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PSHB Standard 2027

The family-friendly plan for those who want strong coverage and affordable copays

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2027 PSHB Standard rates
Pay frequency	Self Only \| CODE 37D	Self Plus One \| CODE 37F	Self and Family \| CODE 37E
Biweekly — employed	$84.77	$182.26	$225.18
Monthly — retired	$183.67	$394.90	$487.90

2027 PSHB Standard rates
Pay frequency	Self Only \| CODE 37D	Self Plus One \| CODE 37F	Self and Family \| CODE 37E
	Pay frequency Biweekly — employed	Self Only \| CODE 37D $84.77	Self Plus One \| CODE 37F $182.26	Self and Family \| CODE 37E $225.18	Pay frequency Monthly — retired	Self Only \| CODE 37D $183.67	Self Plus One \| CODE 37F $394.90	Self and Family \| CODE 37E $487.90

These rates do not apply to all Enrollees. If you are in a special enrollment category, please refer to the PSHB Program website or contact the agency 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 G.E.H.A Plan Brochure.

Costs (what you pay in-network)
Network benefits²	You pay
Yearly deductible (in-network)	$350 for Self Only $700 for Self Plus One or Self and Family
Out‑of‑pocket maximum³ (in-network)	$6,500 for Self Only $13,000 for Self Plus One or Self and Family
Preventive care Annual physical exam, routine screenings, immunizations and more	$0
Primary care office visits	$20
Mental health office visits	$20
Specialist office visit	$35
MinuteClinic^® / Urgent care facility visit	$10 / $30
Unlimited telehealth visits, including mental health	$0
Emergency room visit	30%⁴
Hospital care; outpatient / inpatient	15%⁴ / 15%⁴
Lab services (QuestSelect benefit)	$0
Lab services (other than QuestSelect)	15%⁴
X-rays and other diagnostic services	15%^4,7
Maternity; childbirth delivery professional services	$0
Chiropractic care (up to 20 visits per year)	$35
Acupuncture (up to 20 visits per year)	15%⁴
Preventive dental care, twice yearly	50%

Costs (what you pay in-network)
Network benefits²	You pay
	Network benefits² Yearly deductible (in-network)	You pay $350 for Self Only $700 for Self Plus One or Self and Family	Network benefits² Out‑of‑pocket maximum³ (in-network)	You pay $6,500 for Self Only $13,000 for Self Plus One or Self and Family	Network benefits² Preventive care Annual physical exam, routine screenings, immunizations and more	You pay $0	Network benefits² Primary care office visits	You pay $20	Network benefits² Mental health office visits	You pay $20	Network benefits² Specialist office visit	You pay $35	Network benefits² MinuteClinic^® / Urgent care facility visit	You pay $10 / $30	Network benefits² Unlimited telehealth visits, including mental health	You pay $0	Network benefits² Emergency room visit	You pay 30%⁴	Network benefits² Hospital care; outpatient / inpatient	You pay 15%⁴ / 15%⁴	Network benefits² Lab services (QuestSelect benefit)	You pay $0	Network benefits² Lab services (other than QuestSelect)	You pay 15%⁴	Network benefits² X-rays and other diagnostic services	You pay 15%^4,7	Network benefits² Maternity; childbirth delivery professional services	You pay $0	Network benefits² Chiropractic care (up to 20 visits per year)	You pay $35	Network benefits² Acupuncture (up to 20 visits per year)	You pay 15%⁴	Network benefits² Preventive dental care, twice yearly	You pay 50%

Prescription costs

(what you pay in-network)

Go to caremark.com to find a pharmacy near you or access drug costs, specialty drug lists and additional details about your prescriptions.

For out-of-network benefits and details on specialty drugs that are injected or infused, check the G.E.H.A Plan Brochure.

Prescription benefits
Prescription drug benefits^2,5	Retail (30-day)	Mail service (90-day)	Specialty CVS exclusive (30-day)
Generic	$10	$25	50% ($350 max)
Preferred brand-name	40% ($350 max)⁶	40% ($700 max)⁶	50% ($350 max)⁶
Non-preferred brand-name	60% ($450 max)⁶	60% ($900 max)⁶	50% ($500 max)⁶

Prescription benefits
Prescription drug benefits^2,5	Retail (30-day)	Mail service (90-day)	Specialty CVS exclusive (30-day)
	Prescription drug benefits^2,5 Generic	Retail (30-day) $10	Mail service (90-day) $25	Specialty CVS exclusive (30-day) 50% ($350 max)	Prescription drug benefits^2,5 Preferred brand-name	Retail (30-day) 40% ($350 max)⁶	Mail service (90-day) 40% ($700 max)⁶	Specialty CVS exclusive (30-day) 50% ($350 max)⁶	Prescription drug benefits^2,5 Non-preferred brand-name	Retail (30-day) 60% ($450 max)⁶	Mail service (90-day) 60% ($900 max)⁶	Specialty CVS exclusive (30-day) 50% ($500 max)⁶

Standard benefits that go beyond

Enhanced member discounts¹

Access member discounts on travel, fitness, personal care, groceries, childcare and more

Member discount program

Health Rewards

Get rewarded for engaging in healthy behaviors

Health Rewards

Vision discount¹

Eye exams, frames, lenses and more

Vision discount

Ready to enroll?

Whether it’s Standard or another G.E.H.A plan you’re considering, we can help.

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1 These benefits are neither offered nor guaranteed under contract with the PSHB Program but are made available to all Enrollees who become members of a G.E.H.A health plan and their eligible family members.

2 In-network providers agree to limit what they will charge you. You pay a fixed dollar amount or percentage of the provider's negotiated amount.

3 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before G.E.H.A begins paying for 100% of covered services. This is a combined maximum for both medical care and prescriptions.

4 Calendar year deductible applies.

5 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.

6 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.

7 Standard, you pay a $250 copay for advanced outpatient high tech imaging such as MRI, CT, PET, etc.

Visual representations do not imply endorsement by any government agency or department.

This is a brief description of the features of the G.E.H.A Standard health plan. Before making a final decision, please read the Plan's Federal brochure RI 71-021. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.

We reinvest our dollars to ensure our plans and member experience are second to none.

G.E.H.A plans are packed with the extra features and benefits federal employees want most.

Visit the G.E.H.A formulary to learn about the coverage and costs for your prescriptions.

We have 1.7 million providers in our national network — plus worldwide coverage for access to health care while traveling abroad.

We're the benefits provider of choice for 2+ million federal employees, retirees and their families.

G.E.H.A plans are packed with the extra features and benefits federal employees want most.

Visit the G.E.H.A formulary to learn about the coverage and costs for your prescriptions.

We have 1.7 million providers in our national network — plus worldwide coverage for access to health care while traveling abroad.

We offer two comprehensive dental plans with the right coverage for every stage of life.

G.E.H.A plans are packed with the extra features and benefits federal employees want most.

Both G.E.H.A dental plans include no in-network deductibles with over 450,000 provider locations nationwide.

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PSHB Standard 2027