Included with Elevate
Medical benefits with Medicare A & B primary in-network 1
What you pay
Telehealth visits, including behavioral health and dermatology geha.com/MDLIVE Vision discount 5 (see page 4) geha.com/Vision Hearing aid discount 5 geha.com/Hearing Gym membership discount 5 geha.com/Fitness Electric toothbrush discount 5 geha.com/Toothbrush Teeth whitening discount 5
• Unlimited telehealth visits, including behavioral health with MDLIVE geha.com/MDLIVE • Preventive care; adult routine screenings • Primary physician office visit • MinuteClinic © (where available) geha.com/MinuteClinic • Chiropractic care (manipulative therapy), including X-rays; up to 12 visits per year • Acupuncture; up to 20 treatments per year
$0
$10
• Specialist care; office visit
$25 $50
• Urgent care
• Emergency care • Hospital care; inpatient and outpatient • Outpatient professional surgical services • Inpatient professional surgical services
25% 2
$250
geha.com/Whitening For a complete list of included benefits visit geha.com/Savings
Out-of-pocket maximum in-network 1 ,3
What you pay
$7,000 $14,000
Self Only
Self Plus One and Self and Family
5 These benefits are neither offered nor guaranteed under contract with the FEHB program, but are made available to all enrollees who become members of a GEHA medical plan and their eligible family members.
NEW! Subscribers can select an annual plan perk. Options include a Fitbit wearable device including Monthly Premium Membership, $125 gift card for DICK’S Sporting Goods or REI, or a Daily Burn virtual fitness subscription. 4 See page 5. geha.com/PlanPerk
Ready to enroll? opm.gov | 800.332.9798
1 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 GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus) at geha.com/PlanBrochure 2 Calendar year deductible applies. 3 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of covered services. This is a combined maximum for both medical care and prescriptions. 4 These benefits are neither offered nor guaranteed under contract with the FEHB program, but are made available to subscribers who become a member of GEHA’s Elevate and Elevate Plus medical plans.
07 2022 GEHA MEDICARE BENEFITS
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