Standard medical 2023
Comprehensive coverage for all life stages
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 |
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 (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 |
1These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a GEHA medical plan and their eligible family members.
2Calendar year deductible applies.
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¤ |
¤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 Standard
Health Rewards
Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year.
Pregnancy and childbirth
GEHA maternity benefits include discounts on breast pumps and rewards for visiting your provider.
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 Standard Option medical plan. Before making a final decision, please read the Plan’s Federal brochure RI 71-006. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.
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 to help new shoppers Mon. – Fri. from 7 a.m. – 7 p.m. Central time.
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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 71-006. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.