Plan Brochure

Plan Brochure

NEW! 2022 PCABP Plan Brochure:

Dear Policyholder:
Enclosed is your 2022 plan brochure for the Panama Canal Area Benefit Plan (PCABP). This plan brochure describes the benefits of the PCABP Program beginning on January 1, 2022 
Please read your entire plan brochure very carefully and hopefully most of the questions you have about your coverage will be answered.

Below are the highlights of the 2022 benefit changes:

Program-wide change
• Effective in 2022, premium rates are the same for Non-Postal and Postal employees.
Changes to this Plan
• Your share of the premium rate will increase for Self Only, Self Plus One, and Self and Family. Please refer to the back cover of this brochure.
• We have updated Section 5(a) Preventive Care to include new or extended coverage following recommendations by the U.S. Preventive Service Task Force (USPSTF) concerning screening for hypertension, lung cancer, and unhealthy drug
use. There is no cost sharing under the POS option, and under the FFS US option.
• We have updated Women's Preventive Services to include new coverage on breast cancer chemoprevention counseling and screening for urinary incontinence following recommendations by the Health Resources and Services Administration
(HRSA). There is no cost sharing when received from an in-network provider under the POS option, and under the FFS US option. See Section 5(a) under Preventive Care, adult
• We have updated preventive care benefits for children to align with recommendations from the American Academy of Pediatrics (AAP) Bright Future Guidelines. There is no cost sharing when received from an in-network provider under the POS option, and under the FFS US option. See Section 5(a) under Preventive Care, child
• We have updated vaccine coverage under Section 5(a) Preventive Care, for children and adults based on the recommendations from the Advisory Committee on Immunization Practices (ACIP) and Center for Disease Control and Prevention, including but not limited to COVID19 vaccine as authorized under FDA, Emergency or compassionate use provisions. There continue to be no cost sharing for covered vaccines for POS members and for enrollees who reside in the United States under FFS US option.

• We have updated Section 5(b) Organ/Tissue Transplants to expand coverage of Allogeneic transplants for Myeloproliferative Disorders (MPDs) and no longer limit it to advanced stage, and coverage for all autologous Tandem transplants (subject to medical necessity). The Plan will also no longer cover Allogenic transplants for Amyloidosis and Autologous transplants for Acute lymphocytic or non-lymphocytic (i.e. myelogenous) leukemia. See pages 47 and 48.
Clarifications
• We have updated language under Section 5(a) Orthopedics and prosthetic devices, to show that internal prosthetic devices coverage includes penile prosthesis. See page 37.
• We have also updated language under Section 5(a) Orthopedics and prosthetic devices, to show that preauthorization for prostheses is required. See page 37.
• We have updated language under Section 5(b) under Reconstructive surgery to show that reconstructive surgery requires preauthorization. See page 4.
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If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices about your prescription drug coverage.  Please see the enclosed notice for more detail.
In addition, this letter serves as a reminder that YOUR PAPER CLAIMS for covered services you receive in hospitals outside of Panama and performed by physicians outside of Panama MUST BE SENT TO OUR POST OFFCE BOX ADDRESS AT:

AXA Assistance
PO Box 31-0940
Miami, FL. 33231- 0940

 

*This is a summary of the features of the Panama Canal Area Benefit Plan. Before making a final decision, please read the Plan’s Federal brochure (RI 72-004). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure..


2022
2022 Plan Brochure English

2021
2021 Plan Brochure English

 

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