2021 GEHA Medical Benefits Guide

Standard Option Page 8


X $15 copay for in-network primary care visits, $30 copay for in-network specialist visits. X Pay $0 for routine, in-network maternity care. X Pay $0 for unlimited telehealth visits, including pediatricians, licensed behavioral health therapists and dermatologists, through MDLIVE.

Elevate Plus Page 10


X Fixed costs, no in-network deductible, copays for common medical expenses and out-of-network medical coverage. X Earn up to $500 for Self Only or $1,000 for Self Plus One and Self and Family through Wellness Pays rewards. X $0 out-of-pocket costs for common surgeries through BridgeHealth.

High Option Page 12


X Comprehensive brand-name and specialty prescription coverage. X Low copays for doctor visits ( $20 primary and specialist). X $600 Medicare Part B premium reimbursement. X $2,500 hearing aid benefit. X Low cost-share for a variety of inpatient and outpatient services ( 10% coinsurance).

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