The October 23, 2012, chat with GEHA President Richard Miles has concluded. The transcript is available below and will remain online throughout Open Season.

Don’t forget: Open Season starts Monday, November 12, and ends on Monday, December 10.

Lima, Ohio (GEHA Standard Option): Will GEHA cover shingle shots?

Richard Miles: For members ages 60 and older, the shingles vaccination is covered under GEHA’s preventive care benefit. GEHA will pay 100% of the plan allowance when the vaccination is received at an in-network physician’s office or in-network pharmacy. For members ages 50-59, the shingles vaccination is covered when medically necessary under regular plan benefits. Please present your GEHA ID card at the time of service.

Bellefonte, Pennsylvania (GEHA Standard Option): Once I get to my $350 deductible, what will I have to pay? What is my deductible when I go to the doctor’s office for a visit, and what is it for generic drugs?

Richard Miles: Under Standard Option, your copays for office visits with in-network doctors are $10 for a primary care doctor and $25 for a specialist. Office visits are not subject to the deductible.

For other medical, surgical and hospital services, you are responsible for a $350 calendar year deductible, before GEHA pays 85% of the allowable amount for covered services in-network or 65% of the allowable out-of-network.

Your copay for covered generic prescriptions is $5 for up to a 30-day supply. For most new fills of generics at mail order, the copay is waived and you pay nothing.

Sacramento, California (Connection Dental Federal (FEDVIP)Standard): I currently (2012) have a GEHA Dental Plan. Do I have to take any action during Open Season to continue my plan into the next year (2013)?

Richard Miles: No. As long as you are eligible for FEDVIP benefits, your enrollment continues automatically. You do not need to do anything unless you wish to make a change.

California, Kentucky (GEHA High Option): Why don’t Medicare subscribers get a price reduction on premiums since Medicare is primary?

Richard Miles: FEHB laws do not allow for a plan to charge different premiums to members enrolled in the same plan option, regardless of other coverage. However, when you have Medicare A & B primary, GEHA High and Standard options pay 100% of covered hospital and doctor expenses after Medicare. You pay no deductible or copays for surgical and medical benefits.

Racine, Wisconsin: Can my son be added to my medical insurance? He lives with me, but he is 23 and is not working.

Richard Miles: Under the Affordable Health Care Act, children are eligible under your family health plan until their 26th birthday regardless of student status, residency or marriage.

Omaha, , Nebraska (GEHA Standard Option): Are yearly well woman exams covered?

Richard Miles: When you see an in-network provider, annual well woman exams (including pap and mammogram) are paid at 100% of the plan allowance.

Vicksburg, Mississippi (GEHA High Option, Connection Dental Federal (FEDVIP) High): Who can be covered as family members on my plan?

Richard Miles: Your GEHA health plan covers your legal spouse and children under the age of 26. Your Connection Dental Federal plan covers your legal spouse and children under the age of 22.

San Marcos, Texas (GEHA Standard Option): How will GEHA change with respect to the Affordable Care Act?

Richard Miles: We do not believe that there will be many changes to our already comprehensive health plan coverage as a result of the Affordable Care Act.

There are some administrative changes coming. We have a new Summary of Benefits and Coverage (SBC) document, an abbreviated brochure provided by all health plans in a simple format for easy comparison. Also, we are required to provide plan notices in a culturally and linguistically appropriate method. People who speak Chinese, Navajo, Spanish or Tagalog can access language services and can request a translated copy of the SBC.

Baltimore, Maryland (Connection Dental Federal (FEDVIP) Standard): My daughter will be 23 in December. I can carry her on my health plan until her 26th birthday. Can I carry her on a dental plan until age 26?

Richard Miles: Dental plans were not part of the Age 26 provision in the Affordable Care Act. As a result, an unmarried dependent child can no longer be covered on a parent’s FEDVIP plan after age 22.

Seaford, Delaware (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): Can I subscribe to High Option dental if I am only Standard Option medical?

Richard Miles: Yes. You can mix and match your GEHA plans to maximize the way they help with your personal needs.

And for those who are not yet GEHA members, you can have GEHA dental plan without having a GEHA health plan -- and vice versa.

Houston, Texas (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): In 2013, will GEHA offer any ortho services for adults? I would really like to get braces, however the cost with no insurance is very expensive.

Richard Miles: We are not adding coverage for adult orthodontics in 2013.

San Diego, California: As a federal retiree with a FEHB plan, should I buy Medicare part B?

Richard Miles: Let me tell you how GEHA works if you choose to have Medicare Part A and B. First the normal plan deductibles with GEHA are eliminated. We offer paperless reimbursement, your physician files their claims directly with Medicare and sends GEHA an electronic record of their payment and we then process those charges and in most cases you will be left with no liability. OPM.gov has some excellent information available regarding your health plan and Medicare.

Everyone is charged a premium for Medicare Part B coverage. The Social Security Administration can provide you with premium and benefit information. Review the information and decide if it makes sense for you to buy the Medicare Part B coverage. If you do not sign up for Medicare Part B when you are first eligible, you may be charged a Medicare Part B late enrollment penalty of a 10% increase in premium for every 12 months you are not enrolled. If you didn’t take Part B at age 65 because you were covered under FEHB as an active employee (or you were covered under your spouse’s group health insurance plan and he/she was an active employee), you may sign up for Part B (generally without an increased premium) within 8 months from the time you or your spouse stop working or are no longer covered by the group plan. You also can sign up at any time while you are covered by the group plan. If you are eligible for Medicare, you may have choices in how you get your health care. Medicare Advantage is the term used to describe the various private health plan choices available.

Prescott, Arizona (GEHA HDHP Option): My husband is self-employed, so I have carried him on the family plan for many years. Is it true that at this point (having been covered for well over 5 years), I could opt for single and he could opt for single?

Richard Miles: This might be a better question for your Health Benefits Officer (HBO), but I understand that the law permits you to choose only between Self Only coverage or Self and Family coverage only. Other coverage types -- such as Self and Spouse, Self and One Child [two children, three children, etc.], and Self Plus One -- are not available. If your husband isn’t a current or former federal employee, he would not be eligible for a Self-only policy on his own.

Fort Worth, Texas (GEHA Standard Option): Does my plan give me access to health clubs in my area (76106)? If yes, how do I get a list?

Richard Miles: Connection Fitness by GlobalFit is available at no cost to all GEHA health plan members. Through our partnership with GlobalFit, GEHA members can access discounts on gym memberships. You can find a gym in your area by logging onto globalfit.com/geha.

Homestead, Florida (GEHA High Option, Connection Dental Federal (FEDVIP) High): Do we get a free dental cleaning once a year?

Richard Miles: Yes, in fact our dental plan covers two routine cleanings a year at 100% of the plan allowable.

Monmouth Junction, New Jersey (Connection Dental Federal (FEDVIP) High): With what dental plan can we receive the maximum benefits, and what are those benefits?

Richard Miles: Our Connection Dental High Option offers the most comprehensive benefits. Click for the 2013 High Option benefit summary.

Memphis, Georgia (GEHA High Option, Connection Dental Federal (FEDVIP) High): Will GEHA cover my fiance?

Richard Miles: Congratulations on your upcoming marriage. If you have a Self Only enrollment, you may change to a Self and Family enrollment when you marry. You may change your enrollment 31 days before to 60 days after your marriage.

When you change to Self and Family because you marry, the change is effective on the first day of the pay period that begins after your employing office receives your enrollment form; benefits will not be available to your spouse until you marry.

Lithonia, Georgia (GEHA HDHP Option, Connection Dental Federal (FEDVIP) Standard): I am an annuitant, age 64, and have a HDHP. How does the HDHP interface with Medicare? How far in advance should I begin the Medicare application process? Thanks.

Richard Miles: Medicare should send you information regarding your enrollment prior to your 65th birthday. When you enroll in Medicare, you are no longer eligible for contributions to an HSA. You will automatically transition to a health reimbursement arrangement (HRA) the month prior to the month of your 65th birthday, unless you notify GEHA that you will not be enrolled in Medicare A, B, or D.

The Villages, Florida (GEHA Standard Option): I am concerned about the merger of Medco with Express Scripts. Is this going to cause changes of computer e-mail addresses, etc.? I am almost 91 years old and partially blind, and any excessive time on the computer is a problem.

Richard Miles: The website address is changing from medco.com to express-scripts.com. However, members going to medco.com will be automatically routed to express-scripts.com, so that should be a smooth transition for you. When using the website, you will continue to use your current user name and password.

Crownpoint, New Mexico (GEHA High Option, Connection Dental Federal (FEDVIP) High): Do I have vision benefits with my plan?

Richard Miles: Both your GEHA health plan and your GEHA dental plan offer you coverage in Connection Vision^® powered by EyeMed at no additional cost. Through Connection Vision, you and your covered family members each pay a $5 copay for an annual eye exam when you use a qualified EyeMed participating provider.

Cincinnati, Ohio (GEHA Standard Option, Connection Dental Plus): Regarding GEHA’s health insurance plans, is there a maximum for what GEHA will pay out for catastrophic protection? My annual out-of-pocket catastrophic protection is $5,000, but is there a yearly or lifetime maximum that GEHA will pay out, i.e., $500,000 or $1 million?

Richard Miles: There are no lifetime maximums under the health plan.

Atlanta, Georgia (GEHA High Option): I will have both Medicare Part A & B coverage when I retire in December. What is the difference in coverage between High Option and Standard Option? From what I can tell from the reading the brochures, the coverage seems to be the same.

Richard Miles: When you have Medicare parts A and B primary, both GEHA High and Standard option plans pay 100% of covered hospital and doctor expenses after Medicare.

Prescription benefits are different under the two plan options. Please compare the difference in your medication costs to see which option would be most cost-effective for you.

2013 Plan Year

Prescriptions (In-Network*)	Medicare A & B with Standard What You Pay	Medicare A & B with High What You Pay
Retail pharmacy   Generic (30-day supply)	$5 copay	$5 copay**
Brand (single-source)	50%, up to $200 max	20%, up to $150 max**
Brand (multi-source)	50%, up to $200 max	$5, plus difference in cost of brand-name drug over generic equivalent**
Mail order         Generic (90-day supply)	Nothing (most new prescriptions), then $15 copay	Nothing (most new prescriptions), then $10 copay
Brand (single-source)	50%, up to $500 max	15% (up to $350 max)
Brand (multi-source)	50%, up to $500 max	$10, plus additional cost of brand-name drug over generic equivalent
*For out-of-network benefits, see the 2013 GEHA plan brochure. **Costs for initial prescription and first refill. You pay 50% for additional refills at retail. For long-term prescriptions, please use Mail Order for greater cost savings. With Medicare A&B, you pay lower copays. For specialty drugs that are injected or infused, see the GEHA Plan Brochure.

Glasgow, Missouri (GEHA High Option): I presently have another health plan and have never really been happy with it. Do you all have some kind of table where you can compare your plan against other, including medicines?

With your plan, can you go to the doctor of your choice? We have had the same family doctor for 40 years here in Glasgow. I don’t want to have to drive to Columbia, Missouri, to get a shot for a cold or sore throat.

Richard Miles: GEHA offers a How to Choose a Health Plan guide to help you choose a health plan that will best serve you. As a PPO plan, GEHA allows you to use the doctor of your choice. You can use our online provider search to see if your doctor is in our network.

In addition, OPM offers online plan comparison tools that can help you compare the insurance options in your area.

On a personal note, my mother was born and raised in Glasgow and I visited there this past summer. It is a wonderful small town with a lot of history.

Arlington, Texas (GEHA High Option, Connection Dental Federal (FEDVIP) High): Why doesn’t GEHA Connection Dental Federal cover anesthesia? Some of the dental specialists (such as oral specialists) will not perform service if you are not under.

Richard Miles: The plan does not cover local anesthesia when billed separately because the cost for many procedures that require local anesthesia already include local anesthesia. For example, local anesthesia is considered part of the price the dentist charges you to extract a tooth; if the plan were to cover a separate charge for local anesthesia, we would be paying twice. The exception to this is when general anesthesia (putting someone completely under) is needed to perform a covered service because the patient has a justifiable medical or dental condition that would not allow them to tolerate the procedure while conscious (common examples of this are very young patients or mentally handicapped patients who are incapable of understanding what is happening).

Cream Ridge, New Jersey (GEHA Standard Option): We are going to move to North Carolina when I retire. Does GEHA cover retired people in North Carolina?

Richard Miles: Absolutely, we cover federal employees and retirees nationwide. You can use our online provider search to start shopping for doctors in North Carolina before you move.

Bremerton, Washington (GEHA High Option, Connection Dental Federal (FEDVIP) High): We will be retiring soon. Can we keep these health plans, and what will they cover? My husband will be 62 when he retires.

Richard Miles: When you retire, you can usually stay in the FEHB Program. Generally, you must have been enrolled in the FEHB Program for the last five years of your Federal Service. Your coverage with GEHA does not change upon retirement.

San Antonio, Texas (GEHA High Option, Connection Dental Federal (FEDVIP) High): I have Medicare and GEHA High Option as well as GEHA Federal Dental High. Are there any remote advantages to taking out the Part D prescription plan.

Richard Miles: OPM has determined that GEHA’s prescription drug coverage is, on average, expected to pay out as much as the standard Medicare prescription drug coverage will pay for all plan participants and is considered Creditable Coverage. Thus, you do not need to enroll in Medicare Part D and pay extra for prescription drug benefit coverage. If you decide to enroll in Medicare Part D later, you will not have to pay a penalty for late enrollment as long as you keep your FEHB coverage.

However, if you choose to enroll in Medicare Part D, you can keep your FEHB coverage and your FEHB plan will coordinate benefits with Medicare. Therefore there is some benefit to enrolling in Part D but it may not offset the added cost of the premium.

Rocklin, California (GEHA High Option, Connection Dental Federal (FEDVIP) High): What happens to my GEHA insurance when I divorce?

Richard Miles: There are a couple of continuation of coverage options available for divorced spouses who are losing coverage under the FEHB Program.

The first option is Temporary Continuation of Coverage (TCC). This coverage entitles you to the same benefits as you have under the Self + Family enrollment. Your eligibility for this coverage is determined by your spouse’s personnel office and coverage can continue up to 36 months.

The second option is through our Connection Health Plan. This plan is not part of the FEHB program, so the benefits are different.

Please feel free to contact our Customer Service Department at (800) 821-6136 for additional information.

Las Cruces, New Mexico: I will become a federal employee in the next few days. I am wanting to enroll in a dental/vision plan. Do you offer a dual plan?

Richard Miles: We do not offer a comprehensive combined dental and vision plan. However, all of our dental members receive the value-added benefit of Connection Vision^® powered by EyeMed that allows you and your covered family members one routine eye exam per year for only $5 when you use a participating EyeMed provider. In addition, with Connection Vision you can save a significant amount on your eyewear needs at participating locations such as LensCrafters, Pearle Vision, Sears Optical, Target Optical, JC Penney Optical and thousands of private practitioners.

Lander, Wyoming (GEHA Standard Option): Does GEHA have a hearing aid plan?

Richard Miles: The plan does cover up to $250 per ear under Standard Option and up to $500 per ear under High Option for hearing aids. Benefits are payable once every five years. Members also have access to the Connection Hearing discount program through HearPO.

Please contact hearpo.com/geha or call (866) 211-6048 for additional information or a list of participating providers.

Denver, Colorado (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): Will you please make this chat available after you’re done? I have a medical procedure at that time, and I will miss it. But I am very interested.

Richard Miles: We hope that your medical procedure goes as planned and that you recover quickly. This transcipt of questions and answers will stay right here on our website through Open Season, so you can review it at your convenience.

Take care!

Alexandria, Virginia: What are some of your major changes to the health plan for 2013?

Richard Miles: Here’s the full list of our changes for 2013:

San Diego, California: If I sign up for your FEDVIP plan, is there a waiting time before we can have dental work done? Or will it be limited in service for a period of time?

Richard Miles: Our FEDVIP dental plan has no waiting periods except for Class D (children’s orthodontic services), which has a 12-month waiting period before benefits begin.

That’s a change for 2013; the waiting period for children’s orthodontics used to be 24 months.

San Antonio, Texas (Connection Dental Federal (FEDVIP) High): Is it true that when I go to the dentist, I must present my health insurance card (not GEHA) as my primary insurance and my GEHA dental insurance card as the secondary? I don’t have dental coverage under my health insurance? I am confused.

Richard Miles: The rules for the FEDVIP program require that your FEHB plan be the first payor. These rules are the same for all FEDVIP plans. As a result, if your FEHB plan pays for dental services, we will consider the amount paid by your FEHB plan before we calculate benefits payable by us. If your primary FEHB plan covers some dental services, you do need to present both both cards, so that the dentist knows how to file your claims.

Beltsville, Maryland: If I enroll in a GEHA health plan and a GEHA dental plan, does my dentist have to submit two claims (one to GEHA health plan and one to GEHA dental) or just one claim to GEHA?

Richard Miles: No, the dentist can submit the claim once to GEHA. We will see that it is processed by both our health and dental plans.

Boston, Massachusetts (GEHA Standard Option): Do I need a referral to see a specialist?

Richard Miles: No referral is needed to see a specialist.

The Villages, Florida: This isn’t really a question; it’s a compliment. I can only hope that this gets to you, Mr. Miles, but I wanted you to know how GRATEFUL my family is for your company.

I lost my husband last November to blood clots related to treatment for pancreatic cancer. It was so fast. He died 6 months to the day of his completely unexpected diagnosis. We were both Federal employees and GEHA was with us every step of the fight.

No, actually GEHA carried us so we COULD fight! I have literally 3 gigantic 3 inch binders full of EOBs and not a single squawk from GEHA! It would frighten me to actually add it up, but it had to be close to $500,000, and I never heard a word of complaint from GEHA. In all those treatments, only one "denial" -- a $41 charge for a doctor to read an "automated" blood test! (and for the record I agreed with you and refused to pay also).

GEHA was simply AMAZING! It’s hard to explain how crucial your coverage was to us. It allowed us to concentrate our energies on FIGHTING the cancer and NOT the insurance company! My worries were about how to keep him upbeat and comfortable, not how I would pay for another session of chemo.

In the end, GEHA contributed greatly to my overarching sense of peace in that while I am devastated that I lost my best friend, I am at peace knowing that we fought like Hell and turned over every possible rock to find a cure.

I only wish I could tell you in person what a difference you made to us in the worst time in our lives. So...THANK YOU for being a partner with us in our fight. I will remember who REALLY stood with me in my time of need!

Richard Miles: Thank you for your very kind comments. I am very pleased to hear that we were there for you during a difficult time. We place a great deal of emphasis on providing services when it is needed most and we have a lot of caring and compassionate employees who make it happen. I hope that better times are ahead for you.

Ithaca, New York (GEHA Standard Option): I saw voluntary sterilization under family planning shows my cost as "Nothing" if I use a PPO. Does that mean no deductible and no copay apply either?

Richard Miles: In 2013, family planning services listed in the plan brochure, including voluntary sterilization, are covered at 100% of the plan allowance at an in-network provider. You will not pay a deductible and coinsurance for these services.

Pelham, New York (GEHA High Option): I have been receiving my medications by mail through Medco. Now that Medco merged with Express Scripts and Express Scripts has a deal with Walgreen’s, can I go to a Walgreen’s retail pharmacy to get a refill, especially when I am running out and cannot wait for my meds?

Richard Miles: GEHA’s High Option benefit provides both retail and mail service options for members using prescription medications. The retail pharmacy network has and continues to provide access to many pharmacies nationwide, including Walgreen’s. Mail service medications are filled by Medco -- now Express Scripts -- pharmacies.

GEHA High Option members can use either retail or mail service pharmacies for their medications. Members using medications to treat chronic conditions (i.e., medications taken every day) may find mail service to be a convenient, cost-effective option. Members may also use retail pharmacies for medications, including those for chronic conditions. Retail copays increase for GEHA High Option members after the second retail fill of chronic medications and, therefore, patients may find that mail service is a great option for chronic medications.

Knoxville, Iowa (Connection Dental Federal (FEDVIP) High): Under "Implant Services," the 2013 GEHA Connection Dental Federal brochure states: "We will limit benefits ... such as partial denture (bridge) ... to a maximum calendar benefit of $800." I do not understand this. Does it mean that no matter how many replacement teeth are in the bridge, only $800 will be paid?

Richard Miles: Yes, if it is an implant-supported bridge, the maximum amount the plan will pay is $800.

Vista, California (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): Does GEHA cover blood transfusions during a surgery procedure? I am also covered by Medicare.

Richard Miles: Yes, GEHA would cover a blood transfusion during surgery if it was considered medically necessary.

Leesburg, Virginia (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): When on the Self and Family plan, who is included in the "Family" portion of the plan? For example, could it cover an ex-husband?

Richard Miles: Your self and family enrollment includes coverage for you, your spouse, and your dependent children under age 26, including foster children when approved by your employing or retirement office. FEHB guidelines does not include coverage for an ex-spouse under a family enrollment. However, there are other options available for an ex-spouse. Please feel free to contact our Customer Service Department for additional information.

Alexandria, Virginia (GEHA HDHP Option): Does the HDHP plan cover any dental work, such as cleanings? Do dental expenses qualify toward the HDHP deductible?

Richard Miles: You do not need to meet your deductible to receive benefits under the HDHP for dental. GEHA pays 50% up to the plan allowance for diagnostic and preventive services for each person per year: 2 examinations, 2 cleanings, 2 fluoride treatments and $150 in allowed X-ray charges (payable at 50%).

Dental claims are not counted toward your deductible or catastrophic protection out-of-pocket expenses.

Kathleen, Georgia: During Open Season, I will be shopping for a health plan that is best suited as supplemental coverage for Medicare. What is your best plan for this scenario?

Richard Miles: Both our High and Standard option plans work great when you Medicare A and B as your primary carrier. Both GEHA plans will reimburse you for your Medicare deductibles and coinsurance for covered expenses. There are no separate GEHA plan deductibles or copays for members with Medicare. The main difference between the plans is the prescription benefit. If you utilize high-cost brand-name prescription drugs, the High Option plan may be your best choice. If you mainly use generic medications, then Standard option can be a better fit. For more details, please look at GEHA benefits online or call us at 800-821-6136. Thank you for considering GEHA this Open Season.

Condon, Montana (GEHA High Option): I have received notice from Western Montana Clinic (WMC) in Missoula that, as of 1/1/13, WMC will no longer be considered as an in-network provider by GEHA. Why is this happening, please? I have been a member of GEHA since the mid-1980s, and this has never happened.

Richard Miles: Please confirm with the office that they are not with United HealthCare. If they are not, please feel free to nominate them to become a participating provider. Is there a particular physician in the group that you usually see?

Columbus, Georgia (Connection Dental Federal (FEDVIP) High): Why not a have a rate for "Self + One" in your GEHA medical plan just as you have in your GEHA dental plan?

Richard Miles: Under the law, federal health plans are not allowed to offer a "Self + One" option. As you point out, FEDVIP dental plans do have that option. We aren’t opposed to offering a "Self + One" option for health plans, but it would require Congressional legislation.

Fairfax, Virginia (GEHA High Option): I am contemplating switching to GEHA this Open Season. However, I am expecting my first child in March 2013, and I want to make sure that your maternity coverage is adequate to my current carrier. What is your maternity coverage and will I experience any issues if I switch to your plan halfway through my pregnancy?

Richard Miles: Both GEHA’s High and Standard Option plans cover complete maternity care at 100% if you go to a participating provider. GEHA would provide these benefits whether you were with the plan at the beginning of your pregnancy or pregnant when you enrolled.

If you go to a non-participating provider with the High Option plan, you would be responsible for 25% of the plan allowance and any difference between our plan allowance and the provider’s billed amount. If you go to a non-participating provider under the Standard Option plan, you would be responsible for 35% of the Plan allowance and any difference between our allowance and the provider’s billed amount. Click for more on our Maternity Program.

Bellbrook, Ohio (GEHA Standard Option): Under PPACA Women’s Preventive Health Benefits, breastfeeding support, supplies and counseling are to be covered with no member cost sharing for non-grandfathered plans starting on plan years beginning after 8/1/2012. Will GEHA be doing this in 2013?

Richard Miles: Beginning Janury 1, 2013, GEHA will cover breastfeeding support, supplies, and counseling for each birth at 100% when services are provided by an in-network provider.

Coverage for breast pump and supplies:

• A double channel electric breast pump with double suction capability can be purchased for breast-feeding patients with a physician’s prescription every two years.

- There is no cost to the member when the designated pump is obtained through GEHA’s breast pump contracted provider. You must obtain the breast pump and supplies from our contracted provider.
- Supplies are included with the initial order and two additional supply sets are allowed in a 12-month period. Call (800) 321-0591 anytime in the last two months of the pregnancy and submit your physician’s order. The pump and supplies will be delivered within 1-5 business days.

Oceanside, California (GEHA High Option, Connection Dental Federal (FEDVIP) High): Are orthodontics for myself covered on this FEDVIP plan? Or is it only for children under the age of 19?

Richard Miles: Orthodontics are only covered for children under age 19.

Baltimore, Maryland (GEHA Standard Option): My spouse has a pre-existing condition (diabetes). How does my selecting GEHA health affect him? Can he be covered?

Richard Miles: FEHB plans have no pre-existing condition exclusion, so your husband would be covered with no limitations due to his diabetes.

Arlington, Virginia (GEHA High Option, Connection Dental Federal (FEDVIP) High): With the new waiting period for orthodontics being 12 months, does the waiting period start in January 2013 or when we first enrolled in the plan? My son already has braces, so how will this benefit work for us? If we are overseas, does this make a difference?

Richard Miles: The orthodontic waiting period begins with your effective date as long as you are continuously enrolled with no break in coverage. Let’s assume that your son was enrolled and you joined on January 1, 2012, and had his braces put on sometime after the date you joined the plan. Benefits would become available starting in January 2013 because he would have been continually enrolled for 12 months on January 1, 2013, and the bands were placed after he became a covered dependent. The billed amount is prorated over the length of the treatment plan and then benefits are considered for the months after the waiting period is met.

For overseas, in most cases we are able to convert expenses to dollars and translate services. It is helpful to write your name and GEHA ID number either on the bill or on a separate piece of paper with an outline of the services rendered in English. We will do our best to work with what you send us. For more details, click Outside the United States.

Anchorage, Alaska (Connection Dental Federal (FEDVIP) High): I have moved to an area where my preferred dentist is not currently in-network with GEHA. How difficult is it to get them in the GEHA system if they are willing?

Richard Miles: It’s not a difficult process. The first step would be for you or someone in you provider’s office to complete our online dental nomination form. Once we receive that nomination, we’ll contact your provider directly and complete the process. If your dentist chooses to join the network, the normal timeframe to complete the nomination process is about 60 days.

Chicago, Illinois (Connection Dental Federal (FEDVIP) High): I am getting ready to retire. Can I take my insurance with me?

Richard Miles: Yes, you can continue your FEDVIP coverage when you retire. Also, unlike FEHB, there is no five-year requirement for continuing FEDVIP coverage into retirement. If you have FEDVIP coverage when you retire, it will automatically continue into retirement, no matter how long you have had the coverage.

Logan, Utah (GEHA High Option, Connection Dental Federal (FEDVIP) High): Please address any big changes in coverage for 2013. What will premiums be?

Thanks -- and Jingle Bells -- it’s snowing in northern Utah this morning!

Richard Miles: Snow? Wow -- we’re on our way to 82 and sunny here in Lee’s Summit today.

For our health plans, there are no major benefit changes for 2013. We are making some minor changes to comply with the Affordable Care Act, such as eliminating lifetime and annual benefit limits on some services such as infertility testing, allergy testing and nutritional counseling. We are also improving our preventive care benefits, expanding prescription-contraceptive coverage for women, and improving coverage for chiropractic services. You can review the 2013 health plan brochure for further details. The non-postal rates increased from 5 percent to 7 percent.

For our FEDVIP dental plans, the rate increase for the High Option plan will be less than 3 percent and the Standard Option plan’s premium will decrease slightly. We also improved benefits in both plans. We raised the annual benefit maximum from $5,000 to $12,000 on the High Option plan and from $1,200 to $2,500 on the Standard Option plan. We also reduced the waiting period for children’s orthodontic services and increased the benefit. Please review the 2013 FEDVIP dental plan brochure for more details.

Our new issue of the Keynotes newsletter contains a table on page 2 that shows more detail about how the 2013 rates have changed from 2012.

Sandston, Virginia (GEHA Standard Option): I don’t want to change anything on my health plan for next year -- what do I do?

Richard Miles: We are very pleased to hear you are electing to continue your health plan coverage with GEHA for 2013. There is no action required when you are electing to remain with your current plan.

Seattle, Washington (GEHA Standard Option): After the out of pocket catastrophic limit is met, what is the amount GEHA will cover up to? (i.e., treatment of terminal illness)

Richard Miles: Once the calendar year out of pocket limit is met GEHA will reimburse 100% of the plan allowable based upon medical necessity. GEHA also has Hospice benefits that are paid at 100%.

Albany, Georgia (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): Can I switch to High Option dental and keep my Standard Option health plan?

Richard Miles: Absolutely!

Albuquerque, New Mexico: I hear rumblings locally throughout the physician community that GEHA is being absorbed/bought out by another company. Is this the case and if so, when will GEHA members be made aware of this and how will it affect current members? Thank you.

Richard Miles: As with many rumors this one is not true. Since you are from New Mexico, which is moving from our PPO USA network of providers to United HealthCare network of providers for 2013, I am wondering if that is where this rumor may be coming from. We are merely renting their network and we are not being bought by another company and hope to remain in the FEHB program for many years to come.

Lincoln, Nebraska (GEHA Standard Option): I am considering the High Deductible health plan. Who is the target audience for this health plan?

Richard Miles: The plan works well for persons that are healthy and visit their doctors for their routine care and that occassional illness. Here are a few of the advantages to this plan. •Combines a high-deductible health plan (HDHP) with a health savings account (HSA). •Health care expenses may be covered by money saved in an HSA - money GEHA deposits for you plus money you may also contribute. •You get unlimited adult preventive care paid at 100% with in-network doctors. For most other health care, you pay the first $1,500 each year (or $3,000 for Self + Family). After you pay that deductible, GEHA pays 95% of most in-network care. •Vision care is covered for no additional premium.* •Money in your HSA earns tax-free interest. •No taxes on GEHA’s contributions to your HSA. •You may take a tax deduction on your personal contributions. •No taxes on HSA withdrawals for eligible medical expenses. •GEHA pays your HSA set-up fee and monthly bank fees. 2013 benefits at a glance

Huntsville, Alabama (GEHA Standard Option): Would please add acupuncture as a covered procedure in the GEHA Standard Option?

Richard Miles: Medically necessary acupuncture is covered for up to 20 visits per calendar year when rendered by an MD or DO. Services are subject to the calendar year deductible and coinsurance.

Springfield, Illinois (Connection Dental Federal (FEDVIP) High): If a doctor is billing for work he did not perform, who do I complain to?

Richard Miles: You may contact us by phone at (877) 434-2336 or write to us at GEHA Connection Dental Federal, PO Box 2336, Independence, MO, 64051-2336. Please give the detailed information about the services, including the name, address and phone number of the dentist. We will contact the dentist. Thank you.

Chinle, Arizona (GEHA High Option, Connection Dental Federal (FEDVIP) High): My 13-year-old son will have his braces in January 2013. How much of his orthodontic is covered -- is it $1,500 or $2,500? Please walk me through how the dollor amount is applied to his services.

Richard Miles: Once your 12 month waiting period has been met and the teeth are banded, we divide the billed amount and the allowed amount by the proposed length of the treatment plan and process payments quarterly. For example, under the High Option, if the provider is charging $3800 for a 24-month treatment plan. We would pay $332.49 at the end of each quarter (as long as he remains a covered child) until the life time maximum of $2,500 is reached.

Denver , Colorado (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): If my child already has braces, is he eligible for the orthodontics benefit? If not, will the retainers at least be covered?

Richard Miles: If you child had his braces placed before you joined this plan, he would not be eligible for orthodontic benefits.

Philadelephia, Pennsylvania (GEHA High Option, Connection Dental Federal (FEDVIP) High): If my daughter turned 22 this month, will I still have to pay for her the rest of the year?

Richard Miles: You should not need to pay for your daughter the rest of the year. BENEFEDS has been contracted to administer the FEDVIP program. They are responsible for enrollment, eligibility and premiums. You may contact them by visiting BENEFEDS.com, e-mailing them at service@BENEFEDS.com or calling (877) 888-3337.

Seymour, Tennessee (GEHA High Option): How much is the 2013 health premium for Postal retirees?

Richard Miles: As a retiree, your premiums are deducted from your annuity monthly. The monthly rates are:

High Option
Self Only: $197.51
Self and Family: $468.86

Standard Option
Self Only: $97.36
Self and Family: $221.41

Milwaukee, Wisconsin (GEHA HDHP Option, Connection Dental Federal (FEDVIP) Standard): If I have had the Dental Standard plan for two years and want to switch to the High plan, do I need to wait an additional 12 months before being eligible for the $2,500 orthodontia benefits?

If so, after the 12 months, will I be eligible for the difference between the Standard Option plan and the High Option plan for orthodontia benefits (i.e., $1,000)?

Richard Miles: Prior to 2013, if your child has been enrolled for two years, your child has met the waiting period and is eligible for orthodontic benefits. Effective January 1, 2013, you child only needs to have been previously enrolled for 12 months in order to be eligible for orthodontic benefits. The waiting period does not start over. It is based on the effective date of the child. The teeth must be banded while covered under the plan.

Charleston, South Carolina (GEHA Standard Option): I have Medicare and GEHA Standard Optoin -- is this the best choice?

Richard Miles: Standard Option is an excellent choice. If you use generic medications, there is a $5 copay at your local pharmacy or $15 by mail for a 90-day supply.

If you find you may be taking more name-brand medications, then you may want to look at our High Option plan. Click My Drug Cost to access a handy tool that can help you make an informed decision on the best plan choice.

New Freedom, Pennsylvania (GEHA High Option, Connection Dental Federal (FEDVIP) High): I have been very pleased with everyone at GEHA. Everyone has been so nice and helpful and get to the root of any problem in a short time. Just thought you should like to hear nice things about GEHA. Have a great day!

Richard Miles: Thank you so much for your praise, we love to hear how we are doing. We are here to help you with your health and dental concerns, so please feel free to call us at anytime.

Atlanta, Georgia (GEHA High Option, Connection Dental Federal (FEDVIP) High): Will the dental plan also include eye exams

Richard Miles: As a GEHA Dental Plan member, you can save on vision through Connection Vision powered by EyeMed. You and your covered family members each pay only $5 for your annual routine eye exam at any EyeMed participating provider. In addition, with your Connection Vision powered by EyeMed you can save a significant amount on your eyewear needs at participating locations such as LensCrafters, Pearle Vision, Sears Optical, Target Optical, JC Penney Optical and thousands of private practitioners.

Los Angeles, California (Connection Dental Federal (FEDVIP) Standard): Hi there. I want to make sure that if I switch from Standard to High Option during Open Season, my orthodontic waiting period will be waived at the beginning of 2013, because I will already have been a GEHA dental Standard Option member for 12 months in 2012. Thanks.

Richard Miles: Assuming your child’s effective date was January 1, 2012, the waiting period will be met January 1, 2013. As long as your child is continously enrolled in GEHA Connection Dental Federal (High or Standard Option) with no lapse in coverage, the waiting period is calculated from your child’s effective date.

Fargo, North Dakota (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): How can we get more dentists to accept GEHA? It’s really rare that anyone in our area will accept our insurance.

Richard Miles: If you would like to complete our online dental nomination form, we will contact them with information on how to become a Connection Dental provider. The decision to join is up to the dentist, but nominations from patients are often effective in the dentist’s decision to join the network.

New York, New York (GEHA HDHP Option): What are your practices for adding new doctors to your network? Can a member suggest a doctor for the network?

Richard Miles: Absolutely! You can complete our online nomination form. Or, you can call GEHA’s Customer Service department (800) 821-6136, and they can direct you to the department that does that. Of course the choice to join GEHA’s provider network is up to the provider, but we welcome member nominations!

Lapel, Indiana: Under your dental plan is there a waiting period for having wisdom teeth out. And how much is covered?

Richard Miles: There is no waiting period for the extraction of an impacted tooth. Removal of impacted teeth is considered a covered Class B service in Connection Dental Federal . The following procedures are covered under the plan: D7220 Removal of impacted tooth - soft tissue D7230 Removal of impacted tooth - partially bony. D7240 Removal of impacted tooth - completely bony The rules establishing the FEDVIP program require that FEDVIP dental plans pay after any benefits payable by your FEHB plan and many of the FEHB plan cover the removal of impacted teeth is often covered under their oral surgery benefits. If your FEHB plan covers removal of impacted teeth, you would need to submit charges first to your FEHB carrier and then send the bill and your FEHB carrier’s explanation of benefit statement to us for processing.

Alexandria, Virginia (GEHA HDHP Option): How does the HDHP plan cover international expenses, say, while posted abroad for the U.S. Department of State?

Richard Miles: After your deductible is met, GEHA’s Foreign Claims Department will apply PPO benefits to services rendered by an overseas (foreign) medical provider and medical types of service rendered by overseas (foreign) dental providers (e.g., oral surgery, etc.).

Overseas providers may require payment for services in advance. If that happens, for covered services you receive in hospitals outside the United States and Puerto Rico and performed by physicians outside the United States, send a completed International Claim Form and the itemized bills to: GEHA, Foreign Claims Department, P.O. Box 4665, Independence, MO 64051-4665.

Miami, Florida (Connection Dental Federal (FEDVIP) Standard): If I needed to replace a crown or needed a root canal, what would this plan cover?

Richard Miles: Root canals and crowns fall under Class C services. We would reimburse the following percentage based on our allowable:

For High Option, Class C: We pay 50%, you pay 50%
For Standard Option, Class C: We pay 35%, you pay 65%

To view our plan allowance, click Dental Pricing Lookup. If you are a member, log in to your account. If you are a guest, click Not Yet a GEHA Member. Finally, enter the Zip code where treatment is to be provided and select the type of service you are interested in seeing.

Sacile, Italy , New York (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): My question concerns the extra option under the "EYE" plan, however , I found out that it does not exist in Italy, but my monies have been deducted each month. !!!! I sent a letter about two months ago, asking that they refund my monies or else give me credit toward my dental plan. NO ANSWER

Richard Miles: Connection Vision Powered by EyeMed is given, free of charge to you as a member of GEHA. You do not pay anything for this value added benefit. While there are no participating EyeMed providers in Italy, you can submit your routine eye exam charge for out-of-network benefits.

Oklahoma City, Oklahoma (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): If the primary insuree is elgible for medicare in March of 2013 is the spouse who is not elgible for medicare able to continue with coverage for 2013 and is it still considered a family play?

Richard Miles: Yes, they would be eligible to continue coverage under your family enrollment.

Atlanta, Georgia (GEHA Standard Option): Will I be able to get free birth control with any GEHA plan based on the new Affordable Care Act (ACA)rules and regulations

Richard Miles: Effective 1/1/13, oral contraceptives with a doctor’s prescription will be covered at no charge for female members. A doctor’s prescription submitted to a retail, mail service or direct claim will be covered.

Las Vegas, Nevada (GEHA High Option): I have retired from Government Service but working in private industry. Can I add a Dental Plan to my Health Plan now and if so, how much will it cost?

Richard Miles: In general, if you are eligible to enroll in FEHB, then you are eligible to enroll in FEDVIP. You may enroll through BENEFEDS during Open Season. This year Open Season runs from November 12 through December 10. You may contact them by visiting BENEFEDS.com, e-mailing them at service@BENEFEDS.com or calling (877) 888-3337.

We also offer the GEHA Connection Dental Plus plan that you may be eligible to enroll in immediately. This is not an OPM sponsored program. To enroll in this plan, visit geha.com/cdplus and complete the enrollment form/application.

Centreville, MD, Maryland (Connection Dental Federal (FEDVIP) Standard): Why don’t you offer coverage on composite fillings? I have spent over $600 out-of-pocket on my family this year.

Richard Miles: In 2012, we cover composite fillings the same as amalgam fillings. Please call our Customer Service Department at (877) 434-2336 for more information regarding your denial.

Wilmington, Delaware (GEHA Standard Option): The GEHA prescription benefits indicate that for brand name drugs, the co-pay is up to 50%. If GEHA is my primary insurance and I have secondary insurance through my spouse, would I end up paying more for my brand name drugs? My spouse’s plan has lower copays for brand name drugs. How do I handle the paperwork for GEHA and a secondary insurance?

Richard Miles: Prescriptions should always be submitted to the primary insurer first and the secondary insurer after that. Retail pharmacies can often process both transactions electronically so that you will only pay the amount due after both insurers have paid their portion of your total prescription cost. If the medication is covered by both prescrition plans, you may not have any out of pocket costs.

Southaven, Mississippi (Connection Dental Federal (FEDVIP) Standard): I signed up for GEHA dental insurance last year; but, I haven’t received a membership card. I’ve gotten correspondence from GEHA, though.

Richard Miles: Please call our customer service at 877-434-2336 and request a replacement set of ID cards be mailed to you.

Fairfax, Virginia: Can you please provide an overview of your maternity benefits?

Richard Miles: On our High and Standard Option plans if you use a preferred physician and hospital GEHA reimburses those services at 100% of the plan allowable. We also cover the routine nursery care of the newborn child during the covered portion of the mother’s maternity stay. Screening for gestational diabetes for pregnant women between 24-28 weeks gestation or first prenatal visit for women at a high risk. Breastfeeding support, supplies, and counseling for each birth. And Folic acid supplements – with a prescription, women who are/or could become pregnant. You do not need precertification of a maternity admission for a routine delivery 48 hours after a vaginal delivery or 96 hours after a cesarean section.

San Jose, California (GEHA HDHP Option): Will Medicare Part B pay my deductible on my GEHA HDHP HSA plan?

Richard Miles: No. If you have Medicare Part B, you are not eligible for an HSA. If you have Medicare and the HDHP, we can provide a health reimbursement arrangement (HRA) instead of an HSA. The contributions to your HRA can be used to pay your Part B premiums. Part B will not pay the deductible of the HDHP.

Kansas City, Missouri (Connection Dental Federal (FEDVIP) Standard): Can I switch options from standard to high before open season and when can we take advantage of new shorter waiting periods for ortho work. Currently not have reached original 24 month period,I am at 21 months currently. Can we start ortho work now since waiting period is shortened to 12 months.

Richard Miles: Any amount credited towards your child’s orthodontic waiting period will be used to meet the 12-month waiting period January 1, 2013. If your child were to start treatment in 2012, you would not be eligible for the pro-rated portion of the treatment plan that was incurred in 2012 as the waiting period was not met. However, any remaining portion applicable for 2013 would be eligible for benefits.

Hot Springs, Arkansas (GEHA Standard Option): Does my GEHA coverage include annual physicals? Medicare is my primary and GEHA, secondary.

Richard Miles: GEHA does continue to offer you benefits for your preventive services and immunizations. You may also want to check out Medicare’s changes to some preventive care services when you use a Medicare participating provider. These changes can allow you to get the best of both of your plans.

Salem , Illinois (Connection Dental Federal (FEDVIP) High): My wife is looking at having some bridge work done but we don’t understand the "missing teeth clause (Not having this insurance prior to) My wifes front were removed from an accident in childhood. She had a bridge placement 30 years ago before this insurance was in place. We have had this insurance 5 years her bridge has become loose/damaged and she has another missing tooth (prior to this insurance) she would like to include into the new bridge. They tell us due to "missing teeth clause" NONE of the bridge work will be covered. Why will it at least not cover the bridge already in place at the time of the insurance policy

Richard Miles: In 2013, "Initial" partials are covered under the plan when medically necessary. The "replacement" of an existing prosthodontic (partial) device will be considered a covered service only if at least one of the following conditions is met:

• The replacement appliance replaces an existing appliance that is at least 5 years old and cannot be made serviceable.
• The replacement appliance is required as the result of accidental bodily injury that occurs after the date the person became a covered person and the appliance cannot be made serviceable.

In other words, in 2013 we eliminated the "missing tooth clause."

Philadelphia, Pennsylvania: How much will GEHA pay for upper and lower dentures?

Richard Miles: To view our plan allowance, click Dental Pricing Lookup. If you are a member, log in to your account. If you are a guest, click Not Yet a GEHA Member. Finally, enter the Zip code where treatment is to be provided and select the type of service you are interested in seeing.

Orlando, Florida (Connection Dental Federal (FEDVIP) High): I just have a comment. Most of these questions are basic questions that can be found by reading the GEHA plan coverage. Should more specific questions be asked via Customer Service on a one-on-one basis?

Richard Miles: Good morning. We’ve received hundreds of questions this morning and in the weeks leading up to today. I try to select the questions that will be of interest to a big part of our audience. Please don’t hesitate to contact Customer Service with more specific questions that you don’t see discussed here today.

Clarkston, Georgia (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): I am enrolled in both GEHA Standard Option and VSP. Am I overinsured for vision care?

Richard Miles: The Connection Vision Powered by EyeMed does not pay benefits towards any glasses or contacts, it only offers discounts towards those items from EyeMed providers.

Sioux City, Iowa (GEHA Standard Option): I just wanted to say thank you for switching who GEHA preferred providers are. Up until Jan 1, 2013, we could hardly find anyone. As of the upcoming new year, it looks like you are adding a bunch of them. Thank you!

Richard Miles: You are very welcome! We had to make the difficult decision to discontinue operating the PPO USA network, but we’re happy that you will enjoy our new arrangement with UnitedHealthcare (UHC), which will allow you to continue to see preferred providers.

Phoenix, Arizona: I’ve had the same FEHB carrier for almost 18 years. The prescription process for me is very onerous, esp. with the Formulary and almost-mandatory use of electronic RXs. The latter means I can’t switch pharmacies when I want unless I go to the Medical Provider (additional cost) and get a new RX emailed to the new pharmacy.

I’m relatively healthy - no heart problems, no diabetes - and want to save money. How easy is your RX process, both Standard and High Options? Are electronic RXs required? Do I have to visit the MD Provider when I want to switch pharmacies? Also, can I get 90-day supplies of an RX with GEHA? If so, which plan(s)? Thank you.

Richard Miles: Please speak with your physician about your preference regarding prescriptions. Electronic prescriptions are not required although they are a safe alternative and most members and physicians find them to be convenient. If you prefer that the physician give you a paper prescription, they can do that for you.

No it is not required to see your physican to switch pharmacies. As long as there are refills remaining, the member would contact the pharamacy they wish to utilize and request a script transfer.

Yes, you can obtain up to a 90-day supply with a physician order/prescription through the mail service pharmacy.

GEHA members can contact Express Scripts Customer Service by calling the 800# on their card or use express-scripts.com to get formulary information and preferred alternatives and pharmacy choices that may save them money.

, Virginia (GEHA High Option): why when on 12/1/2012 medicare becomes our primary and geha our secondary the rates do not go down?

Richard Miles: Your premiums do not decrease when Medicare becomes the primary payer. However, GEHA’s health plans work with Medicare to offer special benefits for federal retirees. If you have Part A and B as your primary GEHA pays 100% of covered hospital and doctor expenses after Medicare. You pay no deductibles or copays for surgical and medical benefits with GEHA Standard or High option.

Virginia Beach, Virginia (GEHA Standard Option): I currently live in Virginia and amy move to Atlanta next year would I be covered?

Richard Miles: You bet! GEHA covers federal employees nationwide and even overseas.

Lexington, Kentucky (Connection Dental Federal (FEDVIP) High): I currently do not have the health insurance plan but am thinking about switching over. If I have lab tests done as part of my annual physical exam, how much will the insurance pay for and how much will I be expected to pay out of pocket?

Richard Miles: Under our High Option and Standard Option plans, covered lab services are paid at 100% when you use LabCard. Under the Health Savings Advantage HDHP plan, covered lab services are paid at 100% in-network, with no deductible, under our preventive care benefit. You do pay for tests when you use a lab not in the network. Under our High Option, you will be responsible for 25% of the plan allowance and any difference between our allowance and the billed amount. For Standard Option, your responsibility is 35% plus the difference between our allowance and the billed amount. Under the HDHP, you will pay the deductible, then 25% of the plan allowance.

Baltimore, Maryland (GEHA HDHP Option): I have heard different things about the fate of health savings accounts (HSAs) in 2014. Has GEHA determined whether it will still be able to offer the HDHP with an HSA, as they do today, once the after the Patient Protection and Affordable Care Act goes into full effect goes into full effect in 2014? If so, will any major changes occur? If not, then what options will GEHA be able to make available for customers who like the flexibility and lower premiums of an HDHP/HSA plan?

Richard Miles: We do not anticipate any major changes to our health plan offerings in 2014 due to the Affordable Care Act, including GEHA’s Health Savings Advantage High Deductible Health Plan. The primary change related to the Affordable Care Act has already occurred. Back on January 1, 2011, over-the-counter medicines or drugs became considered a qualified medical expense only if they are purchased with a prescription.

Nixa, Missouri (GEHA High Option, Connection Dental Federal (FEDVIP) High): My husband and I only have Medicare A in addition to our GEHA coverage. Is it possible to add Medicare B at this time? We have been retired for several years.

Richard Miles: The decision to enroll in Medicare is yours. If you do not sign up for Medicare Part B when you first become eligible, you may be charged a Medicare Part B late enrollment penalty of a 10% increase in premium for every 12 months you are not enrolled.

New York, New York (GEHA HDHP Option): Can you describe what this change in coverage means and how,if at all, it applies to the High Deductible plan? "The annual calendar year deductible has been removed from the scheduled benefits for chiropractic visits and x-rays. "

Richard Miles: Under our High and Standard Option plans, members do not have to meet the deductible before the plan pays benefits for chiropractic care. Members in the HDHP plan will continue to meet the deductible before the plan pays for chiropractic care. After you meet the deductible, GEHA will pay $20 per visit for 12 visits per year and $25 per year for spinal X-rays.

Portland, Oregon (Connection Dental Federal (FEDVIP) High): I understand that the orthodontia limit is going to be increased in 2013. My son got braces last year, but will continue to incur orthodontia expenses this year. Will the new limits apply to him?

Richard Miles: The allowable is prorated over the length of the treatment plan. If the allowable has already been considered prior to 2013, no additional benefits will be payable. However, if any allowable is left in 2013, the remaining allowable will be considered at the higher reimbursement rate.

San Diego, California (Connection Dental Federal (FEDVIP) High): I have the FEDVIP dental plan, and just read this plan also gives substantial discounts to eye glasses if I go to Pearle Vision, Target, etc., will my dental ID card be used to show I have coverage?

Richard Miles: You should have received a separate card for Connection Vision powered by EyeMed. If you did not receive it, please contact EyeMed at (877) 808-8538 and request they send you a replacement card.

Chicago, Illinois (Connection Dental Federal (FEDVIP) High): I am a federal employee with a High Option GEHA dental plan. Do I also have vision coverage with this plan? If so who is my coverage with? I called Avevis and they said they do not cover me. Thanks.

Richard Miles: As a GEHA Dental Plan member, you get vision exam coverage for no additional premium. Through Connection Vision powered by EyeMed, you and your covered family members each pay only $5 for an annual routine eye exam when you use a qualified EyeMed participating provider. Or, if you use a provider that does not participate, EyeMed will reimburse you up to $45 for an annual routine eye exam. File out of network claims to:

EyeMed Vision Care
Attn: OON Claims
P.O. Box 8504
Mason, OH 45040-7111

Visit Connection Vision® powered by EyeMed or call (877) 808-8538.

Lubbock, Texas (GEHA Standard Option): My husband turns 65 in July of 2013, can I put him on my plan?

Richard Miles: There are certain life events that will allow you make changes outside of open season. You will need to contact your personnel or retirement office at that time. They will process any changes to your enrollment and forward the information to us.

Conway, Arkansas (GEHA High Option): Must one be enrolled in the Dental Plan to be covered under the Vision Connection or does being covered under GEHA Health also cover Vision Connection?

Richard Miles: Both GEHA Health plan members and GEHA Dental plan members receive Connection Vision Powered by EyeMed. It is a value added benefit offered by GEHA to our members.

Montpelier, Idaho (Connection Dental Federal (FEDVIP) High): I have the High Option dental and am in the process of getting 2 implants for teeth that were removed before I joined GEHA 3 years ago. Will the 2013 plan pay any benefits for this procedure?

Richard Miles: Beginning in 2013 there is no longer an exclusion for replacement of teeth extracted prior to joining the plan. Given your example, if your dentist performs a covered implant procedure to replace a tooth extracted prior to joining GEHA, the service would be eligible for coverage (up to the $800 implant maximum). Please see pages 26-27 of the 2013 Connection Dental Federal brochure for a complete description of the benefits and limitations applicable to implants.

San Diego, California (Connection Dental Federal (FEDVIP) High): Hi, will my dental (FEDVIP) ID card suffice for Pearle Vision, etc., to purchase eye glasses?

Richard Miles: No, you would need to use the separate vision card, however participating EyeMed providers can often check coverage for you.

You should have received a separate card for Connection Vision powered by EyeMed. If you did not receive it, please contact EyeMed at (877) 808-8538 and request they send you a replacement card.

San Antonio, Texas (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): I have both GEHA health plan and GEHA dental plan. I understand that Health plan provides some dental coverage in addition to dental plan. How is this presented to Dentist’s office. Should only dental card be presented? Should both cards be presented?

Richard Miles: Provide your dentist office with both your Medical and Connection Dental Federal cards. With both plans with GEHA we will handle them both with a single claim submission from your dentist but it does assist them in knowing you have both coverages.

Orlando, Florida (Connection Dental Federal (FEDVIP) High): The question referred to implant and denture bridge. This is confusing. In GEHA coverage is an implant a bridge or a tooth implant? I have never heard a bridge referred to as an implant. Now I am confused as to whether a tooth implant is covered or just a bridge. . .please explain.

Richard Miles: In 2013, we will allow up to $800 per person, per year for implants. The allowable is for all implant related services including the implant, the abutment and the crown.

A bridge may be attached to an existing tooth or it may be attached to an implant. If the bridge is attached to an implant, the $800 maximum applies to the bridge and the implant.

Our chat is complete. Thanks for joining us today. If I did not answer your question during the chat, we will follow up by email if you provided us a valid email address.

I want to thank all of our current GEHA members. Almost half of our health plan members have been with GEHA for 10 years or more, and we appreciate that loyalty. If you’re not currently with GEHA, I hope you’ll take a closer look at our plans to see if we’re a good fit for you and your family.

I also want to thank all of the staff members at GEHA who have assisted me with today’s chat.

Best wishes to you all.

Richard Miles
GEHA President

As you begin thinking about your health and dental options for next year, here are some links to our 2013 materials:

2013 Health Summary (PDF) 2013 Health Brochure (PDF) 2013 Health Premiums

2013 HDHP Summary (PDF) 2013 HDHP Brochure (PDF) 2013 HDHP Premiums

2013 Dental Summary (PDF) 2013 Dental Brochure (PDF) 2013 Dental Premiums

For information about our FEHB health plans, go to www.geha.com or call us at (800) 262-GEHA.

For information about our FEDVIP dental plan, GEHA Connection Dental Federal, go to www.gehadental.com or call (877) 434-2336.

If you have comments about this online chat format, or if you would like to offer suggestions for future chats, please send an email to editor@geha.com.