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
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