a new plan for those who expect the unexpected
Elevate Plus
No deductible when you use in-network providers. Copays for most common medical expenses.
Elevate Plus offers a balance of predictable costs for in-network services, along with personalized concierge support to help you get the most value out of your plan.
When you enroll in Elevate Plus option, you get:
- Fixed costs. No in-network deductible. Know what you’re paying upfront for many common services. Simple and straightforward, so you can focus on care.
- Out-of-network coverage.
- Digital tools to navigate your health care experience. Our personalized programs help you get the most out of your plan.
- Free 24/7 online doctor visits. Health care on your terms. Get online access to doctors, including dermatologists and licensed therapists through MDLIVE.
- Your bridge to better health. Get the highest quality of care for the widest range of surgical services, all at no additional cost.
2020 Rates
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.
Costs for services in 2020
The table below summarizes your in-network cost for medical benefits with GEHA's Elevate Plus plan. For complete information, refer to the GEHA Plan Brochure.
Copays
| Copay | What you pay in-network |
|---|---|
| Primary physician office visit | $20 |
| Specialist | $35 |
| MinuteClinic (where available) | $10 |
| Urgent care | $50 |
| Annual eye exam | $0 through EyeMed |
Other services
| Service | What you pay in-network |
|---|---|
| Preventive lab services | Nothing |
| Well-child visit; up to age 22 | Nothing |
| Adult routine screening | Nothing |
Maternity care
| Service | What you pay in-network |
|---|---|
| Routine provider care | Nothing |
| Inpatient care | $200 per day, up to $1,000 per admission |
Out-of-pocket maximums and yearly deductibles
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Calendar-year deductible (in-network) | $0 | $0 | $0 |
| Out-of-pocket-maximum (in-network) | $6,000 | $12,000 | $12,000 |
Prescriptions
The table below summarizes your cost for prescription drugs with GEHA’s Elevate Plus plan. 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.
You should know ... this plan includes a comprehensive drug list and mail order service. Retail prescriptions can only be picked up at an in-network pharmacy location. If your pharmacy location is a priority, you can evaluate available pharmacy locations and your prescription costs at info.caremark.com/GEHA.
Retail pharmacy – 30-day supply
| What you pay in-network | What you pay out-of-network | |
|---|---|---|
| Generic | $5 | You pay 100% of all charges |
| Preferred brand-name | $80 copay¤ | You pay 100% of all charges |
| Non-preferred brand-name | 40% of allowance¤ | You pay 100% of all charges |
Mail service pharmacy – 90-day supply
| What you pay in-network | What you pay out-of-network | |
|---|---|---|
| Generic | $12 | n/a |
| Preferred brand-name | $200 or the cost of the drug, whichever is less¤ | n/a |
| Non-preferred brand-name | 40% of allowance¤ | n/a |
¤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.
Key plan features
DIGITAL HEALTH CARE
ONLINE DOCTOR VISITS
SURGICAL CONCIERGE
^GEHA supplemental benefits are neither offered nor guaranteed under contract with the FEHB, but are made available to all enrollees and family members who become members of a GEHA medical plan. For information on year-round savings for GEHA dental members, visit Savings for GEHA dental members.
This is a brief description of the features of the GEHA Elevate Plus medical plan. Before making a final decision, please read the Plan’s Federal brochure RI 71-018. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.