M.D.
M.D. IPA — High Option
FEHB Offered in 2027|M.D. IPA|Traditional|HMO
Premium
biweekly · employee paysSelf Only
$116.62biweekly · employee pays
vs 2026−$101.00 -46.4%
Lowest$77.06 (2013)
Highest$260.86 (2024)
Since 2013+51.3%
Self Plus One
$227.77biweekly · employee pays
vs 2026−$120.32 -34.6%
Lowest$144.46 (2016)
Highest$453.08 (2024)
Since 2016+57.7%
Self & Family
$464.23biweekly · employee pays
vs 2026−$278.55 -37.5%
Lowest$192.83 (2013)
Highest$846.37 (2024)
Since 2013+140.7%
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.
- 2019Largest increase: +32.1%Self Only employee share went from $102.03 to $134.83.
- 2027Largest decrease: -46.4%Self Only employee share went from $217.62 to $116.62.
Full rate schedule
Plan yearIn-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| 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
- Total Annual Part B Premium Reimbursement Amount Per Enrollee (MAPD)$1,800
- Tier 0$0 Copayment
- Tier 1$15 Copayment
- Tier 2$60 Copayment
- Tier 3$150 Copayment
- Tier 4$300 Copayment
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible Waiver with Parts A & BNot applicable
- Out-of-Pocket Maximum with Parts A & B$5,000
- 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 AMember Pays Nothing
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNot applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- 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$150
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$30 Copayment
- Specialist Office Visit$40 Copayment
- Emergency Care$350 Copayment
- Urgent Care$50 Copayment
- Doctor Costs for Inpatient SurgeryMember Pays Nothing
- Hospital Inpatient Cost Per Admission$250 Copayment
- Hospital Room CostsMember Pays Nothing
- Other Inpatient Hospital CostsMember Pays Nothing
- Doctor Costs for Outpatient SurgeryMember Pays Nothing
- Other Outpatient Surgery Costs$150 Copayment
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)$50 Copayment
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)$100 Copayment
- Enhanced Lab NetworkNot applicable
- Applied Behavioral Analysis (ABA)Member Pays Nothing
- Chiropractic50% Coinsurance
- Occupational Therapy$40 Copayment
- Physical Therapy$40 Copayment
- Speech Therapy$40 Copayment
- Professional Services (Mental Health and Substance Use Disorder)$30 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)$250 Copayment
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays Nothing
- Diagnosis and Treatment (Infertility Services)$30 Copayment
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)$150 Copayment
- Artificial Insemination Services (e.g. ICI, IVI, IUI)50% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)50% Coinsurance
- Surgical Procedures$150 Copayment
- Reconstructive Surgery$150 Copayment
- Hearing Services$30 Copayment
- Hearing Aids (external)Not Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)$30 Copayment
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)$250 Copayment
- Hospice CareMember Pays Nothing
- Home Health Services (Skilled Nursing Care)$20 Copayment
- Durable Medical Equipment50% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)$50 Copayment
- Diabetes Education$30 Copayment
- Nutritional Counseling$30 Copayment
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsCovered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture$40 Copayment
- 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 | Not applicable | Not applicable | Not applicable |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | Not applicable | Not applicable | Not applicable |
| Annual out-of-pocket maximum | Not applicable | Not applicable | Not applicable |
- Type of accountNot Applicable
- Tier 0$999 Copayment
- Tier 1$999 Copayment
- Tier 2$999 Copayment
- Tier 3$999 Copayment
- Tier 4$999 Copayment
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)Not applicable
- Deductible waiver (with Medicare Part B as Primary)Not applicable
- Deductible Waiver with Parts A & BNot applicable
- Out-of-Pocket Maximum with Parts A & BNot applicable
- Primary Care Physician Office Visit with Medicare A & B PrimaryNot applicable
- Specialty Physician Office Visit with Parts A & BNot applicable
- Inpatient Hospital Services with Parts A & BNot applicable
- Outpatient Hospital Services with Part ANot applicable
- Outpatient physician services (with Medicare Part B as Primary)Not applicable
- Part B Premium Reimbursement with Parts A & BNot applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- 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$150
- Preventive CareMember Pays All Charges
- Primary Care Office VisitMember Pays All Charges
- Specialist Office VisitMember Pays All Charges
- Emergency Care$350 Copayment
- Urgent CareMember Pays All Charges
- Doctor Costs for Inpatient SurgeryMember Pays All Charges
- Hospital Inpatient Cost Per AdmissionMember Pays All Charges
- Hospital Room CostsMember Pays All Charges
- Other Inpatient Hospital CostsMember Pays All Charges
- Doctor Costs for Outpatient SurgeryMember Pays All Charges
- Other Outpatient Surgery CostsMember Pays All Charges
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)Member Pays All Charges
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)Member Pays All Charges
- Enhanced Lab NetworkNot applicable
- Applied Behavioral Analysis (ABA)Member Pays All Charges
- ChiropracticMember Pays All Charges
- Occupational TherapyMember Pays All Charges
- Physical TherapyMember Pays All Charges
- Speech TherapyMember Pays All Charges
- Professional Services (Mental Health and Substance Use Disorder)Member Pays All Charges
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)Member Pays All Charges
- Diagnosis and Treatment (Infertility Services)Member Pays All Charges
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)Member Pays All Charges
- Artificial Insemination Services (e.g. ICI, IVI, IUI)Member Pays All Charges
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical ProceduresMember Pays All Charges
- Reconstructive SurgeryMember Pays All Charges
- Hearing ServicesMember Pays All Charges
- Hearing Aids (external)Not Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays All Charges
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)Member Pays All Charges
- Hospice CareMember Pays All Charges
- Home Health Services (Skilled Nursing Care)Member Pays All Charges
- Durable Medical EquipmentMember Pays All Charges
- Outpatient Rehabilitation (Skilled Nursing Care Facility)Member Pays All Charges
- Diabetes EducationMember Pays All Charges
- Nutritional CounselingMember Pays All Charges
- 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 TreatmentNot Covered
- EyeglassesNot Covered
- Contact LensesNot Covered
- AcupunctureMember Pays All Charges
- Chronic Disease Management: Heart DiseaseNot Covered
- Chronic Disease Management: ObesityNot Covered
- Chronic Disease Management: HypertensionNot Covered
- Chronic Disease Management: AsthmaNot Covered
States
3District of ColumbiaMarylandVirginia
Counties covered
| State | Area |
|---|---|
| District of Columbia | Entire state |
| Maryland | Entire state |
| Virginia | Alexandria City, Arlington, Clarke, Culpeper, Fairfax, Fairfax City, Falls Church City, Fauquier, Frederick, Fredericksburg City, Greene, Harrisonburg City, King George, Loudoun, Madison, Manassas City, Manassas Park City, Orange, Page, Prince William, Rappahannock, Rockingham, Shenandoah, Spotsylvania, Stafford, Warren, Winchester City |
Service area over time
| Year | States / areas listed |
|---|---|
| 2027 | District of Columbia, Maryland, Virginia |
| 2026 | District of Columbia, Maryland, Virginia |
| 2025 | District of Columbia, Maryland, Virginia |
| 2024 | District of Columbia, Maryland, Virginia |
| 2023 | District of Columbia, Maryland, Virginia |
| 2022 | District of Columbia, Maryland, Virginia |
| 2021 | District of Columbia, Maryland, Virginia |
| 2020 | District of Columbia, Maryland, Virginia |
| 2019 | District of Columbia, Maryland, Virginia |
| 2018 | District of Columbia, Maryland, Virginia |
| 2017 | District of Columbia, Maryland, Virginia |
| 2016 | District of Columbia, Maryland, Virginia |
| 2015 | District of Columbia, Maryland, Virginia |
| 2014 | District of Columbia, Maryland, Virginia |
| 2013 | District of Columbia, Maryland, Virginia |