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High

Welcome to your medical plan page


What’s new in 2024

  • Medicare B subsidy of $100 per month when you choose to elect GEHA High Medicare Advantage Plan coverage.
  • Infertility coverage only for artificial insemination (AI). Coverage for drugs associated with AI and in vitro fertilization (IVF limited to three cycles annually).
For a complete list of plan changes, download the plan brochure.

High coverage


Yearly deductible

Yearly deductible in-network1 You pay
Self Only $350
Self Plus One or Self and Family $700

Out-of-pocket maximum

Out-of-pocket maximum in-network1,2 You pay
Self Only $5,000
Self Plus One or Self and Family $10,000

Your medical benefits

Medical benefits in-network1 You pay
  • Unlimited telehealth visits, including mental health, with MDLIVE
  • Preventive care; adult routine screenings
  • Well-child visit; up to age 22
  • Maternity; preventive prenatal and postnatal office visits
  • Maternity; childbirth/delivery professional services
  • Maternity; childbirth/delivery facility services
  • Outpatient accidental injury, including ER (within 72 hours)
  • Outpatient lab services
$0
  • Vision coverage; eye exams2
$5
$10
  • Primary physician office visit
  • Mental health office visit
  • Specialist care; office visit
  • Chiropractic care; (manipulative therapy), including X-rays; up to 20 visits per year
$20
$35
  • ER visit; medical emergency
  • Hospital care; outpatient
  • Professional surgical services
  • X-rays and other diagnostic services
  • Acupuncture; up to 20 treatments per year
10%3
  • Hospital care; inpatient
$100 per admission plus 10%
  • Preventive dental care; twice yearly
Balance after GEHA pays $22 per visit

Your prescription benefits

Prescription benefits in-network1,2 You pay
30-day retail generic $103
30-day retail preferred brand-name 25% ($150 max3,4)
30-day retail non-preferred brand-name 40% ($200 max3,4)
90-day mail service generic $20
90-day mail service preferred brand-name 25% ($350 max4)
90-day mail service non-preferred brand-name 40% ($500 max4)
30-day specialty CVS exclusive generic and preferred brand-name 25% ($150 max4)
30-day specialty CVS exclusive non-preferred brand-name 40% ($200 max4)

High and Medicare coverage


Yearly deductible

Yearly deductible with Medicare A & B primary 1 You pay
Self Only $0
Self Plus One or Self and Family $0

Out-of-pocket maximum

Out-of-pocket maximum in-network1 You pay
Self Only $5,000
Self Plus One or Self and Family $10,000

High and Medicare medical benefits

Medical benefits with Medicare A & B primary in-network1,2,3 You pay
$0
  • Vision coverage; eye exams3
$5
  • Preventive dental care
Balance after GEHA pays $22 per visit

High and Medicare prescription benefits

Prescription benefits in-network1,2 You pay
30-day retail generic $103
30-day retail preferred brand-name 20% ($150 max3,4)
30-day retail non-preferred brand-name 35% ($200 max3,4)
90-day mail service generic $15
90-day mail service preferred brand-name 15% ($350 max4)
90-day mail service non-preferred brand-name 30% ($500 max4)
30-day specialty CVS exclusive generic and preferred brand-name 15% ($150 max4)
30-day specialty CVS exclusive non-preferred brand-name 30% ($200 max4)

Included benefits & discounts



Pharmacy benefits

Retail pharmacy

Fill your prescriptions at more than 67,000 in-network pharmacies nationwide including CVS, RiteAid, Walgreens, Walmart and more.
Visit CVS.com

Mail service pharmacy

Have medications delivered to your door with CVS Caremark Mail Service Pharmacy. Many non-specialty drugs qualify for 90-day refills.
Learn more

Estimate medication costs

Visit our check drug costs tool, hosted by CVS Caremark, to evaluate your medication costs.
Learn more

Your exclusive discounts

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Vision discount1

With all GEHA medical plans, you get low copays on eye exams and discounts on frames and lenses through EyeMed.®
Learn more
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Medical alert discount1

Get free Life Alert® activation, plus a 10% monthly discount, for responsive emergency help.
Learn more
Hearing aid 

Hearing aid discount1

Receive TruHearing discounted pricing on hearing aids and save 30% to 60%, averaging more than $2,600 per pair. High plan members also receive a $2,500 hearing aid benefit.
Learn more
electric toothbrush 

Electric toothbrush discount1,2

Save more than 70% off a premium electric toothbrush by cariPRO.®
Learn more
tooth whitening icon 

Teeth whitening discount1

Receive a 20% discount off the lowest published price on all Smile Brilliant® home teeth whitening products. Includes custom-fitted trays, whitening gel and desensitizing gel.
Learn more

Find care


Other care resources

Baby carriage 

Maternity resources

Count on GEHA’s maternity program for answers to your questions about pregnancy, prenatal care and your GEHA benefits.
Learn more
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Your team of health professionals

Your dedicated group of health professionals will help move you toward your health goals by assisting with lifestyle choices, medications, health care providers, educational materials and more.
Call 888.216.8246 ext. 3984
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New for 2024: Infertility benefits

Infertility coverage only for artificial insemination (AI). Coverage for drugs associated with AI and in vitro fertilization (IVF limited to 3 cycles annually). Preauthorization is required. Member must meet the Plan’s definition of infertility.
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Order your complimentary maternity resource kit

The maternity resource kit includes a wealth of knowledge about what to expect during each trimester of your pregnancy, such as e-books and gifts for both you and your baby.
geha.com/Maternity
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Childbirth classes

New for 2024: Up to $150 allowance for in-network or out-of-network childbirth classes provided by a covered provider or facility.
two people icon 

Order your breast pump

Your breast pump benefit covers one dual suction, double-channel electric breast pump at 100%, with a physician’s prescription, every 12 months when purchased from an in-network provider (such as your OB/GYN). A new prescription is required when requesting a new or replacement pump. Additional pumps may be obtained at your expense. Limit to one pump every 12 months with birth/delivery.

To see if your preferred breast pump is available from an in-network provider, visit
geha.com/Maternity-Program

Health Rewards


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How it works

This program gives two adult members per household (age 18+) the opportunity to earn Health Rewards for participating in activities that promote healthy behavior.
Earn your rewards
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Your Health Rewards reloadable debit card

After completing your first eligible rewards activity, you’ll automatically receive a Health Rewards reloadable debit card in the mail. Rewards are credited to your account once you complete a rewardable activity on our digital platform or once GEHA receives claims notification of a rewardable activity.
Activate your account
Two hands with a trophy 

Redeeming your rewards

You can spend your available rewards on all 213(d) qualified medical expenses – such as eyeglasses or contacts, orthodontics, doctor visits and dental care – using your Health Rewards reloadable debit card.
Use your rewards

Resources


Plan documents

Topic
Resource
2024 High Plan Brochure Download (PDF)
2024 High Member Guide Browse the e-book
2024 Medical Benefits Guide Browse the e-book
2024 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