Elevate Plus 2024
The conventional plan for proactive people who always stay in-network
- Low copays for non-traditional care, like chiropractic and acupuncture
- $200 deductible for Self Only. $400 deductible for Self Plus One and Self and Family. 15% coinsurance for some services.
- Copays for most common services.
- Specialist copay of $50 per visit
- Earn rewards with the Rally® digital health platform
- Mental health benefit, including telehealth, from MDLIVE
- Vision discounts and $0 annual eye exam included with EyeMed1
2024 Elevate Plus rates
|Pay frequency||Self Only||Self Plus One||Self and Family|
|Biweekly — employed||$102.55||$232.73||$253.08|
|Monthly — retired||$222.19||$504.25||$548.34|
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.
|Medical benefit||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; preventive prenatal and postnatal office visits||$0|
|Maternity; childbirth/delivery professional services||$0|
|Vision coverage; eye exams1||$0|
|MinuteClinic visit (where available)||$10|
|Primary care physician office visit||$30|
|Mental health office visit||$30|
|Chiropractic care (manipulative therapy), including X-rays; up to 15 visits per year||$30|
|Acupuncture; up to 20 visits per year||$30|
|Specialist care office visit||$50|
|Urgent care facility visit||$50|
|X-rays and other diagnostic services||$502|
|Maternity; childbirth/delivery facility services||15%3|
|Hospital care; inpatient and outpatient||15%3|
|Outpatient and inpatient professional surgical services||15%3|
2You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA's 2024 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete list.
3Calendar year deductible applies.
Prescription benefitsThe table below summarizes your cost for prescription drugs with the Elevate Plus plan. This plan has no out-of-network pharmacy coverage. 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.
|30-day retail generic||$10|
|30-day retail preferred brand-name||$80 copay¤|
|30-day retail non-preferred brand-name||50% of allowance¤|
|90-day mail service generic||$20|
|90-day mail service preferred brand-name||$200¤|
|90-day mail service non-preferred brand-name||50% of allowance¤|
|30-day specialty CVS exclusive generic and preferred brand-name||40% of allowance ($500 max¤)|
|30-day specialty CVS exclusive non-preferred brand-name||50% of allowance¤|
Highlights that are special to Elevate Plus
Digital health care
$0 telehealth visits
1 These benefits are neither offered nor guaranteed under contract with the FEHB Program but are made available to all Enrollees who become members of the GEHA Elevate Plus plan and their eligible family members. For information on year-round savings for GEHA dental members, visit Savings for GEHA dental members.