Included with HDHP
Medical benefits in-network 1
What you pay
Telehealth visits, including behavioral health 3 geha.com/MDLIVE Vision benefit and discount 5 (see page 20) geha.com/HDHPVision Gym membership discount 5 geha.com/Fitness Electric toothbrush discount 5 geha.com/Toothbrush Teeth whitening discount 5 geha.com/Whitening For a complete list visit geha.com/Savings Learn about health savings accounts geha.com/HSA
• Unlimited telehealth visits, including behavioral health, with MDLIVE geha.com/MDLIVE
$0
2,3
• Maternity; routine care • Hospital care; inpatient maternity
$0 2
• Preventive care; adult routine screenings • Well-child visit; up to age 22 • Preventive dental care, twice yearly
$0
• Primary physician office visit • Specialist care; office visit • Urgent care • Emergency care • Hospital care; inpatient and outpatient • MinuteClinic © (where available) geha.com/MinuteClinic • Lab services • Other diagnostic services • Professional surgical services • Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year • Acupuncture; up to 20 treatments per year
5% 2
Medicare A & B primary? See page 25 or visit geha.com/Medicare
Out-of-pocket maximum in-network 1,4
What you pay
$5,000 $10,000
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.
Learn how to enroll at geha.com/Enroll
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 71-014 (HDHP) at geha.com/PlanBrochure 2 Calendar year deductible applies. 3 If the deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed cha r ges. 4 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.
07 2022 GEHA MEDICAL PLANS
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