Compare prescription costs
Elevate 4 You pay
HDHP 5 You pay
Standard You pay
Prescription benefits in-network 1,2,3
$4
25%
$10
30-day retail generic
50% ( $500 max)
50% ( $200 max 6 ) 50% ( $300 max 6 )
25% 6
30-day retail preferred brand-name
100%
40% 6
30-day retail non-preferred brand-name
25%
$20
90-day mail service generic
No benefit
50% ( $500 max 6 ) 50% ( $600 max 6 ) 50% ( $250 max 6 ) 50% ( $400 max 6 )
25% 6
90-day mail service preferred brand-name No benefit
90-day mail service non-preferred brand-name
40% 6
No benefit
50% ( $500 max)
30-day specialty CVS exclusive generic and preferred brand-name
25% 6
30-day specialty CVS exclusive non-preferred brand-name
100%
40% 6
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. 2 The out-of-pocket maximum is the maximum amount of coinsurance and copays 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. 3 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications. 4 To provide a low premium, this plan does not include mail-order prescriptions or out-of-network pharmacy coverage, and it has a limited pharmacy network. Find a pharmacy at geha.com/Find-Care 5 Calendar year deductible applies. 6 If you choose a brand-name medication when a generic is available, you will be charged the generic copay plus the difference in cost between the brand-name and the generic.
You’ve got options with retail prescriptions Pay less for prescriptions filled at an in-network pharmacy location. Locations include any CVS Pharmacy location, but you don’t have to go to a CVS to pay in-network prices. Find an in-network pharmacy location at geha.com/Find-Care
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2023 GEHA medical plans
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