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:
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's Elevate Plus plan. For complete information, refer to the GEHA Plan Brochure.
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 |
Service | What you pay in-network |
---|---|
Preventive lab services | Nothing |
Well-child visit; up to age 22 | Nothing |
Adult routine screening | Nothing |
Service | What you pay in-network |
---|---|
Maternity; routine preventive care | Nothing |
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 |
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.
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 |
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.
^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.