Medical benefits in-network 1
You pay
$0 2, 3
Unlimited telehealth visits, including mental health, with MDLIVE
Maternity; routine care Maternity; inpatient care
$0 2
Preventive care; adult routine screenings Well-child visit; up to age 22 Preventive dental care, twice yearly
$0
$5
Vision coverage; eye exam and additional benefits
Primary physician office visit Mental health office visit Specialist care office visit Urgent care facility ER visit Hospital care; inpatient and outpatient MinuteClinic ® where available Lab services X-ray and 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
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 Calendar year deductible applies. 3 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the plan allowance. 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.
Prescription benefits in-network 1,2,3
You pay
25%
30-day retail generic
25% 4
30-day retail preferred brand-name
40% 4
30-day retail non-preferred brand-name
25%
90-day mail service generic
25% 4
90-day mail service preferred brand-name
40% 4
90-day mail service non-preferred brand-name
25% 4
30-day specialty CVS exclusive generic and preferred brand-name
30-day specialty CVS exclusive non-preferred brand-name 40% 4 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 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications. 3 Calendar year deductible applies. 4 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.
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2023 GEHA medical plans
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