2021 GEHA Medical Benefits Guide

Definitions.

Helpful resources.

If you have questions about the information contained in this benefits guide please call one of our helpful Benefits Advisers.

Calendar year deductible

What you pay each year before the plan begins to pay out benefits.

800.262.4342

Talk to a Benefits Adviser who can help you choose from GEHA‘s portfolio of plans.

Coinsurance

The percentage you pay for a covered health care service, after you‘ve met your deductible.

geha.com/Select-A-Plan

Answer a few questions to see which plan may be your best fit.

Copay

A fixed amount you pay for a service or prescription.

Portion of monthly HDHP premium that GEHA contributes to a Health Savings Account (HSA) or Health Reimbursement Arrangement (HRA). A health care provider who is a part of GEHA‘s provider network. These providers agree to limit what they will charge you. The remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin. The maximum amount you pay each year for coverage. Includes copays, deductibles and coinsurance, but not premiums. Once the limit is met, the plan pays the remainder of your covered health care expenses for the rest of the year. Cost of health care goods and services after subtracting the insurance company’s negotiated discount. For complete details see the definition of “Plan allowance” in Section 10 of any GEHA plan brochure. geha.com/PlanBrochure

Search our extensive nationwide network for a provider or a medical facility (including urgent care clinics) near you.

GEHA contribution

geha.com/Find-Care

In-network provider

geha.com/Prescriptions

Verify drug costs based on your medical plan and prescription dosage.

Net deductible (HDHP)

geha.com/Rates

Get details on medical plans and supplemental benefits for each.

geha.com/Medicare

Explore how GEHA medical plans work with Medicare.

Out-of-pocket max

geha.com/MinuteClinic

Find a MinuteClinic® near you, where available.

Plan allowance

geha.com/OutsideUSA

Learn about your coverage when you’re outside of the United States.

U.S. Office of Personnel Management. The official source of information for federal employees eligible for FEHB plans.

opm.gov/Healthcare-Insurance

PPO

A preferred provider organization.

Premium

What you pay monthly or biweekly for coverage.

geha.com/Enroll

Tips for new enrollees or for those who are changing plans.

Prescription benefits

What you pay as a copay or percentage of coinsurance for medication.

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