Compare medical benefits
Elevate You pay
HDHP You pay
Standard You pay
Medical benefits in-network 1
Unlimited telehealth visits, including mental health, with MDLIVE Preventive care; adult routine screenings Well-child visit; up to age 22
$0
$0 2, 3
$0
$0
$0
$0
$0
$5
$5
Vision coverage; eye exams
$0
$0 3
$0
Maternity; routine care
$10
5% 3
$10
MinuteClinic ® where available
$10
5% 3
$20
Primary physician office visit
$10
5% 3
$20
Mental health office visit
$30
5% 3
$35
Specialist care office visit
$50
5% 3
$35
Urgent care facility
25% 3
5% 3
15% 3
ER visit; accidental
25% 3
5% 3
15% 3
ER visit; medical
25% 3
5% 3
15% 3
Hospital care; inpatient
25% 3
$0 3
$0
Maternity; inpatient care
25% 3
5% 3
15% 3
Hospital care; outpatient
$250
5% 3
15% 3
Inpatient professional surgical services
25% 3
5% 3
15% 3
Outpatient professional services
25% 3
5% 3
15% (QuestSelect $0 )
Lab services
25% 3
5% 3
15% 3 ,4
X-rays and other diagnostic services
Chiropractic care visit (manipulative therapy), including X-rays. Limited per year. Acupuncture visit; up to 20 treatments per year
$10
5% 3
$35
$10
5% 3
15% 3
$0
50%
Preventive dental care
No benefit
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 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the plan allowance. 3 Calendar year deductible applies. 4 Standard, you pay $250 ($100 professional fee, $150 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA’s 2023 plan brochure RI 71-006 (High and Standard) at geha.com/PlanBrochure
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2023 GEHA medical plans
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