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Preventive medications

GEHA | September 4, 2018

Prescriptions Everyday health
Learn how GEHA promotes your health by providing preventive medications at a $0 copay with a physician's prescription.

GEHA covers the following preventative medications with a physician's prescription at a $0 copay to promote better health as recommended under the Patient Protection and Affordable Care Act. For the most up-to-date information, visit uspreventiveservicestaskforce.org.

Please note: A prescription is required to process any claim for preventive care medications or products under GEHA's prescription benefits, including over-the-counter medications.

Asprin
  • All single-ingredient generic oral dosage forms ≤81 mg over-the-counter only (requires a prescription) for prevention of cardiovascular disease (CVD) for age ranges 50-59;
  • and 81 mg generic over-the-counter for the prevention of preeclampsia after 12 weeks of gestation.
  • Limit of 100 units per fill applies for both populations.
Fluoride supplements (not toothpaste or rinses)
  • Single-ingredient oral dosage forms ≤ 0.5 mg
  • Covered for patients age 0-5
  • No gender restriction
Folic acid supplements (over-the-counter)
  • Single ingredient generic 0.4 mg tab
  • Single ingredient generic 0.8 mg tab
  • Gender: Female only
  • Covered for patients age 55 and younger
  • Limit of 100 units per fill 
Vitamin D (Rx and over-the-counter)
  • Single entity vitamin D2 or D3 containing 1,000IU or less per dosage form
  • Combination products that also contain calcium (combination of two agents only for the combinations)
  • Prescription or over-the-counter (requires a prescription) for individuals age 65 and over
Generic taxmoxifen and raloxifene
  • With prescription for women ages 35 and over for the prevention of breast cancer
Colorectal cancer prevention - Bowel prep products (Rx only)
  • Brand (until generics become available) 
  • No gender restriction
  • Covered for patients ages 50-74
  • Low-volume products only
Women's preventive service - contraceptives
  • Oral, emergency, injectable, patch, barrier and miscellaneous brand-name and generic prescriptions or over-the-counter (requires a prescription). Women only and limits may apply. 
Statins
  • Low to moderate dose of certain generic statins for individuals ages 40 to 75.