SAMB
SAMBA — High
FEHB Offered in 2027|SAMBA|Traditional|PPO
Also listed as: SAMBA Health Benefit Plan
Premium
biweekly · employee paysSelf Only
$308.98biweekly · employee pays
vs 2026+$82.89 +36.7%
Lowest$114.55 (2013)
Highest$308.98 (2027)
Since 2013+169.7%
Self Plus One
$686.75biweekly · employee pays
vs 2026+$186.02 +37.1%
Lowest$291.70 (2024)
Highest$686.75 (2027)
Since 2016+126.8%
Self & Family
$742.68biweekly · employee pays
vs 2026+$198.63 +36.5%
Lowest$294.24 (2013)
Highest$742.68 (2027)
Since 2013+152.4%
Premium history
SharePeriodRate type
Year by year
follows the chart's share, period and rate-type selection| Year | Self Only | Δ | Self Plus One | Δ | Self & Family | Δ | Listed as |
|---|
Changelog
- 2012Tracked since 2012Earliest plan year in the data set.
- 2016Self Plus One enrollment addedOPM introduced the Self Plus One enrollment type government-wide in 2016.
- 2020Renamed“SAMBA” → “SAMBA Health Benefit Plan”
- 2024Largest decrease: -18.2%Self Only employee share went from $156.09 to $127.74.
- 2026Largest increase: +40.5%Self Only employee share went from $160.97 to $226.09.
- 2026Renamed“SAMBA Health Benefit Plan” → “SAMBA”
Full rate schedule
Plan yearIn-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | $300 | $600 | $600 |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | $300 | $600 | $600 |
| Annual out-of-pocket maximum | $5,000 | $10,000 | $10,000 |
| Prescription out-of-pocket maximum | $5,000 | $10,000 | $10,000 |
- Type of accountNot Applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket Maximum per enrollee$5,000
- Total Annual Part B Premium Reimbursement Amount Per Enrollee (MAPD)$1,200
- Tier 0$0 Copayment
- Tier 1$10 Copayment
- Tier 230% Coinsurance
- Tier 345% Coinsurance
- Tier 4$999 Copayment
- Tier 5$999 Copayment
- Mail Order PharmacyYes
- Deductible waiver (with Medicare Part A as Primary)No
- Deductible waiver (with Medicare Part B as Primary)Deductible waived
- Deductible Waiver with Parts A & BDeductible waived
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & BMember Pays Nothing
- Outpatient Hospital Services with Part A15% Coinsurance
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNo
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CDeductible waived
- Out-of-Pocket Maximum with Part C$0
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Part CMember Pays Nothing
- Inpatient Hospital Services with Part CMember Pays Nothing
- Outpatient Hospital Services with Part CMember Pays Nothing
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Part C$1,200 Maximum
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$15 Copayment
- Specialist Office Visit$25 Copayment
- Emergency Care15% Coinsurance
- Urgent Care$15 Copayment
- Doctor Costs for Inpatient Surgery15% Coinsurance
- Hospital Inpatient Cost Per Admission$250 Copayment
- Hospital Room CostsMember Pays Nothing
- Other Inpatient Hospital Costs15% Coinsurance
- Doctor Costs for Outpatient Surgery15% Coinsurance
- Other Outpatient Surgery Costs15% Coinsurance
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)15% Coinsurance
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)15% Coinsurance
- Enhanced Lab NetworkMember Pays Nothing
- Applied Behavioral Analysis (ABA)15% Coinsurance
- Chiropractic15% Coinsurance
- Occupational Therapy15% Coinsurance
- Physical Therapy15% Coinsurance
- Speech Therapy15% Coinsurance
- Professional Services (Mental Health and Substance Use Disorder)$15 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)$250 Copayment
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)15% Coinsurance
- Diagnosis and Treatment (Infertility Services)15% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)15% Coinsurance
- Artificial Insemination Services (e.g. ICI, IVI, IUI)15% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures15% Coinsurance
- Reconstructive Surgery15% Coinsurance
- Hearing Services15% Coinsurance
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)15% Coinsurance
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)Member Pays Nothing
- Hospice Care15% Coinsurance
- Home Health Services (Skilled Nursing Care)15% Coinsurance
- Durable Medical Equipment15% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)15% Coinsurance
- Diabetes Education15% Coinsurance
- Nutritional Counseling15% Coinsurance
- Routine Dental Exams and Cleaning for AdultsNot Covered
- Routine Dental Exams and Cleaning for ChildrenNot Covered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture15% Coinsurance
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Out-of-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | $300 | $600 | $600 |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | $300 | $600 | $600 |
| Annual out-of-pocket maximum | $6,000 | $12,000 | $14,000 |
- Type of accountNot Applicable
- Tier 0$0 Copayment
- Tier 1$10 Copayment
- Tier 230% Coinsurance
- Tier 345% Coinsurance
- Tier 4$999 Copayment
- Tier 5$999 Copayment
- Mail Order PharmacyYes
- Deductible waiver (with Medicare Part A as Primary)No
- Deductible waiver (with Medicare Part B as Primary)Deductible waived
- Deductible Waiver with Parts A & BDeductible waived
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & BMember Pays Nothing
- Outpatient Hospital Services with Part A35% Coinsurance
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNo
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CDeductible waived
- Out-of-Pocket Maximum with Part C$0
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Part CMember Pays Nothing
- Inpatient Hospital Services with Part CMember Pays Nothing
- Outpatient Hospital Services with Part CMember Pays Nothing
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Part C$1,200 Maximum
- Preventive Care35% Coinsurance
- Primary Care Office Visit35% Coinsurance
- Specialist Office Visit35% Coinsurance
- Emergency Care15% Coinsurance
- Urgent Care35% Coinsurance
- Doctor Costs for Inpatient Surgery35% Coinsurance
- Hospital Inpatient Cost Per Admission$350 Copayment
- Hospital Room Costs35% Coinsurance
- Other Inpatient Hospital Costs35% Coinsurance
- Doctor Costs for Outpatient Surgery35% Coinsurance
- Other Outpatient Surgery Costs35% Coinsurance
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)35% Coinsurance
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)35% Coinsurance
- Enhanced Lab NetworkNot applicable
- Applied Behavioral Analysis (ABA)35% Coinsurance
- Chiropractic35% Coinsurance
- Occupational Therapy50% Coinsurance
- Physical Therapy50% Coinsurance
- Speech Therapy35% Coinsurance
- Professional Services (Mental Health and Substance Use Disorder)35% Coinsurance
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)$350 Copayment
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)35% Coinsurance
- Diagnosis and Treatment (Infertility Services)35% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)35% Coinsurance
- Artificial Insemination Services (e.g. ICI, IVI, IUI)35% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures35% Coinsurance
- Reconstructive Surgery35% Coinsurance
- Hearing Services35% Coinsurance
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)35% Coinsurance
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)$350 Copayment
- Hospice Care35% Coinsurance
- Home Health Services (Skilled Nursing Care)50% Coinsurance
- Durable Medical Equipment50% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)35% Coinsurance
- Diabetes Education35% Coinsurance
- Nutritional Counseling35% Coinsurance
- Routine Dental Exams and Cleaning for AdultsNot Covered
- Routine Dental Exams and Cleaning for ChildrenNot Covered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture35% Coinsurance
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Offered nationwide.
Service area description
| State | Description |
|---|---|
| Nationwide | Nationwide |
Service area over time
| Year | States / areas listed |
|---|---|
| 2027 | Nationwide |
| 2026 | Nationwide |
| 2025 | Nationwide |
| 2024 | Nationwide |
| 2023 | Nationwide |
| 2022 | Nationwide |
| 2021 | Nationwide |
| 2020 | Nationwide |
| 2019 | Nationwide |
| 2018 | Nationwide |
| 2017 | Nationwide |
| 2016 | Nationwide |