2019 High Option


GEHA’s High Option is a smart pick if you take brand-name prescription drugs because it includes comprehensive prescription coverage with potentially the lowest out-of-pocket costs.

Personalize your rates

The pricing information displayed below is based on your home location of
in
as a
who needs coverage for

These rates do not apply to all enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer that maintains your health benefits enrollment.

The table below summarizes your in-network cost for medical benefits with GEHA High Option. For complete information see the GEHA Plan Brochure.

  • Non-Postal biweekly
  • Postal biweekly – Category 1
  • Postal biweekly – Category 2
  • Monthly (retirees)
  • Non-Postal biweekly
  • Postal biweekly – Category 1
  • Postal biweekly – Category 2
  • Monthly (retirees)
  • Non-Postal biweekly
  • Postal biweekly – Category 1
  • Postal biweekly – Category 2
  • Monthly (retirees)
  • Non-Postal biweekly
  • Postal biweekly – Category 1
  • Postal biweekly – Category 2
  • Monthly (retirees)

Category 1: Postal Category 1 rates apply to career bargaining unit employees who are represented by the following agreements: APWU, IT/AS, NALC, NPMHU, and NRLCA.

Category 2: Postal Category 2 rates apply to career bargaining unit employees who are represented by the following agreement: PPOA.

What you can expect to pay for services in 2019

The information below is for Self Only, Self Plus One, and Self and Family coverage. For complete information, refer to the GEHA Plan Brochure.

Enrolled in Medicare? Visit Medicare + GEHA to see how GEHA works with Medicare.

Cost of Services In-Network
Copays
Primary physician and Specialist$20
MinuteClinic (where available)$10
Urgent Care$35
Annual eye exam$5 through EyeMed
Other services
Covered lab services$0, through Lab Card
Well child visits; up to age 22$0
Routine adult screenings$0, 100% coverage
Dental diagnostic/preventiveBalance, after GEHA pays $22 per visit, 2 times/year
Maternity care
From a physician or when you go to the hospital$0, 100% coverage
Hospital/facility care
Inpatient (you must pre-certify)$100 per admission copay, 10% of other charges
Outpatient, emergency room and other charges10% of allowance (calendar-year deductible applies)

Out-of-pocket maximums and yearly deductibles

  • Out-of-pocket-maximum
  • Calendar-year deductible
  • GEHA’s HSA/HRA premium pass-through contribution
  • Net deductible after pass-through
  • Out-of-pocket maximum
  • Calendar-year deductible
  • GEHA’s HSA/HRA premium pass-through contribution
  • Net deductible after pass-through
  • Out-of-pocket maximum
  • Calendar-year deductible
  • GEHA’s HSA/HRA premium pass-through contribution
  • Net deductible after pass-through
  • Out-of-pocket maximum
  • Calendar-year deductible
  • GEHA’s HSA/HRA premium pass-through contribution
  • Net deductible after pass-through

Prescription benefits

The table below summarizes your cost for prescription drugs with GEHA High Option. For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure.

To find a drug cost based on your benefit plan and prescription dosage, check your drug costs.

Enrolled in Medicare? Visit Medicare + GEHA to see how GEHA works with Medicare.

In-NetworkOut-of-Network
Retail pharmacy — 30-day supply
Generic$10$10 copay‡# plus difference between plan and drug cost
Preferred brand-name medication25%, up to $150 max‡¤25%, up to $150 max‡¤#
Non-preferred brand-name medication40%, up to $200 max‡¤40%, up to $200 max‡¤#
Mail-order pharmacy — 90-day supply
Generic$20n/a
Preferred brand-name medication25%, up to $350 max¤n/a
Non-preferred brand-name medication40%, up to $500 max¤n/a

Savings^

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Vision Coverage

Get $5 annual eye exams and discounts on eyewear.
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hearing-aid discounts

Save 30% to 60% off the average retail price of hearing aids.
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teeth whitening

Save 20% as you whiten your teeth from the comfort of home.
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health rewards

Up to $250 in incentives for members who complete simple and convenient health screenings.
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gym discounts

Access over 9,000 fitness centers nationwide for $25 a month (plus a $25 enrollment fee and taxes).
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medical alert system

Get discounted emergency response services from Life Alert.