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Summary: Providers verify APWU Health Plan eligibility at uhss.umr.com or by calling Provider Services at 866-204-8020, with EDI payer ID 39026 for High Option primary medical claims and 44444 for secondary and dental claims. Members are eligible through PSHB (postal, enrollment codes 23A to 23F) or FEHB (non-postal federal, codes 471 to 476) and must be or become an APWU member or associate member. Open Season for plan year 2027 runs November 9 to December 14, 2026. For faster payer checks, consider SPRY, which supports eligibility verification and billing for rehab clinics.
To verify APWU Health Plan eligibility, providers use the UnitedHealthcare Provider Portal at uhss.umr.com or call Provider Services at 866-204-8020 (24/7 automated, with representatives from 7 a.m. to 6 p.m. ET, Monday to Friday). Primary medical claims for the High Option go to EDI payer ID 39026, and secondary medical and dental claims use EDI 44444. Members are eligible if they are postal employees or annuitants in the Postal Service Health Benefits (PSHB) Program, or non-postal federal employees in FEHB, and they must be or become an APWU member or associate member.
This guide covers both audiences that search for this topic: providers and billing offices who need the portal, phone numbers, EDI IDs, claims addresses and precertification lines, and members who need the eligibility rules, enrollment codes (23A to 23F for PSHB, 471 to 476 for FEHB), premiums, open season dates and Temporary Continuation of Coverage. Information was checked against the APWU Health Plan provider page, the 2026 OPM PSHB brochure and OPM program pages in October 2026.
APWU Health Plan eligibility at a glance
| Item | Detail | Source |
|---|---|---|
| Provider portal | UnitedHealthcare Provider Portal, uhss.umr.com | apwuhp.com provider page |
| Provider Services | 866-204-8020; 24/7 automated, representatives 7 a.m. to 6 p.m. ET, Monday to Friday | apwuhp.com provider page |
| Plan customer service | 800-222-2798 (TTY 800-622-2511) | OPM brochure RI 71-019 |
| Network | UnitedHealthcare PPO network in all states and the U.S. Virgin Islands | OPM brochure RI 71-019 |
| Plan options | High Option and Consumer Driven Option | OPM brochure RI 71-019 |
| PSHB enrollment codes | High Option 23A, 23B, 23C; Consumer Driven Option 23D, 23E, 23F | OPM PSHB brochures |
| FEHB enrollment codes | High Option 471, 472, 473; Consumer Driven Option 474, 475, 476 | OPM brochure RI 71-004 |
| Membership rule | Be or become a dues-paying or associate APWU member; associate fee $35 a year ($36 for Retirees Department members) | OPM brochure RI 71-019 |
| Open Season for plan year 2027 | November 9 to December 14, 2026 | OPM news release |
APWU Health Plan eligibility and contact finder
APWU Health Plan eligibility and contact finder
Choose whether you are a provider office or a member. Providers get the right portal, phone number, EDI ID or claims address for the task. Members get a program (PSHB or FEHB), the enrollment codes and the eligibility checks that apply to their situation.
Based on the APWU Health Plan provider page, the 2026 OPM brochures (RI 71-019 for PSHB and RI 71-004 for FEHB) and OPM program pages, checked in October 2026. Contact details can change, and the member ID card shows the current claims address. This tool does not confirm an individual's coverage.
How providers verify APWU Health Plan eligibility
Eligibility is verified through the UnitedHealthcare Provider Portal at uhss.umr.com or by phone, according to the plan's provider page. The portal is a provider tool, so members should call the number on their ID card or use the member portal at apwuhp.com. The APWU Health Plan site also lists CAQH CORE certification for eligibility, benefits, claims and payment transactions.
- Collect the card details. Copy the member ID, name, date of birth and the plan option (High Option or Consumer Driven Option) from the ID card and photo ID.
- Check eligibility online. Sign in to the provider portal at uhss.umr.com and confirm active coverage on the date of service.
- Call if the portal does not settle it. Provider Services at 866-204-8020 is automated 24/7 and staffed 7 a.m. to 6 p.m. ET, Monday to Friday.
- Record the result. Save the date, time, method and reference number in the patient account so it supports the claim later.
- Check precertification. Confirm whether the service needs prior approval (see the table below) and call before delivering it.
- Bill the right payer route. Use the EDI IDs and claims addresses below, and check the ID card for current mailing information.
Clinics that verify many payers can speed this up with real-time eligibility verification and our insurance eligibility verification guide. APWU High Option primary medical claims go to UnitedHealthcare Shared Services, whose portal is hosted on umr.com, so our UMR eligibility guide and UnitedHealthcare eligibility guide are useful companions.
APWU provider phone numbers, EDI IDs and claims addresses
| Task | How to do it | Details |
|---|---|---|
| Eligibility and claim status | Provider portal or phone | uhss.umr.com; 866-204-8020 (24/7 automated; representatives 7 a.m. to 6 p.m. ET, Monday to Friday) |
| Primary medical claims, High Option | EDI or paper | EDI payer ID 39026; UnitedHealthcare Shared Services, PO Box 30783, Salt Lake City, UT 84130-0783; online submission is available in the portal |
| Secondary medical and dental claims | EDI or paper | EDI payer ID 44444; APWU Health Plan, P.O. Box 8660, Elkridge, MD 21075 |
| Dental questions | Phone | 800-222-2798 (800-222-APWU), 8:30 a.m. to 6:30 p.m. ET, Monday to Friday |
| Plan automated line | Phone | 800-222-2798 (24/7 automated) |
| Join the UnitedHealthcare network | Online | uhcprovider.com |
The plan notes that current mailing information appears on member ID cards, so check the card before sending paper claims. For claim denials after submission, use our claim denial calculator and denial-reduction strategies.
Prior authorization and precertification
The APWU Health Plan provider page lists services that need prior approval. Call the High Option line at 866-569-2064 or the Consumer Driven Option line at 855-808-3003 before the service is delivered.
| Service | Requirement |
|---|---|
| Inpatient hospital, residential treatment and skilled nursing facility stays | Precertification required. Minimum $500 penalty for inpatient hospital procedures without approval (High Option) |
| Radiology: CT, MRI, MRA and PET scans | Precertification required. $100 penalty for outpatient radiology without approval (High Option) |
| Durable medical equipment | Precertification required |
| Inpatient mental health and substance use | Call UHC Behavioral Health Solutions at least 2 business days before admission |
| Extended newborn hospital stays and planned admissions | 48 hours of advance notice for planned admissions |
| Minimally invasive treatment of back and neck pain (High Option) | Prior approval required per the OPM brochure |
The two published Consumer Driven Option numbers differ: the plan's provider page lists 855-808-3003, while the OPM 2026 brochure lists UnitedHealthcare at 800-718-1299. Confirm the number on the member's card. We could not confirm outpatient physical therapy visit limits or copays in the parts of the brochure we could access; see Section 5 of the OPM brochure or call 800-222-2798 before treating. For authorization workflows in general, see our prior authorization calculator.
Who is eligible for the APWU Health Plan
Eligibility depends on your employer, your employment status and APWU membership. According to OPM, the PSHB Program serves eligible Postal Service employees, Postal Service annuitants and their eligible family members, and since January 1, 2025, postal employees and annuitants can no longer enroll in FEHB plans. Non-postal federal employees and annuitants who are eligible for FEHB can still enroll in the APWU Health Plan through FEHB.
| Group | Program | Key rule |
|---|---|---|
| Career postal employees | PSHB | Eligible for PSHB; must be or become an APWU member or associate member |
| Postal Service Employees (PSEs) | PSHB | Eligible after one year (365 days) of employment per OPM |
| Postal annuitants | PSHB | Most Medicare-eligible annuitants and family members must enroll in Part B to keep PSHB coverage, with limited exceptions |
| Non-postal federal employees and annuitants | FEHB | Eligible for FEHB; APWU membership or associate membership required |
| Family members | Same program as the enrollee | Spouse and eligible children follow FEHB family-member rules |
APWU membership and associate membership
The plan is open to people who are or become dues-paying members or associate members of the American Postal Workers Union, AFL-CIO. Most associate members pay a $35 annual fee, Retirees Department members pay $36, and some people are exempt by law.
Enrollment types
Self Only covers the enrollee. Self Plus One covers the enrollee and one eligible family member. Self and Family covers the enrollee and all eligible family members. Each enrollment type has its own code, shown below.
| Option and enrollment type | PSHB code | FEHB code |
|---|---|---|
| High Option, Self Only | 23A | 471 |
| High Option, Self Plus One | 23C | 473 |
| High Option, Self and Family | 23B | 472 |
| Consumer Driven Option, Self Only | 23D | 474 |
| Consumer Driven Option, Self Plus One | 23F | 476 |
| Consumer Driven Option, Self and Family | 23E | 475 |
Postal workers: use the 23A to 23F codes. The 471 to 476 codes belong to the FEHB version of the plan and are often mistaken for postal codes.
How to verify your own APWU Health Plan eligibility (members)
- Confirm your program. Postal employees and annuitants use PSHB, and non-postal federal employees use FEHB.
- Check your employment status. PSEs need one year (365 days) of employment; career employees and annuitants should confirm their status with their employing office or retirement system.
- Confirm APWU membership. You must be a dues-paying member or become an associate member ($35 a year for most).
- Match your enrollment code. Use the code for your option and enrollment type from the table above.
- Check the effective date. Coverage generally begins on the first day of the pay period after processing for enrollment outside Open Season. Newly eligible employees generally have 60 days to enroll.
- Use your ID card and the member portal. Customer service is 800-222-2798, and members can manage their account at apwuhp.com.
APWU Health Plan premiums and open season
Open Season for plan year 2027 runs from November 9 through December 14, 2026. OPM reports that average PSHB premiums rise 8.2% for enrollees in 2027 (6.7% overall) and that a redesigned PSHB Enrollee Portal and a simplified qualifying life event process launch during Open Season. The table shows PSHB biweekly employee premiums; the 2026 High Option figures come from the plan's flyer, and the 2027 figures come from a third-party summary dated October 1, 2026, so verify them in OPM's 2027 PSHB premium file before quoting them to members.
| Option and enrollment type | 2026 | 2027 (reported, verify with OPM) |
|---|---|---|
| High Option, Self Only | $107.15 | $142.97 |
| High Option, Self Plus One | $216.18 | $279.13 |
| High Option, Self and Family | $275.94 | $358.28 |
| Consumer Driven Option, Self Only | Not listed in sources checked | $100.21 |
| Consumer Driven Option, Self Plus One | Not listed in sources checked | $217.81 |
| Consumer Driven Option, Self and Family | Not listed in sources checked | $237.61 |
APWU also published 2026 Consumer Driven Option special biweekly rates for career APWU bargaining unit members enrolled in PSHB for more than one year: $30.16 for Self Only, $70.60 for Self Plus One and $82.48 for Self and Family. See the APWU rates article for the conditions. OPM publishes official rates on its PSHB premiums page.
2026 benefit changes in the OPM brochure
| Change | Detail |
|---|---|
| Voluntary male sterilization | Covered at 100% with a PPO provider |
| Iatrogenic infertility | Lifetime maximum removed; $15,000 annual cap |
| Custom foot orthotics | New $200 annual limit |
| Hospice care | Lifetime maximum removed; $15,000 annual cap |
| Gender transition services | No longer covered under the PSHB Program |
| Emergency ambulance | Now covered as a PPO service |
| High Option | Introduces the Omada weight loss program |
| Consumer Driven Option | $25 health reward for preventive colonoscopy or Cologuard |
If you lose eligibility: Temporary Continuation of Coverage
| Topic | Rule |
|---|---|
| Who qualifies | Separating employees (unless gross misconduct), children who lose coverage at 26, and former spouses after divorce or annulment |
| Maximum duration | Up to 18 months for separating employees; up to 36 months for children and former spouses |
| Premium | The full premium (employee and Government shares) plus a 2% administrative charge |
| Election deadline | 60 days from the later of the notice or the separation (employees); 60 days for former spouses after the qualifying event; children 60 days from the later of their 26th birthday or the notice |
| When it starts | When the 31-day temporary extension of coverage ends |
| Notice | The employing office must notify eligible people within 61 days |
Other options include the Health Insurance Marketplace at healthcare.gov. See OPM's TCC page for details.
Common eligibility problems and fixes
| Problem | Likely cause | What to do |
|---|---|---|
| Portal shows no coverage | Wrong plan option, wrong date of service or a newly enrolled member | Confirm the ID card, date of service and plan option, then call 866-204-8020 |
| Postal worker has a 471 to 476 code | Mixing up FEHB and PSHB codes | Postal workers use 23A to 23F; confirm with the plan |
| Claim denied for no precertification | Service required prior approval | Check the precertification table and call 866-569-2064 (High Option) or 855-808-3003 (Consumer Driven Option) before the service |
| Claim sent to the wrong place | Primary versus secondary routing or an outdated address | Use EDI 39026 for High Option primary claims, 44444 for secondary and dental, and check the ID card address |
| Member has Medicare or other coverage | Coordination of benefits | Verify coordination of benefits and send the claim to the primary payer first |
Billing teams can reduce these errors by automating checks in billing software, keeping coding accurate with the CPT code library and ICD-10 code library, and reviewing our guides on medical insurance eligibility verification and verifying patient insurance eligibility. Compare tools in best eligibility verification software for PT.
Frequently asked questions
How do I verify APWU Health Plan eligibility as a provider?
Use the UnitedHealthcare Provider Portal at uhss.umr.com or call Provider Services at 866-204-8020. The line is automated 24/7, and representatives are available 7 a.m. to 6 p.m. ET, Monday to Friday.
What is the APWU provider portal?
It is the UnitedHealthcare Provider Portal at uhss.umr.com, listed on the APWU Health Plan provider page for eligibility verification and online claim submission for High Option primary medical claims. Members use the member portal on apwuhp.com instead.
What is the APWU Health Plan provider phone number?
Provider Services is 866-204-8020. The plan's general customer service line is 800-222-2798 (TTY 800-622-2511), and dental questions are handled at 800-222-APWU (2798).
What is the APWU Health Plan payer ID or EDI number?
The APWU provider page lists EDI payer ID 39026 for High Option primary medical claims, and EDI 44444 for secondary medical and dental claims.
Where do I mail APWU Health Plan claims?
High Option primary medical claims go to UnitedHealthcare Shared Services, PO Box 30783, Salt Lake City, UT 84130-0783. Secondary medical and dental claims go to APWU Health Plan, P.O. Box 8660, Elkridge, MD 21075. Check the member ID card for current mailing information.
Does the APWU Health Plan require prior authorization?
Yes, for listed services such as inpatient stays, skilled nursing facilities, durable medical equipment, and CT, MRI, MRA and PET imaging. Call 866-569-2064 for High Option or 855-808-3003 for Consumer Driven Option before the service.
Who is eligible for the APWU Health Plan?
Postal Service employees and annuitants eligible for PSHB, and non-postal federal employees and annuitants eligible for FEHB, if they are or become dues-paying members or associate members of the APWU. PSEs become eligible after one year (365 days) of employment.
What are the APWU Health Plan enrollment codes?
For PSHB, High Option is 23A (Self Only), 23C (Self Plus One) and 23B (Self and Family), and Consumer Driven Option is 23D, 23F and 23E. For FEHB, High Option is 471, 473 and 472, and Consumer Driven Option is 474, 476 and 475.
Is APWU membership required for the health plan?
Yes. You must be or become a dues-paying member or associate member. Most associate members pay $35 a year, and Retirees Department members pay $36, with some legal exemptions.
What network does the APWU Health Plan use?
The UnitedHealthcare PPO network in all states and the U.S. Virgin Islands, according to the 2026 OPM brochure.
When is Open Season for 2027?
November 9 through December 14, 2026, according to OPM.
Sources and further reading
- APWU Health Plan: Provider information
- OPM: 2026 APWU Health Plan PSHB brochure (RI 71-019)
- OPM: 2026 APWU Health Plan FEHB brochure (RI 71-004)
- OPM: Postal Service Health Benefits Program
- OPM: PSHB plan brochures and enrollment codes
- OPM: PSHB premiums
- OPM: 2026 Federal Benefits Open Season announcement
- OPM: Temporary Continuation of Coverage
- APWU: Your Health Plan rates
- MyFederalRetirement: 2027 premium summary (third-party, verify with OPM)
This page is informational and does not confirm an individual member's coverage. Contact numbers, addresses and premiums change, so verify them with the APWU Health Plan, the member ID card and OPM before relying on them.
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