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 .
The Elevate Plus medical plan does not offer out-of-network coverage.
Service example
Out-of-network price In-network price
$150
$150
Provider’s billed rate
In-network provider’s contracted rate with GEHA and GEHA’s plan allowance for out-of-network providers
$100
$100
$75 75% of $100 $25 25% of $100
$90 90% of $100 $10 10% of $100
What GEHA pays
What you pay (coinsurance)
You also pay the difference between the out-of-network provider’s billed rate and GEHA’s plan allowance
$50
$0
What you pay total for this service
$75
$10
1 See page 17 for definition.
16
2022 GEHA MEDICAL PLANS
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