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High medical 2024

The dependable plan for people who need maximum coverage

View the 2023 High plan

Highlights:

  • Low copays for doctor visits
  • Comprehensive brand-name and specialty prescription coverage
  • Waived coinsurance and copays for Medicare enrollees, excluding prescription benefits
  • $1,000 Medicare Part B premium reimbursement
  • $2,500 hearing aid benefit and other additional discounts
  • Vision coverage with $5 annual eye exam from EyeMed®1
  • Mental health benefit, including telehealth, from MDLIVE

Announcing GEHA Medicare Advantage Plans

New for 2024: GEHA is partnering with UnitedHealthcare to offer Medicare Advantage Plans to bring choice and value to our members through new plan options. Enjoy all the benefits of your original Medicare plan (Parts A and B), with prescription drug coverage (Part D) and additional benefits and features for no additional premium. Once you are enrolled in GHEA's High medical plan with Medicare Parts A&B primary, you qualify for the GEHA High Medicare Advantage Plan, a UnitedHealthcare® Group Medicare Advantage (PPO) plan.

Learn more about the GEHA High Medicare Advantage Plan

1These 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 High plan and their eligible family members.

2024 High rates

Pay frequency Self Only Self Plus One Self and Family
Biweekly — employed $108.65 $249.67 $306.26
Monthly — retired $235.41 $540.95 $663.56

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.
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
Maternity; childbirth/delivery facility services $0
Outpatient accidental injury, including ER (within 72 hours) $0
Outpatient lab services $0
Vision coverage; eye exams1 $5
MinuteClinic visit (where available) $10
Primary care physician office visit $20
Mental health office visit $20
Specialist care office visit $20
Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year $20
Urgent care facility visit $35
ER visit; medical emergency 10%2
Hospital care; outpatient 10%2
Professional surgical services 10%2
X-ray and other diagnostic services 10%2
Acupuncture; up to 20 visits per year 10%2
Hospital care; inpatient $100 per admission plus 10%
Preventive dental care, twice yearly Balance after GEHA pays $22 per visit

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

Term Self Only Self Plus One Self and Family
Yearly deductible (what you pay in-network) $350 $700 $700
Out-of-pocket maximum (what you pay in-network) $5,000 $10,000 $10,000

Prescription benefits

The table below summarizes your cost for prescription drugs with GEHA’s High medical plan. Members with Medicare A & B primary have even lower out-of-pocket costs for preferred and non-preferred brand-name prescriptions.

For added convenience and management of medications, your GEHA prescription benefits include access to presorted multi-dose packets. Presorted packets can be delivered to your home or, if available, picked up at a retail location.

For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure.

To find a drug cost based on your benefit plan and prescription dosage, check your drug costs.

Prescription benefit What you pay in-network
30-day retail generic $10
30-day retail preferred brand-name 25% ($150 max)‡¤
30-day retail non-preferred brand-name 40% ($200 max)‡¤
90-day mail service generic $20
90-day mail service preferred brand-name 25% ($350 max)¤
90-day mail service non-preferred brand-name 40% ($500 max)¤
30-day specialty CVS exclusive generic and preferred brand-name 25% ($150 max)¤
30-day specialty CVS exclusive non-preferred brand-name 40% ($200 max)¤

Highlights that are special to High

cover image for the 2024 geha medical benefits guide

2024 Medical Benefits Guide


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



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