HDHP 2023
Most popular HDHP for federal employees
Highlights:
- Low premiums with a lower net deductible than many traditional FEHB plans
- Reduce out-of-pocket expenses and enjoy a triple tax advantage with a health savings account (HSA)^
- GEHA puts money in your HSA. Use your HSA money to reduce your net deductible or save it and let it grow tax-free^
How this plan pays you back:
- GEHA contributes $900 (Self Only) or $1,800 (Self Plus One or Self and Family) to your HSA
- Earn up to $250 (maximum $500 per household) per year in Health Rewards
2023 HDHP rates
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Biweekly — employed | $69.37 | $149.15 | $183.28 |
| Monthly — retired | $150.30 | $323.15 | $397.11 |
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 mental health, with MDLIVE | $01,2 |
| Maternity; routine care | 0%1 |
| Maternity; inpatient care | 0%1 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Preventive dental care, twice yearly | $0 |
| Vision coverage; eye exam and additional benefits | $5 |
| Primary physician office visit | 5%1 |
| Mental health office visit | 5%1 |
| Specialist care office visit | 5%1 |
| Urgent care facility | 5%1 |
| ER visit | 5%1 |
| Hospital care; inpatient and outpatient | 5%1 |
| MinuteClinic (where available) | 5%1 |
| Lab services | 5%1 |
| Other diagnostic services | 5%1 |
| Professional surgical services | 5%1 |
| Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year | 5%1 |
| Acupuncture; up to 20 treatments per year | 5%1 |
2 If deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charge.
Deductible and out-of-pocket max (in-network)
Prescription benefits
The table below summarizes your cost for prescription drugs with GEHA’s HDHP. For details on specialty drugs that are injected or infused, check the GEHA Plan Brochure.| What you pay in-network | |
|---|---|
| 30-day retail generic | 25% of plan allowance, after deductible* |
| 30-day retail preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 30-day non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
| 90-day mail service generic | 25% of plan allowance, after deductible* |
| 90-day mail service preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 90-day mail service non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
| 30-day specialty CVS exclusive generic and preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 30-day specialty CVS exclusive non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
*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
2023 Medical Benefits Guide
Highlights that are special to HDHP
Vision benefits
Health Rewards3
$0 telehealth visits4
For information on year-round savings for GEHA dental members, visit Savings for GEHA dental members.
3 HDHP + HSA members can use their rewards on qualified dental and vision care expenses until they meet their deductible. Then, all eligible medical and pharmacy expenses qualify, too.
4 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the plan allowance.
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.
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