Our lowest premium plan.
- Our lowest premium plan
- Low copays for doctor visits, and chiropractic and acupuncture visits
- Engaging digital wellness portal powered by Rally Health
How this plan pays you back:
- NEW! Subscribers can select an annual plan perk. Options include a Fitbit wearable device including monthly Fitbit Premium Membership, a $125 gift card for DICK'S Sporting Goods or REI, or a Daily Burn virtual fitness subscription.
- Earn up to $500 (maximum $1,000 per household) in Wellness Pays annually
2022 Elevate rates*
|Self Only||Self Plus One||Self and Family|
|Biweekly – employed||$48.74||$112.11||$136.48|
|Monthly – retired||$105.61||$242.90||$295.71|
*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 (what you pay in-network)In-network providers agree to limit what they will charge you. You pay a fixed dollar amount or a percentage of the provider’s negotiated amount. For out-of-network benefits, check the GEHA Plan Brochure.
|What you pay|
|Unlimited telehealth visits, including behavioral health, with MDLIVE||$0|
|Preventive care; adult routine screenings||$0|
|Well-child visit; up to age 22||$0|
|Maternity; routine care||$0|
|Primary physician office visit||$10|
|MinuteClinic (where available)||$10|
|Chiropractic care (manipulative therapy), including X-rays; up to 12 visits per year||$10|
|Acupuncture; up to 20 treatments per year||$10|
|Specialist care; office visit||$25|
|Urgent care facility||$50|
|Hospital care; including inpatient maternity||25%1|
|Hospital care; outpatient||25%1|
|Other diagnostic services||25%1|
|Outpatient professional surgical services||25%1|
|Inpatient professional surgical services||$250|
The table below summarizes your cost for prescription drugs with GEHA’s Elevate 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.
Retail pharmacy – 30-day supply
|What you pay in-network||What you pay out-of-network|
|Generic||$4 copay||You pay 100% of all charges|
|Preferred brand-name||50% of allowance up to $500 max||You pay 100% of all charges|
|Non-preferred brand-name||You pay 100% of all charges||You pay 100% of all charges|
Mail service pharmacy – 90-day supply
|The mail service pharmacy is not available for the Elevate plan.|