Elevate Plus 2022
Highlights:
- No deductible. Copays for most common services.
- Low copays for non-traditional care, like chiropractic and acupuncture
- Engaging digital wellness portal
- NOTE: This plan has no out-of-network coverage
How this plan pays you back:
- NEW! Subscribers can select an annual plan perk. Options include a SilverSneakers fitness benefit, 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 Plus rates*
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Biweekly – employed | $79.13 | $182.51 | $190.63 |
| Monthly – retired | $171.44 | $395.44 | $413.04 |
*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 with MDLIVE | $0 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Lab services | $0 |
| Maternity; routine preventive care | $0 |
| MinuteClinic (where available) | $10 |
| Primary physician office visit | $25 |
| Chiropractic care (manipulative therapy), including X-rays; up to 15 visits per year | $25 |
| Acupuncture; up to 20 treatments per year | $25 |
| Specialist care; office visit | $40 |
| Urgent care | $50 |
| Other diagnostic services | $501 |
| In-office professional surgical services | $75 |
| Emergency care | $200 |
| Outpatient and inpatient professional surgical services | $200 |
| Hospital care; inpatient including maternity | $250 per day up to $1,000 per admission |
| Hospital care; outpatient | $250 per day per facility |
1You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA's 2022 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete
list.
Prescriptions – 30-day supply
The table below summarizes your cost for prescription drugs with the Elevate Plus plan. For details on specialty drugs that are injected or infused, check the GEHA Plan Brochure. For added convenience and management of medications, prescription benefits include access to presorted multi-dose packets. Packets can be delivered to your home or, if available, picked up at a retail location. To find drug costs with the Elevate Plus plan, use this handy check your drug costs tool.| In-network | Out-of-network | |
|---|---|---|
| Generic | $10 | You pay 100% of all charges |
| Preferred brand-name | $80 copay¤ | You pay 100% of all charges |
| Non-preferred brand-name | 50% of allowance¤ | You pay 100% of all charges |
Mail service pharmacy
| In-network | Out-of-network | |
|---|---|---|
| Generic | $20 | n/a |
| Preferred brand-name | $200 or the cost of the drug, whichever is less¤ | n/a |
| Non-preferred brand-name | 50% 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.
Highlights that are special to Elevate Plus
Digital Health Care
GEHA's digital platform provides a fun way to stay motivated and earn up to $500 per person.
$0 Telehealth Visits
Access certified doctors, including pediatricians, licensed behavioral health therapists and dermatologists.
Surgical Concierge
$0 out-of-pocket surgery costs. Your dedicated Care Coordinator will help you every step of the way.
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.
2022 Medical Benefits Guide
Review this guide with all our plans, including rates, costs, extra services, and side-by-side comparisons
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Our Benefits Advisers are available Mon. – Fri. from 7 a.m. – 7 p.m. Central time and are ready to answer your questions.
If you’re a current GEHA member and need help, call 800.821.6136 (medical) or 877.434.2336 (dental).
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