Compare medical benefits for all plans.
Medical benefits. What you pay in-network. 2
Medical benefits. What you pay in-network. 2
geha.com/Find-Care
geha.com/Find-Care
Elevate Plus
High
Elevate
HDHP
Standard
$0 1,3
Unlimited telehealth visits with MDLIVE geha.com/MDLIVE $0
$0
Unlimited telehealth visits with MDLIVE geha.com/MDLIVE $0
$0
- Preventive care; adult routine screenings - Well-child visit; up to age 22 - Maternity; routine preventive care
- Preventive care; adult routine screenings - Well-child visit; up to age 22 - Maternity; routine preventive care
$0
$0
$0
$0
$0
MinuteClinic © (where available) geha.com/MinuteClinic Primary physician office visit geha.com/Find-Care
$10 $20 $35 $50
$10 $20 $20 $35
MinuteClinic © (where available) geha.com/MinuteClinic Primary physician office visit geha.com/Find-Care
$10 $10 $25 $50
5% 1 5% 1 5% 1 5% 1 5% 1 5% 1 5% 1 $0 1 5% 1 5% 1 5% ¹
$10 $15 $30 $35
Specialist care; office visit
Specialist care; office visit
Urgent care
Urgent care
$150 $150
$0 (must be within 72 hours)
25% 1 25% 1 25% 1 25% 1 25% 1 $250 25% 1
15% 1 15% 1 15% 1
Emergency care; accidental Emergency care; medical Hospital care; inpatient Hospital care; inpatient maternity
Emergency care; accidental Emergency care; medical Hospital care; inpatient Hospital care; inpatient maternity
10% 1
$200 per day up to $1,000 per admission $200 per day up to $1,000 per admission
$100 per admission plus 10%
$0
$0
$200 per day per facility
10% 1 10% 1 10% 1
15% 1 15% 1 15% 1
Hospital care; outpatient
Hospital care; outpatient
$200 $150
Inpatient professional surgical services Outpatient professional surgical services Lab Card services geha.com/LabCard
Inpatient professional surgical services Outpatient professional surgical services Lab Card services geha.com/LabCard
$0
$0
No benefit
No benefit
No benefit
$0
10% 10% 1
25% 1 25% 1
5% 1 5% ¹
15% 15% 1
Lab services (non-Lab Card) Other diagnostic services
Lab services (non-Lab Card) Other diagnostic services
$50 4
Balance after GEHA pays $20 per visit, up to 20 visits per year¹ Balance after GEHA pays $25 per year¹
Balance after GEHA pays $20 per visit, up to 20 visits per year Balance after GEHA pays $25 per year
Balance after GEHA pays $20 per visit, up to 20 visits per year
$10 per visit, up to 12 visits per year
$20 per visit, up to 15 visits per year
Chiropractic (spinal manipulation therapy)
Chiropractic (spinal manipulation therapy)
$0
Balance after GEHA pays $25 per year
$0
Chiropractic X-rays
Chiropractic X-rays
Balance after GEHA pays $22 per visit, twice yearly
$0 twice yearly, no deductible
50% twice yearly
Preventive dental care
No benefit
Preventive dental care
No benefit
$20
10% 1
$10
5% 1
15% 1
Acupuncture; up to 20 treatments per year
Acupuncture; up to 20 treatments per year
1
Calendar year deductible applies.
3 If deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charge. 4 You pay 25% for advanced outpatient diagnostic tests such as, CT Scans and MRI’s. Refer to GEHA’s 2021 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete list at geha.com/PlanBrochure
2 In-network providers agree to limit what they will charge you. You pay a fixed dollar amount or a percentage of the provider’s negotiated amount. For out-of-network benefits, refer to one of GEHA‘s 2021 plan brochures: RI 71-006 (High and Standard), RI 71-014 (HDHP) or RI 71-018 (Elevate and Elevate Plus) at geha.com/PlanBrochure
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