Example: It pays to stay in-network.
Whether it’s a fixed dollar amount, or a percentage, we want you to understand what you pay for in- or out-of-network services. We’ve included an example below for a plan with a 10% coinsurance 1 for services in-network and 25% coinsurance for services out-of-network .
Provider’s billed rate
– In-network provider’s contracted rate with GEHA – GEHA’s plan allowance¹ for out-of-network providers
90% of $100: $90
75% of $100: $75
What GEHA pays
10% of $100: $10
25% of $100: $25
What you pay (coinsurance)
You also pay the difference between the provider’s billed rate and GEHA’s plan allowance
What you pay total for this service
1 See page 26 for definition.
Resources for all plans
Talk to a Benefits Adviser who can help me choose a GEHA plan
Talk to GEHA Customer Care
Find an in-network provider near me
Help me select a plan
Check my 2021 drug costs
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