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.
10
2023 GEHA Medicare benefits
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