Standard
Welcome to your medical plan page
What’s new in 2022
- Standard members pay the specialist $30 copay for chiropractic care. This includes X-ray coverage. The cost share will be waived for Standard plan members with Medicare A and B primary.
- Nutritional counseling is covered at 100% in-network.
Standard coverage
Yearly deductible in-network1
| Plan type | What you pay |
|---|---|
| Self Only | $350 |
| Self Plus One | $700 |
| Self and Family | $700 |
Out-of-pocket max in-network1,2
| Plan type | What you pay |
|---|---|
| Self Only | $6,500 |
| Self Plus One | $13,000 |
| Self and Family | $13,000 |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard).
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.
Medical benefits in-network1
| Benefit | What you pay |
|---|---|
|
$0 |
| $10 | |
|
$15 |
|
$30 |
| $35 | |
|
15% |
|
15%2 |
|
50% |
|
$100 |
|
$150 |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard)
2 Calendar year deductible applies.
Your prescription benefits
In-network benefits.1 Visit geha.com/Prescriptions to learn more.2
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
$10 50% ($200 max3) 50% ($300 max3) |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
$20 50% ($500 max3) 50% ($600 max3) |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
50% ($250 max) 50% ($250 max3) 50% ($400 max3) |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard).
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.
Medicare + Standard coverage
Yearly deductible with Medicare A & B primary1
| Plan type | What you pay |
|---|---|
| Self Only | $0 |
| Self Plus One | $0 |
| Self and Family | $0 |
Out-of-pocket max in-network1,2
| Plan type | What you pay |
|---|---|
| Self Only | $6,500 |
| Self Plus One | $13,000 |
| Self and Family | $13,000 |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard).
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.
Standard + Medicare medical benefits
With Medicare A & B primary, go to any provider that accepts Medicare assignment1| Benefit | What you pay |
|---|---|
|
$0 |
|
50% |
1 Refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard)
Your prescription benefits
In-network benefits.1 Visit geha.com/Prescriptions to learn more.2
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
$10 50% ($200 max3) 50% ($300 max3) |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
$20 50% ($500 max3) 50% ($600 max3) |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
50% ($250 max) 50% ($250 max3) 50% ($400 max3) |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-006 (High and Standard).
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.
Included benefits & savings
Pharmacy benefits
Retail pharmacy
Mail service pharmacy
Estimate medication costs
CVS ExtraCare Health Benefit
Your exclusive discounts
Vision discount1,2
Medical alert discount1
Hearing aid discount1,3
Electric toothbrush discount1,4
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 Only when you visit an EyeMed provider.
3This benefit is per person, every 36 months for adults. TruHearing discount pricing can be combined with the hearing aid benefit for even greater savings.
4The cariPROTM 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 DuPontTM bristles are also available at this exclusive, member-only price.
Find care
Choose the right care
Other care resources
Maternity resources
Your care team
Second Opinion
Health Rewards
How it works
Your Health Rewards card
Redeeming your rewards
Resources
Plan documents
| Topic |
Resource |
|---|---|
| 2022 Standard Plan Brochure | Download (PDF) |
| 2022 Standard Member Guide | Browse the e-book |
| 2022 Medical Benefits Guide | Browse the e-book |
| 2022 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 |
This is a brief description of the features of the Standard Option plan. Please read the Plan’s Federal brochure (RI 71-006). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.