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Standard medical 2023

Comprehensive coverage for all life stages

View the 2022 Standard Plan

Highlights:

  • Dependable, traditional coverage
  • Affordable premiums and low copays for common services
  • 100% maternity coverage

How this plan pays you back:

  • Up to two adults 18 and over can earn up to $250 (maximum $500 per household) per year in Health Rewards

2023 Standard rates


Self Only Self Plus One Self and Family
Biweekly — employed $68.77 $147.87 $180.92
Monthly — retired $149.01 $320.39 $392.00

Costs (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 $0
Preventive care; adult routine screenings $0
Well-child visit; up to age 22 $0
Maternity; routine care $0
Maternity; inpatient care $0
QuestSelect™ Lab Benefit (formerly Lab Card®) $0
Vision coverage; eye exams1 $5
MinuteClinic (where available) $10
Primary physician office visit $20
Mental health office visit $20
Specialist care office visit $35
Urgent care facility $35
Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year $35
Lab services other than QuestSelect 15%
ER visit 15%2
Hospital care; inpatient and outpatient 15%2
Professional surgical services 15%2
X-ray and other diagnostic services 15%2
Acupuncture; up to 20 treatments per year 15%2
Preventive dental care, twice yearly 50%
Outpatient professional High Tech Imaging (MRI, CT, PET, etc.) $100
Outpatient facility High Tech Imaging (MRI, CT, PET, etc.) $150

Deductible and out-of-pocket max (in-network)


Self Only Self Plus One Self and Family
Yearly deductible (what you pay in-network) $350 $700 $700
Out-of-pocket-max (what you pay in-network) $6,500 $13,000 $13,000

Prescription benefits

The table below summarizes your cost for prescription drugs with the Standard 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 Standard plan, use this handy check your drug costs tool.

In-network
30-day retail generic $10
30-day retail preferred brand-name 50%, up to $200 max¤
30-day retail non-preferred brand-name 50%, up to $300 max¤
90-day mail service generic $20
90-day mail service preferred brand-name 50%, up to $500 max¤
90-day mail service non-preferred brand-name 50%, up to $600 max¤
30-day specialty CVS exclusive generic and preferred brand-name 50%, up to $250 max¤
30-day specialty CVS exclusive non-preferred brand-name 50%, up to $400 max¤

Highlights that are special to Standard

Health Rewards

Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year.

Vision coverage

Get in-network routine eye exams for $5 and discounts on eyewear.

 

Pregnancy and childbirth

GEHA maternity benefits include discounts on breast pumps and rewards for visiting your provider.

cover image for the 2023 geha medical benefits guide

2023 Medical Benefits Guide


Review this guide with all our plans, including rates, costs, extra services, and side-by-side comparisons


Our Benefits Advisers are available Mon. – Fri. from 7 a.m. – 7 p.m. Central time and are ready to answer your questions.
Are you a current GEHA member?
Medical questions: 800.821.6136
Dental questions: 877.434.2336

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