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Medicare Benefits

GEHA plans work with Medicare to offer special benefits retirees really appreciate.

  • Freedom of choice – see any doctor you choose with no referral needed for specialists. (However, you might need prior plan approval for certain services.)
  • When you are enrolled in GEHA's High Option or Standard Option plan, GEHA will waive or reduce some out-of-pocket costs if Medicare Part A & B is your primary payer.
  • With Medicare A & B primary, benefits are the same whether or not your provider is in our network.
  • No deductible or copays for surgical and medical benefits.
  • No coinsurance for other inpatient hospital charges when Medicare A & B is primary.
  • Pays 100%, up to the plan allowance, for routine physicals and checkups if Medicare doesn't cover them.
  • Vision coverage included with no additional premium, plus discounts on glasses and contact lenses.*
  • No hassles and no paperwork – GEHA Express files Medicare claims electronically.
  • Your health coverage goes wherever you travel, even overseas.
  • Special savings on dental care and hearing aids at no additional cost

These benefits apply only when Medicare is the primary carrier.

The chart above describes GEHA Standard Option and High Option benefits for patients who have Medicare Parts A & B as their primary insurance. When the patient has Medicare Parts A & B primary, the benefits are the same whether inside or outside the GEHA preferred provider network. However, the Health Savings AdvantageSM plan requires that members with Medicare pay coinsurance and a deductible. Please see the Health Savings Advantage benefits page for details.

If the patient has Medicare A only, Medicare B only or a Medicare prepaid plan, please refer to the Medicare section in the GEHA Plan Brochure.

Click here to find out how to enroll in any GEHA health plan. Our free How to Choose a Health Plan brochure can help you select the federal health plan that's right for you and your family.

* Connection Vision® powered by EyeMed benefits are not part of the FEHB contract or premium.