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G.E.H.A Prescription Drug Plan

A Medicare PDP/EGWP that provides even greater prescription benefits

a pharmacist smiles as he give a customer her prescription

G.E.H.A's Prescription Drug Plan/EGWP is a Medicare PDP/EGWP that provides comprehensive prescription benefits.

Your ability to get the prescriptions that you need is important to your health. This additional coverage means that you may receive even greater savings on your prescriptions at no additional cost to your current G.E.H.A premiums.

The G.E.H.A Prescription Drug Plan/EGWP is offered by SilverScript^® Insurance Company, which is affiliated with CVS Caremark^®, G.E.H.A's current pharmacy benefit manager.

Who qualifies for G.E.H.A Prescription Drug Plan/EGWP?

All G.E.H.A PSHB retirees with Medicare Parts A and/or B who live in the United States
All G.E.H.A FEHB retirees with Standard or High with Medicare Parts A and/or B who live in the United States

Interested in enrolling into the G.E.H.A Prescription Drug Plan/EGWP?

Call G.E.H.A at 1-888-774-3709. Customer Care is available Monday–Friday from 8 a.m.–8 p.m. Eastern time. It will take a couple of weeks to process your request. However, once the Centers for Medicare & Medicaid Services (CMS) approves, you will be effective on the first day of the following month.

Not interested in the G.E.H.A Prescription Drug Plan/EGWP?

G.E.H.A PSHB retirees with Medicare Parts A and/or B who cancel their enrollment will not have prescription drug coverage with PSHB.
G.E.H.A FEHB retirees with Standard or High with Medicare Parts A and/or B who cancel their enrollment will be transitioned back to their G.E.H.A High or Standard plan.

Members who cancel their enrollment will receive a confirmation letter in about 10 days.

To disenroll from the G.E.H.A Prescription Drug Plan/EGWP, please complete the disenrollment form.

Need to opt-out/cancel from the G.E.H.A Prescription Drug Program/EGWP prior to your effective date?

Call SilverScript at 1-833-250-3241 or
Make a request in writing and mail to:
SilverScript Insurance Company,
P.O. Box 30016, Pittsburgh, PA 15222

Will I receive a new/separate prescription ID card?

New members will receive a member ID card to use at the pharmacy in a separate mailing.

Here are some key benefits to the EGWP prescription benefit program:

Save on the amount you pay for Part D medications annually with a $2,100 out-of-pocket max
$35 monthly cap on insulin
$0 copay for vaccinations and Affordable Care Act (ACA) preventive medications
Access to more than 63,000 pharmacies nationwide and mail-order prescriptions

Current PDP/EGWP members searching for additional plan benefit information, please visit CVS Caremark's G.E.H.A Prescription Drug Plan (PDP) webpage.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9¹	$20 ¹
Tier 2 – Preferred brand	25% ($200 max)	25% ($500 max) ¹
Tier 3 – Non-preferred brand	50% ($300 max)	50% ($600 max) ¹
Tier 4 – Specialty	33% ($250 max)	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9¹	Mail order 90-day supply $20 ¹	Tier 2 – Preferred brand	Retail 30-day supply 25% ($200 max)	Mail order 90-day supply 25% ($500 max) ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 50% ($300 max)	Mail order 90-day supply 50% ($600 max) ¹	Tier 4 – Specialty	Retail 30-day supply 33% ($250 max)	Mail order 90-day supply N/A

¹ Cost share is more if using a non-preferred pharmacy.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9¹	$15 ¹
Tier 2 – Preferred brand	20% ($150 max)	15% ($350 max) ¹
Tier 3 – Non-preferred brand	35% ($200 max)	30% ($500 max) ¹
Tier 4 – Specialty	15% ($150 max)	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9¹	Mail order 90-day supply $15 ¹	Tier 2 – Preferred brand	Retail 30-day supply 20% ($150 max)	Mail order 90-day supply 15% ($350 max) ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 35% ($200 max)	Mail order 90-day supply 30% ($500 max) ¹	Tier 4 – Specialty	Retail 30-day supply 15% ($150 max)	Mail order 90-day supply N/A

¹ Cost share is more if using a non-preferred pharmacy.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9¹	$20¹
Tier 2 – Preferred brand	25% ($200 max)	25% ($500 max) ¹
Tier 3 – Non-preferred brand	50% ($300 max)	50% ($600 max) ¹
Tier 4 – Specialty	33% ($250 max)	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9¹	Mail order 90-day supply $20¹	Tier 2 – Preferred brand	Retail 30-day supply 25% ($200 max)	Mail order 90-day supply 25% ($500 max) ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 50% ($300 max)	Mail order 90-day supply 50% ($600 max) ¹	Tier 4 – Specialty	Retail 30-day supply 33% ($250 max)	Mail order 90-day supply N/A

¹ Cost share is more if using a non-preferred pharmacy.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9¹	$15¹
Tier 2 – Preferred brand	20% ($150 max)	15% ($350 max)¹
Tier 3 – Non-preferred brand	35% ($200 max)	30% ($500 max)¹
Tier 4 – Specialty	15% ($150 max)	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9¹	Mail order 90-day supply $15¹	Tier 2 – Preferred brand	Retail 30-day supply 20% ($150 max)	Mail order 90-day supply 15% ($350 max)¹	Tier 3 – Non-preferred brand	Retail 30-day supply 35% ($200 max)	Mail order 90-day supply 30% ($500 max)¹	Tier 4 – Specialty	Retail 30-day supply 15% ($150 max)	Mail order 90-day supply N/A

¹ Cost share is more if using a non-preferred pharmacy.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9¹	$20¹
Tier 2 – Preferred brand	$47	$141
Tier 3 – Non-preferred brand	50%	50%
Tier 4 – Specialty	33% ($500 max)	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9¹	Mail order 90-day supply $20¹	Tier 2 – Preferred brand	Retail 30-day supply $47	Mail order 90-day supply $141	Tier 3 – Non-preferred brand	Retail 30-day supply 50%	Mail order 90-day supply 50%	Tier 4 – Specialty	Retail 30-day supply 33% ($500 max)	Mail order 90-day supply N/A

¹ Cost share is more if using a non-preferred pharmacy.

Questions about Medicare Part D or any documents you receive from G.E.H.A and SilverScript?

Call the G.E.H.A and SilverScript Customer Care Line, 24 hours a day, 7 days a week.

Call: 1-833-250-3241

TTY: 711

This is a brief description of the features of Government Employees Health Association, Inc.'s health plans. Before making a final decision, please read the GEHA Federal brochures. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.

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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.

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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.

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

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G.E.H.A Prescription Drug Plan

G.E.H.A's Prescription Drug Plan/EGWP is a Medicare PDP/EGWP that provides comprehensive prescription benefits.

G.E.H.A FEHB EGWP Prescription Drug Plan benefits

G.E.H.A PSHB EGWP Prescription Drug Plan benefits

Questions about Medicare Part D or any documents you receive from G.E.H.A and SilverScript?