A low premium – and a lower-than-expected deductible.

High Deductible Health Plan 2020

View the 2019 High Deductible Health Plan

Take advantage of comprehensive coverage and funds you can use to pay for future health care expenses.

This plan pairs lower premiums with a health savings account (HSA) or a health reimbursement arrangement (HRA).

Why you might like the HDHP:

Pay nothing for in-network preventive medical care.
You pay only 5% of medical services after your deductible is met.
With our premium pass-through, GEHA contributes to your HSA/HRA to lower your net deductible.
Vision benefits are included and you pay nothing for in-network preventive dental treatment, which includes two checkups and one X-ray annually.
Your in-network out-of-pocket maximum for 2020 is only $5,000 for Self Only, or $10,000 for Self Plus One or Self and Family.

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.

	Self Only	Self Plus One	Self and Family
Non-Postal biweekly	$59.29	$127.48	$150.04
Postal biweekly – Category 1	$56.92	$122.38	$144.04
Postal biweekly – Category 2	$49.21	$105.81	$124.53
Monthly (retirees)	$128.46	$276.20	$325.09

Preventive care covered 100%

Like all GEHA plans, this plan covers 100% percent of preventive care costs if you see an in-network provider. Once you meet your annual deductible GEHA pays 95% of most in-network care.

Savings for the future

If you have an HSA, you can make additional deposits into the account. Your savings can be invested through HSA Bank and continue to grow until you decide to use them.^#

GEHA’s contribution

GEHA deposits $900 a year for Self Only; $1,800 for Self Plus One or Self and Family into your HSA or HRA.

Possibility to earn tax-free interest

Any HSA money you don’t spend can earn tax-free interest, allowing you to plan for future health expenses all the way through retirement. If you leave your current job or leave federal employment, any money in your account is yours to keep.

Costs for services in 2020

The table below summarizes your in-network cost for medical benefits with GEHA's High Deductible Health Plan. For complete information, refer to the GEHA Plan Brochure.

Copays

Copay	What you pay in-network
Primary physician office visit	5% after deductible*
Specialist	5% after deductible*
MinuteClinic (where available)	5% after deductible*
Urgent care	5% after deductible*
Routine eye exam	$5 through EyeMed

Other services

Service	What you pay in-network
Preventive lab services	Nothing
Well-child visits; up to age 22	Nothing
Adult routine screening	Nothing
Preventive dental care; twice yearly	Nothing

Maternity care

Service	What you pay in-network
Routine provider care	Nothing after deductible*
Inpatient care	Nothing after deductible*

Out-of-pocket maximums and yearly deductibles

	Self Only	Self Plus One	Self and Family
Out-of-pocket-maximum (in-network)	$5,000	$10,000	$10,000
Calendar-year deductible (in-network)	$1,500	$3,000	$3,000
GEHA’s HSA/HRA premium pass-through contribution	$900	$1,800	$1,800
Net deductible after pass-through¹	$600	$1,200	$1,200

¹Your “net deductible after pass-through” is the bottom-line amount you owe for health care services before GEHA begins to pay. If you have GEHA’s High Deductible Health Plan, GEHA’s pass-through contribution reduces your net deductible.

Prescriptions

The table below summarizes your cost for prescription drugs with GEHA’s HDHP. 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.

Retail pharmacy – 30-day supply

	In-network	Out-of-network
Generic and preferred brand-name medication	25% of plan allowance, after deductible*¤	25% of plan allowance, after plan deductible,* plus difference between GEHA allowance and the cost of the drug¤
Non-preferred brand-name medication	40% of plan allowance, after deductible*¤	40% of plan allowance, after plan deductible,* plus difference between GEHA allowance and the cost of the drug¤

Mail service pharmacy – 90-day supply

	In-network	Out-of-network
Generic or preferred brand-name medication	25% of plan allowance, after deductible*¤	n/a
Non-preferred brand-name medication	40% of plan allowance, after deductible*¤	n/a

*Under the High Deductible Health Plan (HDHP), your deductible is $1,500 for Self Only coverage, and $3,000 for Self Plus One or Self and Family coverage. With the exception of preventive care, vision and dental, you must pay the full deductible before GEHA pays for your health care. You can use funds in your health savings account or health reimbursement arrangement to cover your deductible and other medical expenses.

¤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.

Videos: How an HSA or an HRA works with an HDHP

Key plan features

VISION BENEFITS

The HDHP is GEHA's only plan that includes generous vision benefits for eye exams, frames and lenses, especially if you stay in-network.

LEARN MORE

HEALTH REWARDS

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

LEARN MORE

ELECTRIC TOOTHBRUSH DISCOUNT

All GEHA members can buy a premium electric toothbrush by cariPRO at a discounted price of $27.99 plus shipping and handling.

LEARN MORE

^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.

^# To open an HSA, you must meet IRS eligibility requirements. Contribution amounts are subject to IRS limits. Please see the plan brochure for more information.

This is a brief description of the features of the GEHA High Deductible Health Plan (HDHP). Before making a final decision, please read the Plan’s Federal brochure RI 71-014. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.