2022 GEHA Medical Benefits Guide

Compare deductibles for all plans Yearly deductible in-network. 1 The Elevate Plus medical plan does not offer out-of-network coverage. What you pay each year before the plan begins to pay out benefits. For HDHP, the net deductible is the remaining amount after you subtract the GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin.

Elevate What you pay

HDHP What you pay

Standard What you pay

Elevate Plus What you pay

High What you pay

Plan type

$1,500 yearly deductible −$900 GEHA contribution 2 = $600 your net deductible $3,000 yearly deductible −$1,800 GEHA contribution 2 = $1,200 your net deductible

$350

$0

$350

$500

Self Only

Self Plus One and Self and Family

$700

$0

$700

$1,000

Compare out-of-pocket max for all plans Out-of-pocket max in-network. 1 The Elevate Plus medical plan does not offer out-of-network coverage. The maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins to pay 100% of covered services. This is a combined maximum of medical care and prescriptions.

Elevate What you pay

HDHP What you pay

Standard What you pay

Elevate Plus What you pay

High What you pay

Plan type

$7,000

$5,000

$6,500

$6,000

$5,000

Self Only

Self Plus One and Self and Family

$14,000

$10,000

$13,000

$12,000

$10,000

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 one of GEHA’s 2022 plan brochures: RI 71-006 (High and Standard), RI 71-014 (HDHP) or RI 71-018 (Elevate and Elevate Plus) at geha.com/PlanBrochure 2 GEHA’s contribution will go into a health savings account (HSA) or a health reimbursement arrangement (HRA). Most people qualify for an HSA. Those who don’t are enrolled in an HRA; this group includes Medicare enrollees and those who have non-HDHP coverage elsewhere. Find out which one you’re eligible for at geha.com/IRS969 22 2022 GEHA MEDICAL PLANS

Powered by