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Standard

Welcome to your medical plan page

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What’s new in 2023

  • There is an out-of-network deductible of $700 for Self Only and $1,400 for Self Plus One or Self and Family. The in-network deductible remains the same, $350 for Self Only and $700 for Self Plus One or Self and Family.
  • Primary care physician copay increasing from $15 to $20
  • Specialist visit copay is increasing from $30 to $35
  • Prescription copay maximums apply per each 30-day supply at retail and CVS Specialty
  • Preventive colorectal cancer screening covered at age 45 instead of 50
  • Prediabetes screening covered at age 35 instead of 40. Unlimited diabetes education provided.
For a complete list of plan changes, download the plan brochure.
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Standard 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 max in-network1,2 You pay
Self Only $6,500
Self Plus One or Self and Family $13,000

Your medical benefits

Medical benefits in-network1 You pay
$0
  • Vision coverage; eye exams2
$5
$10
  • Primary physician office visit
  • Mental health office visit
$20
  • Specialist care; office visit
  • Urgent care facility
  • Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year
$35
  • Lab services (other than QuestSelect)
15%
  • ER visit
  • Hospital care; inpatient and outpatient
  • Professional surgical services
  • X-ray and other diagnostic services
  • Acupuncture; up to 20 treatments per year
15%3
  • Preventive dental care; twice yearly
50%
  • Outpatient professional High Tech Imaging (MRI, CT, PET, etc.)
$100
  • Outpatient facility High Tech Imaging (MRI, CT, PET, etc.)
$150

Your prescription benefits

Prescription benefits in-network1,2 You pay
30-day retail generic $10
30-day retail preferred brand-name 50% ($200 max3)
30-day retail non-preferred brand-name 50% ($300 max3)
90-day mail service generic $20
90-day mail service preferred brand-name 50% ($500 max3)
90-day mail service non-preferred brand-name 50% ($600 max3)
30-day specialty CVS exclusive generic and preferred brand-name 50% ($250 max)
30-day specialty CVS exclusive non-preferred brand-name 50% ($400 max3)

Standard and Medicare coverage


Yearly deductible with Medicare A & B primary1

Yearly deductible with Medicare A & B primary1 You pay
Self Only $0
Self Plus One or Self and Family $0

Out-of-pocket maximum

Out-of-pocket max in-network1,2 You pay
Self Only $6,500
Self Plus One or Self and Family $13,000

Standard and Medicare medical benefits

Medical benefits with Medicare A & B primary in-network1,2 You pay
$0
  • Vision coverage; eye exams3
$5
  • Preventive dental care, twice yearly
50%

Standard and Medicare prescription benefits

Prescription benefits in-network1,2 You pay
30-day retail generic $10
30-day retail preferred brand-name 50% ($200 max3)
30-day retail non-preferred brand-name 50% ($300 max3)
90-day mail service generic $20
90-day mail service preferred brand-name 50% ($500 max3)
90-day mail service non-preferred brand-name 50% ($600 max3)
30-day specialty CVS exclusive generic and preferred brand-name 50% ($250 max)
30-day specialty CVS exclusive non-preferred brand-name 50% ($400 max3)

Included benefits & savings



Pharmacy benefits

Retail pharmacy

Fill your prescriptions at more than 66,000 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.® The EyeMed network includes Independent Provider Network, LensCrafters, Pearle Vision, Target Optical, contactsdirect.com, glasses.com and more. 
Learn more
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Medical alert discount1

Get free activation, plus a 10% monthly discount, for responsive emergency help for you and your extended family.
Learn more
Hearing aid 

Hearing aid discount1,2

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

Electric toothbrush discount1,3

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




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.

Nurse Advice Line
Talk to a nurse 24/7/365 at no cost.
MinuteClinic©
Local care for minor issues.
Telehealth
$0 unlimited visits with MDLIVE, including mental health.
Urgent care
Convenient local care option.
Primary and specialty care
Non-emergency doctor care.
Emergency room
Life threatening issues.
Suicide and Crisis Lifeline
Mental health, emotional distress or suicidal crisis-related emergencies.

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

Health Rewards


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How it works

This program gives two adult members per household (age 18+) the opportunity to earn up to $250 each (maximum $500 per household per year) in Health Rewards for participating in activities that promote healthy behavior.
Earn your rewards
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Your Health Rewards 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
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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
2023 Standard Plan Brochure Download (PDF)
2023 Standard 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