Elevate
Welcome to your medical plan page
What’s new in 2023
- Out-of-pocket maximum in-network is now $8,500 for Self Only, and $17,000 for Self Plus One or Self and Family, per calendar year
- Specialist visit copay is increasing from $25 to $30
Exclusive plan perk for Elevate subscribers
Elevate plan subscribers are eligible annually to choose one plan perk from the following:
Choice of Fitbit tracker including a 12-month Fitbit Premium Membership.
$125 gift card for DICK’S Sporting Goods or REI.
12-month Daily Burn virtual fitness subscription.
*Only subscribers in the 50 United States are eligible at this time.
These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to subscribers who become a member of GEHA’s Elevate medical plan.
Elevate coverage
Yearly deductible
| Yearly deductible in-network1 | You pay |
|---|---|
| Self Only | $500 |
| Self Plus One or Self and Family | $1,000 |
Out-of-pocket maximum
| Out-of-pocket maximum in-network1,2 | You pay |
|---|---|
| Self Only | $8,500 |
| Self Plus One or Self and Family | $17,000 |
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.
Your medical benefits
| Medical benefits in-network1 | You pay |
|---|---|
|
$0 |
|
$10 |
|
$30 |
| $50 | |
|
25%3 |
|
$250 |
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 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a GEHA medical plan and their eligible family members.
3 Calendar year deductible applies.
Your prescription benefits
| Prescription benefits in-network1,2,3 | You pay |
|---|---|
| 30-day retail generic | $4 |
| 30-day retail preferred brand-name | 50% ($500 max) |
| 30-day retail non-preferred brand-name | 100% |
| 30-day specialty CVS exclusive generic and preferred brand-name | 50% ($500 max) |
| 30-day specialty CVS exclusive non-preferred brand-name | 100% |
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 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 To provide a low premium, this plan does not include mail-order prescriptions or out-of-network pharmacy coverage, and it has a limited pharmacy network. Find a pharmacy at geha.com/Find-Care
Elevate and Medicare coverage
Yearly deductible
| Yearly deductible in-network1 | You pay |
|---|---|
| Self Only | $500 |
| Self Plus One or Self and Family | $1,000 |
Out-of-pocket maximum
| Out-of-pocket max in-network1,2 | You pay |
|---|---|
| Self Only | $8,500 |
| Self Plus One or Self and Family | $17,000 |
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.
Your medical benefits
| Medical benefits with Medicare A & B primary in-network1 | You pay |
|---|---|
|
$0 |
|
$10 |
|
$30 |
| $50 | |
|
25%3 |
|
$250 |
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 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a GEHA medical plan and their eligible family members.
3 Calendar year deductible applies.
Your prescription benefits
| Prescription benefits in-network1,2,3,4 | You pay |
|---|---|
| 30-day retail generic | $4 |
| 30-day retail preferred brand-name | 50% ($500 max) |
| 30-day retail non-preferred brand-name | 100% |
| 30-day specialty CVS exclusive generic and preferred brand-name | 50% ($500 max) |
| 30-day specialty CVS exclusive non-preferred brand-name | 100% |
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 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 If you choose a brand-name medication when a generic is available, you will be charged the generic copay plus the difference in cost between the brand-name and the generic.
4 To provide a low premium, this plan does not include mail-order prescriptions or out-of-network pharmacy coverage, and it has a limited pharmacy network. Find a pharmacy at geha.com/Find-Care
Included benefits & savings
Pharmacy benefits
Retail pharmacy
Estimate medication costs
Your exclusive discounts
Vision discounts1
Medical alert discount1
Hearing aid discount1
Electric toothbrush discount1,2
Teeth whitening discount1
1 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all enrollees who become members of a GEHA medical plan and their eligible family members.
2 The cariPRO® premium toothbrush removes seven times more plaque than a regular brush, is completely waterproof and comes with a two-year manufacturer’s warranty. Replacement brush heads with high-quality DuPont™ bristles are also available at this exclusive, member-only price.
Find care
Choose the right care
For helpful instructions on how to find in-network primary, specialty and urgent care using GEHA’s Find Care tool, watch this video.
Other care resources
Maternity resources
Rally Health portal
Wellness Pays rewards
How it works
Your Wellness Pays prepaid debit card
Redeeming your rewards
Resources
Plan documents
| Topic |
Resource |
|---|---|
| 2023 Elevate Plan Brochure | Download (PDF) |
| 2023 Elevate Member Guide | Browse the e-book |
| 2023 Medical Benefits Guide | Browse the e-book |
| 2023 Summary of Benefits Coverage | Download (PDF) |
Helpful resources
| Topic |
Resource |
|---|---|
| Create your GEHA web account | geha.com/Register |
| Complete your Enrollment Questionnaire | geha.com/EQ |
| Talk with GEHA Customer Care | geha.com/Contact |
| Use the Find Care Tool | geha.com/Find-Care |
| View the frequently asked questions | geha.com/FAQs |
| Access the GEHA App | Visit the App Store or Google Play |