have to go to an out-of-network facility and need inpatient care you must notify QualChoice as soon as possible or within 48 hours of your stay so that we may attempt to transfer you to an in-network facility.
Please refer to the current plan brochure for copayment amounts.
Your secure, mobile friendly self-service website for health and benefits information. Order an ID card or print a temporary one, check eligibility or claim status, and much more.
Federal enrollment codes for the QualChoice High Option POS Plan are:
- Self Only – DH1
- Self and Family Enrollment – DH2
- Self Plus One – DH3
You and your covered family members have the right to the form of contraception or birth control that your provider recommends is best for your care. FEHB plans must cover, regardless of your gender identity, at least one form of contraception from each category listed in the Women’s Preventive Services Guidelines. There is no out-of-pocket cost for covered contraception. The FDA provides examples of contraceptives categorized in the Women’s Preventive Services Guidelines.
Use the contraception exception process if the contraception recommended by your provider is not covered or has an out-of-pocket cost. You or your provider may submit a Formulary Override Exception (PDF) request.
If you have difficulty accessing contraceptive coverage, you can contact OPM at contraception@opm.gov.