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Health Savings Advantage HDHP
The chart below shows a summary of your cost for prescription drugs with GEHA Health Savings AdvantageSM. Unlike our other plans, this plan requires that members with Medicare pay coinsurance and a deductible. For complete benefit information, refer to the GEHA Plan Brochure.
| 2009 PLAN YEAR |
Health Savings
AdvantageSM High-Deductible Health Plan |
| Prescriptions |
You Pay - In-Network |
You Pay - Out-of-Network |
Mail
order Generic and brand
(90-day supply) |
25% of plan allowance,
after deductible* |
N/A |
Retail
pharmacy Generic and
(30-day supply) brand |
25% of plan allowance,
after deductible* |
25% of plan allowance, after deductible*, plus difference between plan allowance and cost of drug |
| * $1,500 Self Only, $3,000 Family calendar-year deductible. |
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