2023 GEHA Medicare Benefits
Learn how GEHA’s five medical plans work with your Medicare benefits.
geha.com/Medicare | 800.262.4342
What’ s inside 03 Welcome 04 Medicare and GEHA 05 Compare premiums 06 Elevate and Medicare 08 HDHP and Medicare 10 Standard and Medicare 12 Elevate Plus and Medicare 14 High and Medicare 16 Vision discounts and benefits for GEHA plans
16 GEHA’s hearing aid benefit 17 Extras if you choose Elevate 18 Get help choosing the right plan 19 Definitions and terms
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2023 GEHA Medicare benefits
Welcome
Now that you’re retired, let’s get to work We believe health care isn’t one size fits all, and our plans are designed with that in mind. For more than 85 years, GEHA (Government Employees Health Association, Inc.) has provided medical plans designed exclusively for federal employees and military retirees. Medicare is federal health insurance available for eligible individuals ages 65 and over or individuals under 65 with certain disabilities and medical conditions. Medicare has different parts (referred to as Parts A, B, C and D) designed to address your health care needs. GEHA offers our medical plans as supplemental (extra) coverage for what Medicare may not cover.
Elevate and Medicare
HDHP and Medicare
Standard and Medicare
Elevate Plus and Medicare
High and Medicare
With a variety of plans that work with Medicare Parts A & B, GEHA is here for you in retirement or as you prepare to retire.
Open Season begins on Monday, November 14, and concludes on Monday, December 12. NOV DEC
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2023 GEHA Medicare benefits
Medicare and GEHA All GEHA medical plans work with Medicare Parts A & B With a GEHA medical plan to supplement your Medicare coverage, a sudden hospital stay, a prolonged illness or a major surgical procedure won’t overwhelm your budget. Compare how GEHA plans work with Medicare
Elevate and Medicare
HDHP and Medicare
Standard and Medicare
Elevate Plus and Medicare
High and Medicare
Plan service
NEW! $1,000 Medicare Part B premium reimbursement 100% medical coverage (copays and deductibles waived) with Medicare A & B primary
Hearing aid benefit 1
Coverage for in-network and out-of-network care 2 Coverage for care outside of the United States
Non-preferred drug coverage 3
Mail service pharmacy
Choice of plan perk 4
1 Although hearing aid benefits are only available on Standard, Elevate Plus and High plan, hearing aid discounts are available on all plans. Learn more at geha.com/Hearing 2 Though the Elevate Plus plan on its own does not provide out-of-network medical coverage, when it’s combined with Medicare and the provider accepts Medicare assignment, out-of-network cost shares are waived. There are no out-of-network pharmacy benefits for Elevate and Elevate Plus. 3 With High plan, when Medicare A & B is primary, you pay a lower coinsurance for preferred and non-preferred brand medications. 4 These benefits are neither offered nor guaranteed under contract with the FEHB program, but are made available to Subscribers who become a member of GEHA’s Elevate medical plan.
This is a brief description of the features of Government Employees Health Association, Inc.'s medical plans. Before making a final decision, please read the GEHA Federal brochures which are available at geha.com/PlanBrochure . All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.
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2023 GEHA Medicare benefits
Compare premiums
If you are a retired federal employee, you can sign up for a GEHA medical plan by completing OPM form 2809, available through the Office of Personnel Management at opm.gov
Self Only premium and enrollment code
Retired – monthly
$109.83
254 Elevate and Medicare
$150.30
341 HDHP and Medicare
$149.01
314 Standard and Medicare
$185.84
251 Elevate Plus and Medicare
$229.10
311 High and Medicare
Self Plus One premium and enrollment code
Retired – monthly
$257.47
256 Elevate and Medicare
$323.15
343 HDHP and Medicare
$320.39
316 Standard and Medicare
$406.55
253 Elevate Plus and Medicare
$527.56
313 High and Medicare
Self and Family premium and enrollment code
Retired – monthly
$313.46
255 Elevate and Medicare
$397.11
342 HDHP and Medicare
$392.00
315 Standard and Medicare
$454.64
252 Elevate Plus and Medicare
$659.52
312 High and Medicare
These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
Free e-books and videos Learn more about your options with Medicare and GEHA at geha.com/Medicare
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2023 GEHA Medicare benefits
Elevate and Medicare Learn all about this plan at geha.com/Elevate
• GEHA’s lowest premium plan • Low copays for non-traditional care, like chiropractic and acupuncture • Engaging digital wellness hub powered by Rally ® Health
Premium and enrollment code
Retired – monthly
$109.83
254 Self Only
$257.47
256 Self Plus One
$313.46
255 Self and Family
These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
Health care style: a wellness-focused and cost-conscious plan for those without an extensive prescription need
How often you use your plan:
Prescription benefit need:
Low
Average
High
Low
Average
High
How this plan pays you back: • Earn Wellness Pays rewards up to $500 (Self Only) or $1,000 (Self Plus One or Self and Family) annually. Rewards dollars can be used for qualified medical expenses such as copays, and medical, dental and vision expenses. geha.com/WellnessPays • Subscribers can select from an annual plan perk. Options include a 12-month Daily Burn virtual fitness subscription, a $125 gift card for DICK’S Sporting Goods or REI, or your choice of Fitbit device including a 12-month Fitbit Premium Membership. geha.com/PlanPerk
Yearly deductible in-network 1
You pay
$500
Self Only
$1,000
Self Plus One or Self and Family
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.
Out-of-pocket maximum in-network 1,2
You pay
$8,500
Self Only
$17,000
Self Plus One or Self and Family
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, 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.
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2023 GEHA Medicare benefits
Medical benefits with Medicare A & B primary in-network 1
You pay
Unlimited telehealth visits, including mental health, with MDLIVE Preventive care; adult routine screenings Vision coverage; eye exams 2 Primary physician office visit Mental health office visit MinuteClinic ® where available Chiropractic care (manipulative therapy), including X-rays; up to 12 visits per year Acupuncture; up to 20 treatments per year
$0
$10
$30
Specialist care office visit
$50
Urgent care facility
ER visit Hospital care; inpatient and outpatient X-rays and other diagnostic services Lab services Outpatient professional surgical services
25% 3
$250
Inpatient professional surgical services
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 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. 3 Calendar year deductible applies.
Prescription benefits in-network 1,2,3
You pay
$4
30-day retail generic
50% ( $500 max)
30-day retail preferred brand-name
100%
30-day retail non-preferred brand-name
50% ( $500 max)
30-day specialty CVS exclusive generic and preferred brand-name
100%
30-day specialty CVS exclusive non-preferred brand-name
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 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
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2023 GEHA Medicare benefits
HDHP and Medicare Learn all about this plan at geha.com/HDHP
• Low premiums with a lower net deductible than many traditional plans • GEHA contributes to your HRA. Use your HRA money to reduce your net deductible or reimburse Medicare premiums.
Premium and enrollment code
Retired – monthly
$150.30
341 Self Only
$323.15
343 Self Plus One
342 Self and Family $397.11 These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
How often you use your plan:
Prescription benefit need:
Health care style: for the analytical health care consumer, focused on savings
Low
Average
High
Low
Average
High
How this plan pays you back: • Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health Rewards geha.com/HealthRewards • GEHA contributes $900 (Self Only) or $1,800 (Self Plus One or Self and Family) to your HRA
GEHA HRA contribution
Yearly deductible in-network 1
Annual deductible
You pay 2
$1,500
$900
$600
Self Only
$3,000
$1,800
$1,200
Self Plus One or Self and Family
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 net deductible is the remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin.
Out-of-pocket maximum in-network 1,2
You pay
$5,000
Self Only
$10,000
Self Plus One or Self and Family
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, 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.
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2023 GEHA Medicare benefits
Medical benefits with Medicare A & B primary in-network 1
You pay
$0 2 , 3
Unlimited telehealth visits, including mental health, with MDLIVE
Preventive care; adult routine screenings Preventive dental care, twice yearly
$0
$5
Vision coverage; eye exams
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-rays 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.
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. This is a brief description of the features of HDHP. Before making a final decision, please read the Plan’s Federal brochure available at geha.com/PlanBrochure
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2023 GEHA Medicare benefits
Standard and Medicare Learn all about this plan at geha.com/Standard • Traditional coverage with affordable premiums • Good choice for Medicare A & B primary members who take generic prescriptions • You pay $0 for deductibles, copays and coinsurance whether your provider is in-network or out-of-network even outside the United States • You pay $0 for inpatient and outpatient hospital services, surgeries and office visits • $2,500 hearing aid benefit and additional discount
Premium and enrollment code
Retired – monthly
$149.01 $320.39
314 Self Only
316 Self Plus One 315 Self and Family
$392.00 These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
How often you use your plan:
Prescription benefit need:
Health care style: traditional care and coverage to stay on a healthy path
Low
Average
High
Low
Average
High
How this plan pays you back: • Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health Rewards geha.com/HealthRewards
Yearly deductible with Medicare A & B primary 1
You pay
$0
Self Only
Self Plus One or Self and Family $0 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.
Out-of-pocket maximum in-network 1,2
You pay
$6,500
Self Only
$13,000
Self Plus One or Self and Family
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, 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.
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2023 GEHA Medicare benefits
Medical benefits with Medicare A & B primary in-network 1,2
You pay
Unlimited telehealth visits, including mental health, with MDLIVE Preventive care; adult routine screenings Lab, X-ray and diagnostic test services
MinuteClinic ® where available Primary physician office visit
Mental health office visit Specialist care office visit Urgent care facility ER visit Hospital care; inpatient and outpatient Professional surgical services; inpatient and outpatient Outpatient professional High Tech Imaging (MRI, CT, PET, etc.) Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year
$0
$5
Vision coverage; eye exams 3
50%
Preventive dental care, twice yearly
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 With Medicare A & B primary, go to any provider that accepts Medicare assignment. 3 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
You pay
$10
30-day retail generic
50% ( $200 max 3 )
30-day retail preferred brand-name
50% ( $300 max 3 )
30-day retail non-preferred brand-name
$20
90-day mail service generic
50% ( $500 max 3 )
90-day mail service preferred brand-name
50% ( $600 max 3 )
90-day mail service non-preferred brand-name
50% ( $250 max 3 )
30-day specialty CVS exclusive generic and preferred brand-name
50% ( $400 max 3 )
30-day specialty CVS exclusive non-preferred brand-name
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 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 Medicare benefits
Elevate Plus and Medicare Learn all about this plan at geha.com/ElevatePlus
• You pay $0 deductibles, copays and coinsurance for medical care in-network or out-of-network • Engaging digital wellness hub powered by Rally Health • $1,500 hearing aid benefit and additional discounts Though Elevate Plus plan on its own does not provide out-of-network coverage, when it's combined with Medicare and the provider accepts Medicare assignment, out-of-network cost shares are waived.
Premium and enrollment code
Retired – monthly
$185.84 $406.55 $454.64
251 Self Only
253 Self Plus One 252 Self and Family
These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
How often you use your plan:
Prescription benefit need:
Health care style: health-focused and proactive
Low
Average
High
Low
Average
High
How this plan pays you back: • Earn Wellness Pays rewards up to $500 (Self Only) or $1,000 (Self Plus One or Self and Family) annually. Rewards dollars can be used for qualified medical expenses such as copays, and medical, dental and vision expenses. geha.com/WellnessPays
Yearly deductible with Medicare A & B primary 1
You pay
$0
Self Only
$0
Self Plus One or Self and Family
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.
Out-of-pocket maximum in-network 1,2
You pay
$6,000
Self Only
$12,000
Self Plus One or Self and Family
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, 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.
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2023 GEHA Medicare benefits
Medical benefits with Medicare A & B primary in-network 1,2
You pay
Unlimited telehealth visits, including mental health, with MDLIVE Preventive care; adult routine screenings Lab, X-ray and diagnostic test services
MinuteClinic ® where available Primary physician office visit
Mental health office visit Specialist care office visit Urgent care facility ER visit Hospital care; inpatient and outpatient Chiropractic care (manipulative therapy), including X-rays; up to 15 visits per year Professional surgical services; inpatient and outpatient Vision coverage; eye exams 3
$0
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 With Medicare A & B primary, go to any provider that accepts Medicare assignment. 3 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
$10
30-day retail generic
$80 4
30-day retail preferred brand-name
50% 4
30-day retail non-preferred brand-name
$20
90-day mail service generic
$200 4
90-day mail service preferred brand-name
50% 4
90-day mail service non-preferred brand-name
40% ( $500 max 4 )
30-day specialty CVS exclusive generic and preferred brand-name
50% 4
30-day specialty CVS exclusive non-preferred brand-name
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 This plan has no out-of-network pharmacy coverage, and has a limited pharmacy network. Find a pharmacy at geha.com/Find-Care 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 Medicare benefits
High and Medicare Learn all about this plan at geha.com/High
• Comprehensive brand-name and specialty prescription coverage • NEW! $1,000 Medicare Part B premium reimbursement. geha.com/MRA • You pay $0 for deductibles, copays and coinsurance whether your provider is in-network or out-of-network, even outside the United States • You pay $0 for inpatient and outpatient hospital services, surgeries and office visits • $2,500 hearing aid benefit and additional discount
Premium and enrollment code
Retired – monthly
$229.10 $527.56
311 Self Only
313 Self Plus One 312 Self and Family
$659.52 These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer which maintains your health benefits enrollment.
How often you use your plan:
Prescription benefit need:
Health care style: maximum coverage and dependable support
Low Low
Average Average
High High
Low Low
Average Average
High High
How this plan pays you back: • NEW! $1,000 Medicare Part B premium reimbursement • Adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health Rewards. geha.com/HealthRewards
Yearly deductible with Medicare A & B primary 1
You pay
$0
Self Only
$0
Self Plus One or Self and Family
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.
Out-of-pocket maximum in-network 1,2
You pay
$5,000
Self Only
Self Plus One or Self and Family $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. 2 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.
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2023 GEHA Medicare benefits
Medical benefits with Medicare A & B primary in-network 1,2
You pay
Unlimited telehealth visits, including mental health, with MDLIVE Preventive care; adult routine screenings Lab, X-ray and diagnostic test services
MinuteClinic ® where available Primary physician office visit
Mental health office visit Specialist care office visit Urgent care facility ER visit Hospital care; inpatient and outpatient
$0
Professional surgical services; inpatient and outpatient Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year
$5
Vision coverage; eye exams 3
Balance after GEHA pays $22 per visit
Preventive dental; twice yearly
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 With Medicare A & B primary, go to any provider that accepts Medicare assignment. 3 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
You pay
$10 3
30-day retail generic
20% ( $150 max 3, 4 )
30-day retail preferred brand-name
35% ( $200 max 3 , 4 )
30-day retail non-preferred brand-name
$15
90-day mail service generic
15% ( $350 max 4 )
90-day mail service preferred brand-name
30% ( $500 max 4 )
90-day mail service non-preferred brand-name
15% ( $150 max 4 )
30-day specialty CVS exclusive generic and preferred brand-name
30% ( $200 max 4 )
30-day specialty CVS exclusive non-preferred brand-name
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 Costs for initial prescription and first refill. You pay 50% for third and additional refills at retail for 30-day supply. For long-term prescriptions, use mail order or your local retail CVS Pharmacy store (90-day supply) for greater cost savings. 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 Medicare benefits
With all GEHA medical plans, you get discounts on eye exams, frames and lenses through EyeMed. ® The EyeMed network includes Independent Provider Network, LensCrafters, Pearle Vision, Target Optical, contactsdirect.com , glasses.com and more. Members also save on LASIK at participating US Laser Network locations. Learn more at geha.com/Vision The HDHP plan includes additional vision benefits. Learn more: geha.com/HDHPVision Vision discounts and benefits for GEHA plans
Elevate and Elevate Plus you pay 1
Standard and High you pay 1
HDHP you pay
Vision services in-network
$0
$5
$5
Eye exams; retail price
$0 under $100 plus 80% over $100
60% of price
60% of price
Frames; retail price
Eyeglass lenses, standard plastic, single vision; retail price Contact lens, conventional; retail price
Up to $50
Up to $50
$10
$10 under $110 plus 85% over $100
85% of price
85% of price
GEHA’s hearing aid benefit 1 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. • All five GEHA plans offer access to discounted pricing with TruHearing. ®1 Save up to 30% to 60% off hearing aids. Some average more than $2,600 in savings per pair. • Three GEHA plans — Standard, Elevate Plus and High — offer a hearing aid benefit. This benefit is per person, every 36 months for adults. TruHearing discount pricing can be combined with the hearing aid benefit for even greater savings.
Standard GEHA pays
Elevate Plus GEHA pays
High GEHA pays
$2,500
$1,500
$2,500
1 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.
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2023 GEHA Medicare benefits
Extras if you choose Elevate
Elevate subscribers can choose among three options annually to support a healthy lifestyle. It pays to be a GEHA Elevate plan member. This plan includes an exclusive plan perk option to support a healthy lifestyle. It’s quick and easy for Elevate subscribers to claim their plan perk. Sign up for a geha.com account (or log in to your existing account) and update your contact preferences.
Choice of one Fitbit device including a 12-month Fitbit Premium Membership.
12-month Daily Burn virtual fitness subscription.
GEHA’s unique position as a nonprofit member association allows us to offer this bonus plan perk exclusively for the Elevate plan. We don’t have stockholders, which means our priority is putting money back into supporting our members. For more information, visit geha.com/PlanPerk
$125 gift card for DICK’s Sporting Goods or REI.
These products and services are neither offered nor guaranteed under contract with the FEHB Program, but are made available to eligible Subscribers who become members of the GEHA Elevate medical plan Only Subscribers in the 50 United States and the District of Columbia are eligible at this time.
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2023 GEHA Medicare benefits
Get help choosing the right plan GEHA has a plan for every stage of your life. We are here to help you discover which plan is the right fit for you.
Call us Talk to a GEHA Benefits Adviser Monday –Friday, 7 a.m. –7 p.m. Central time. 800.262.4342
Book an appointment Meet one-on-one with a GEHA Benefits Adviser to help answer your questions. geha.com/Meet
Chat online Chat or text with a GEHA Benefits Adviser in real time Monday –Friday, 7 a.m. –7 p.m. Central time. geha.com
Watch on-demand webinars Learn how to find a plan that’s right for you
with an on-demand webinar. geha.com/BenefitsWebinars
Compare plans Easily compare GEHA’s five medical plans. geha.com/CompareMedical
Plan recommender tool Answer a few questions to see a plan that matches your individual or family needs. geha.com/Select-A-Plan
For more information about FEHB plans, visit the U.S. Office of Personnel Management at opm.gov/Healthcare-Insurance
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2023 GEHA Medicare benefits
Definitions and terms
We know some terms can be confusing. As you work your way through this guide, these definitions may help.
Term
Definition
Calendar year deductible
What you pay each year before the plan begins to pay out benefits.
The percentage you pay for a covered health care service, after you’ve met your deductible.
Coinsurance
Copay
A fixed amount you pay for a service or prescription.
Portion of monthly HDHP premium that GEHA contributes to a health savings account (HSA) or health reimbursement arrangement (HRA).
GEHA contribution
A health care provider who is a part of GEHA’s provider network. These providers agree to limit what they will charge you.
In-network provider
The remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin.
Net deductible (HDHP)
The maximum amount you pay each year for coverage. Includes copays, deductibles and coinsurance, but not premiums. Once the limit is met, the plan pays the remainder of your covered health care expenses for the rest of the year.
Out-of-pocket maximum
Cost of health care goods and services after subtracting the insurance company’s negotiated discount. For complete details see the definition of “Plan allowance” in Section 10 of any GEHA plan brochure. geha.com/PlanBrochure
Plan allowance
PPO
A preferred provider organization.
Premium
What you pay monthly or biweekly for coverage.
Prescription benefits
What you pay as a copay or percentage of coinsurance for medication.
This is a brief description of the features of Government Employees Health Association, Inc.’s medical plans. Before making a final decision, please read the GEHA Federal brochures which are available at geha.com/PlanBrochure . All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.
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2023 GEHA Medicare benefits
STANDARD US POSTAGE PAID GEHA
PO Box 21542 | Eagan, MN 55121-9930
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Ready to enroll? If you are a retired federal employee, you can sign up for a GEHA medical plan by completing OPM form 2809, available through the Office of Personnel Management. opm.gov | 800.332.9798
This is a brief description of the features of Government Employees Health Association, Inc.‘s medical plans. Before making a final decision, please read the GEHA Federal brochures which are available at geha.com/PlanBrochure . All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure. Download the plan brochure For information and changes to GEHA’s medical plans, see our three plan brochures – RI 71-006 (High and Standard), RI 71-014 (HDHP) and RI 71-018 (Elevate and Elevate Plus) – which are available at geha.com/PlanBrochure Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information: The Federal Employees Health Benefit (FEHB) program offers numerous health benefits plans and coverage options. Choosing a health plan and coverage option is an important decision. To help you make an informed choice, each FEHB plan makes available a Summary of Benefits and Coverage (SBC) about each of its health coverage options, online and in paper. The SBC summarizes important information in a standard format to help you compare plans and options. GEHA’s SBCs are available on the internet at geha.com/SBC . Paper copies are also available, free of charge, by calling 800.821.6136 . To find out more information about plans available under the FEHB program, including SBCs for other FEHB plans, please visit opm.gov/Insure
geha.com | 800.262.4342
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2023 GEHA Medicare benefits
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