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Chronic Condition Management for Postal Employees | NALC High Option Plan

Living with a chronic illness can feel overwhelming—but you’re not alone. Whether it’s a new diagnosis, a long-term condition, or recovery after hospitalization, the High Option Plan offers extensive chronic condition management programs to support your needs.

You’ll receive:

  • Personalized care coordination

  • Access to specialty care, therapies, and education

  • Support from trusted partners like Cigna, CVS Specialty®, Accordant Health Management®, Optum®, Hello Heart®, Hinge Health®, and Maven®

View the 2025 NALC Health Benefit Plan Brochure

Chronic Condition Programs in the High Option Plan

Take control of your health with clinically supported chronic disease management programs tailored to Postal employees and retirees. The High Option Plan connects you with expert support and digital tools that make managing your condition easier.

What You Get:

  • One-on-one coaching through Your Health First® by Cigna

  • Support for 19 rare and complex conditions via Accordant Health Management®

  • Diabetes management through Transform Care® with CVS Caremark

  • Gap-filling interventions for hypertension, cardiac disorders, and diabetes

  • Health coaching and nutrition counseling

  • Specialized platforms like Hello Heart®, Hinge Health®, and Maven®

No matter when you enroll, choosing the NALC Health Benefit Plan is a positive step toward better health coverage and peace of mind.

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Conditions We Help Manage in the High Option Plan

Our chronic condition program is focused on prevention, support, and long-term wellness.

Complex Conditions Managed by Accordant Health Management®

  • ALS (Lou Gehrig's Disease)

  • CIDP

  • Crohn's Disease

  • Cystic Fibrosis

  • Dermatomyositis

  • Gaucher Disease

  • Hemophilia

  • Hereditary Angioedema

  • HIV

  • Multiple Sclerosis

  • Myasthenia Gravis

  • Parkinson's Disease

  • Polymyositis

  • Rheumatoid Arthritis

  • Scleroderma

  • Seizure Disorders (Epilepsy)

  • Sickle Cell Disease

  • Systemic Lupus Erythematosus

  • Ulcerative Colitis

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Treatment Therapies Covered Under the High Option Plan

Those enrolled in the High Option Plan receive extensive coverage for medically necessary therapies that support chronic condition management.

Covered Treatments Include:

  • Infusion therapy (including IV antibiotics)

  • Respiratory/inhalation therapies

  • Growth hormone therapy

  • Cardiac and pulmonary rehabilitation (Phases I & II)

  • Dialysis (hemodialysis and peritoneal)

  • Chemotherapy and radiation therapy

What’s Not Covered:

  • Chelation therapy (except for acute poisoning from arsenic, gold, lead, or mercury)

  • Prolotherapy

  • ABA therapy that hasn’t been pre-authorized

Cost to You:

  • PPO Providers: 15% of the Plan allowance

  • Non-PPO Providers: 35% of the Plan allowance + any difference between our allowance and the billed amount

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Specialty Medications for Members in the High Option Plan

Managing a chronic or complex health condition can require advanced, long-term prescriptions. The NALC High Option Plan partners with CVS Specialty to ensure Postal employees, retirees, and their families get the care and medication they need—delivered with convenience and expert support.

Coverage Includes:

  • Specialty drugs including biologics, biotech therapies, oral chemotherapy, and gene-based treatments

  • PPO:

    • 200 (30-day)
    • $300 (60-day)
    • $400 (90-day)

  • All specialty prescriptions require prior authorization and must be filled through CVS Specialty

Specialized Support:

  • Step therapy and the Advanced Control Specialty Formulary® to help ensure effective, cost-efficient treatment options

  • Home delivery of specialty medications through for added convenience

  • Case management with personalized coaching to track side effects and support adherence

  • Access to third-party copay assistance programs (when eligible) to help reduce out-of-pocket costs

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Transitional Care Support for those in the High Option Plan

A hospital stay or new diagnosis can change your routine overnight. With the NALC High Option Plan, you’re not alone—our transitional care program connects you to the support you need to recover, adjust, and keep your health on track.

Support Includes:

  • Organized post-hospital care so you know your next steps

  • Help booking follow-up visits and managing prescriptions

  • Coaching from experienced nurses to help prevent a return to the hospital

  • Access to nutrition counseling through the NALC HBP telehealth program, at no cost. visit www.nalchbptelehealth.org

Who It’s For:

Postal employees and retirees recently hospitalized or those newly diagnosed with a chronic or complex condition.

Contact Information for PSHB Chronic Condition Programs

Need Help with Your Chronic Condition Program?

NALC is committed to helping you and your family stay well and supported.

View the 2025 NALC PSHB Plan Brochure

Frequently Asked Questions

FAQ representative
19 serious chronic and rare conditions, including diabetes, lupus, MS, HIV, and Crohn’s Disease.
They provide access to expert support from Cigna, Accordant Health Management, CVS, and more.
Transform Care for diabetes is a personalized, no-cost diabetes management program that offers connected glucometers, test strips, pharmacist counseling, and two annual diabetes screening visits at a CVS MinuteClinic.
You must use CVS Specialty for chronic condition prescriptions. Prior approval is required.
Transitional services include coordinated care, extended specialist access, and dietary consultations.
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