The plan of choice of Medicare enrollees.
High Option 2020View the 2021 High Option plan
A smart pick if you take brand-name prescription drugs.
New: A $600 Medicare Part B premium reimbursement.
You work hard to maintain your health and live a healthy lifestyle. In 2020, count on GEHA’s High Option plan to support you on your wellness journey.
Maybe you depend on brand-name prescription medications. Maybe you’re a Medicare A&B enrollee looking for a $600 reimbursement to help with your Medicare Part B premium payments. Maybe you’ve simply reached that point in life where you’re willing to spend a little more for a premium plan that gives you the confidence to live life to its fullest. High Option was designed with you in mind.
When you enroll in GEHA’s High Option, you’ll get:
- Comprehensive prescription coverage that works with Medicare.
- Get a $2,500 hearing-aid allowance.
More High Option highlights:
- Combines a $600 reimbursement for Medicare Part B premiums with a cost-share waiver, making High Option the plan of choice of Medicare enrollees.
- Low out-of-pocket costs when you need care.
- Similar to other plans, you get worldwide coverage that lets you travel abroad worry-free.
2020 RatesThese 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.
Plan of choice for Medicare enrollees
The combination of a $600 reimbursement for Medicare Part B premiums with a cost-share waiver, makes the High Option the plan of choice for Medicare enrollees.
Low copays for office visits
In-network doctor visit copays are an affordable $20.
Low copays for generic prescriptions
You can get 30-day supplies of generic drugs for just $10.
Coverage for specialty drugs
Limit your out-of-pocket costs for specialty prescriptions and preferred brand-name medicines.
Costs for services in 2020
The table below summarizes your in-network cost for medical benefits with GEHA High Option. For complete information, refer to the GEHA Plan Brochure.
|Copay||What you pay in-network|
|Primary physician office visit||$20|
|MinuteClinic (where available)||$10|
|Routine eye exam||$5 through EyeMed|
|Service||What you pay in-network|
|Preventive lab services||Nothing with Lab Card|
|Well-child visit; up to age 22||Nothing
|Adult routine screening||Nothing
|Preventive dental care||Balance after GEHA pays $22/visit, twice yearly|
|Service||What you pay in-network|
|Routine provider care||Nothing|
Out-of-pocket maximums and yearly deductibles
|Self Only||Self Plus One||Self and Family|
|Calendar-year deductible (in-network)||$350||$700||$700|
The table below summarizes your cost for prescription drugs with GEHA’s 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.
Retail pharmacy – 30-day supply
|Generic||$10 copay‡||$10 copay‡# plus difference between plan and drug cost|
|Preferred brand-name||25%, up to $150 max‡¤||25%, up to $150 max‡¤#|
|Non-preferred brand-name||40%, up to $200 max‡¤||40%, up to $200 max‡¤#|
Mail service pharmacy – 90-day supply
|Preferred brand-name||25%, up to $350 max¤||n/a|
|Non-preferred brand-name||40%, up to $500 max¤||n/a|
‡Costs for initial prescription and first refill. You pay 50% for third and additional refills at retail for 30-day supply. For long-term prescriptions, use mail order or your local retail CVS Pharmacy store (90-day supply) for greater cost savings.
¤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.
#Your claim will be calculated on the coinsurance or the appropriate copayments. Reimbursement will be based on GEHA’s costs had you used a participating pharmacy. You must submit original drug receipts.