2021 GEHA Medical Benefits Guide

Compare prescription coverage for all plans.

What you pay in-network. 2,3

geha.com/Prescriptions

Elevate

HDHP

Standard

$4

25% 1

$10

Generic

50% ($500 max)

25% 1,4

50% ($200 max 4 )

30-day retail

Preferred brand-name

100%

40% 1,4

50% ($300 max 4 )

Non-preferred brand-name

25% 1

$20

Generic

No benefit

25% 1,4

50% ($500 max 4 )

90-day mail service

Preferred brand-name

No benefit

40% 1,4

50% ($600 max 4 )

Non-preferred brand-name

No benefit

50% ($500 max)

25% 1,4

50% ($250 max 4 )

Generic and preferred brand-name

30-day 6 specialty CVS exclusive

100%

40% 1,4

50% ($400 max 4 )

Non-preferred brand-name

Elevate and Elevate Plus do not have out-of-network pharmacy coverage and have a limited pharmacy network. Learn more about prescription coverage at geha.com/Prescriptions

You‘ve got options with retail prescriptions. Pay less for prescriptions that are filled at an in-network pharmacy location. Locations include any CVS Pharmacy location, but you don‘t have to go to a CVS to pay in-network prices.

Save more with mail order prescriptions.

With CVS Caremark’s Mail Service Pharmacy, you can save money and have your routine prescriptions delivered to your home, postage- paid, within about 14 days from the time you submit your prescription. Mail order is not available for the Elevate plan option.

Find an in-network pharmacy location at geha.com/Find-Care

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www.geha.com

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