Frequently Asked Health Questions

You may use the Find Care tool to search for in-network providers in your area or online.

G.E.H.A members can sign in to the MyG.E.H.A member portal for plan-specific provider and CVS Caremark details and personalized information.

Members with Medicare A & B as primary payer can choose any provider who accepts Medicare.

If you are not sure which provider you need to see, review where to go for care to learn more.

You can download a Plan Brochure and other plan materials in the Resource Center.

If you want to receive a hard copy of a Plan Brochure, please contact G.E.H.A Customer Care, and one will be mailed to you.

New enrollments or plan changes:

You should receive your G.E.H.A ID card about 15 calendar days after G.E.H.A receives your enrollment information. If you enroll during Open Season, G.E.H.A will receive your enrollment information once Open Season is over.

If your card hasn’t arrived and it’s been more than 15 calendar days since G.E.H.A received your enrollment, you can:

• Request/reprint a card through the MyG.E.H.A member portal

• Contact G.E.H.A Customer Care, and one will be mailed to you

If you're a new or returning member, you can view and download a digital version of your G.E.H.A ID card through the MyG.E.H.A member portal.

Returning members in the same plan:

For existing members who have requested replacement ID cards through the MyG.E.H.A member portal, please allow 10 to 14 business days from the date of your request.

At the start of a new plan year, you may be issued a new ID card.

Providers that are in-network will file claims on your behalf at the time of service. If your provider is out of network and G.E.H.A is your primary benefits provider, you can submit your claims from the MyG.E.H.A member portal.

1. Log into the MyG.E.H.A member portal
2. Navigate to the Claims and EOBs section
3. Select Submit a claim
4. Choose Get started
5. Following the prompts, upload your claim documentation

If you are mailing in your claims submission, filing an appeal or have additional questions, you can learn more at Claims for G.E.H.A health members.

You can view your claims on the MyG.E.H.A member portal.

1. To get started, sign in or create your MyG.E.H.A member portal account
2. Select View all claims/EOBs located on the member dashboard

This dashboard will show G.E.H.A-processed claims from the past two years.

For more information on how to access your MyG.E.H.A member portal, visit MyG.E.H.A member portal + app for step-by-step instructions.

If you have Self Only coverage, you may change to Self Plus One or Self and Family coverage starting on the first day of the pay period after the family member becomes eligible due to a qualifying life event (such as birth, adoption, marriage or loss of other coverage).

If you are anticipating adding a child to your health plan through birth, adoption or surrogacy, you may change the coverage type on your health plan 31 days before or 60 days after the child becomes eligible.

You must contact your employment or retirement office to have your eligible family member added to the coverage on your health plan. They will provide necessary documentation that you need to complete your enrollment. This documentation should be sent to our Enrollment department at enroll@geha.com.

G.E.H.A funds both HSAs and HRAs up to $1,000 for Self Only and $2,000 for Self Plus One or Self Plus Family plan accounts.

• For HSA account holders, you are able to make additional contributions up to the annual IRS maximums. In 2026 the maximums are $4,400 for Self Only and $8,750 for Self Plus One or Self Plus Family plans. If you are age 55 and older, you are able to contribute an additional $1,000 to your HSA.
• For HRA account holders, G.E.H.A contributions are the only allowed funding each year into your HRA, and you are unable to make additional contributions yourself.

For additional information about your HSA or HRA account, please review the HSA & HRA FAQs.

Your HSA or HRA account will be opened automatically. No action is needed from you.

If you are enrolled in a High Deductible Health Plan (HDHP) and meet IRS eligibility, your HSA will be opened for you through HSA Bank. For the account setup to be completed, you will need to:

• Be enrolled in an HDHP plan through G.E.H.A
• Meet eligibility to contribute to an HSA, as established by the IRS. To learn more, click here.
• Have a residential address on file with HSA Bank (i.e., P.O. boxes are not eligible)

Once HSA Bank creates your account, you’ll be able to register, access and manage your account through the HSA bank website.  

If you are enrolled in an HDHP plan, but are not eligible for an HSA, an HRA will automatically be set up for you instead.

For additional details about eligibility, contributions and how to use your accounts, please review our HSA & HRA FAQs.

If your G.E.H.A enrollment is through active employment, your G.E.H.A health plan is the primary payer. If you are a G.E.H.A health member and are retired, your Medicare plan is the primary payer.

For Federal Employees Health Benefits (FEHB) plan member annuitants / retirees:

FEHB Program members can voluntarily enroll in Medicare Part B. While there may be benefits to electing Medicare Part B, this is not required to maintain your FEHB status.

For Postal Service Health Benefits (PSHB) Program members:

In most cases, PSHB Program members are required to complete Medicare Part B enrollment once they reach age 65 and retire (if retiring after January 1, 2025). Enrollment into Medicare Part B is not required until you have retired. Those who do not elect Medicare Part B upon retiring may lose access to the PSHB Program.

Most PSHB Program members who retired from the Postal Service on or before January 1, 2025, who were not already enrolled in Medicare Part B, are not required to enroll into Medicare Part B to maintain their PSHB status. For exceptions, review Medicare Part B enrollment exceptions for PSHB members.

For both FEHB and PSHB Program members:

Please be aware that if you do not enroll into Medicare Part B when you are first eligible and then decide to enroll at a later date, Medicare may impose a Part B Late Enrollment Penalty (LEP) as a result of your delayed enrollment. Please contact Medicare directly for additional information on penalties.

For more information, visit Medicare + G.E.H.A.

Individuals who enroll into Medicare Part B will be assessed a monthly premium of $202.90 (this may be higher depending on your income). This amount can change each year. If you do not enroll into Medicare Part B when you’re first eligible for Medicare, you may be assessed a Late Enrollment Penalty. Our goal is to make understanding your costs simple — if you need more details or want to see a breakdown of expenses, please click here.

A prior authorization is an advanced review and approval completed by G.E.H.A to confirm certain care (e.g. tests, prescriptions, procedures) is medically necessary before it’s provided. This review helps make sure the care is covered under your plan and medically necessary for you.

To determine medical necessity, G.E.H.A uses evidence-based guidelines developed by medical experts to support safe, effective and appropriate care.

To learn more please visit our authorization page.

Normally, G.E.H.A provides a decision within 15 business days for a standard review. If the prior authorization is marked and qualified as an urgent review, a decision will be provided within 72 business hours. If this is a retro prior authorization, meaning the authorization request was received after care was provided, a decision will be made within 30 business days.

If additional clinical information from your provider is needed during a standard review, the decision timeline may be paused for 60 days while information is requested. If no additional information is received by the end of the 60 days, the review will be completed using the records already provided.

For Federal Employees Health Benefits (FEHB) members:

Enrolling in Medicare Part D has many advantages, including helping limit your prescription drug costs; however, enrollment is voluntary. FEHB members may continue receiving prescription drug coverage through the FEHB Program without enrolling in Part D.

For Postal Service Health Benefits (PSHB) members:

Regulations require retired PSHB members eligible for Medicare to enroll in a Medicare Part D plan. G.E.H.A will automatically enroll eligible PSHB retirees into the CVS SilverScript PDP plan. PSHB members who then opt out of the CVS SilverScript PDP Plan, without enrolling in the G.E.H.A Medicare Advantage plan, will not have prescription coverage with G.E.H.A. If you wish to opt out of the Medicare Part D plan, contact CVS SilverScript at 1-833-250-3241.

Important: Medicare may apply a Part D Late Enrollment Penalty for delayed enrollment. Contact Medicare for details.

When you join Medicare Part D, the exact cost of your monthly premium depends on your chosen plan. If your income exceeds a set threshold, Medicare may add an Income-Related Monthly Adjustment Amount (IRMAA) fee to your monthly Medicare premium, which can change yearly. You might also owe a Late Enrollment Penalty if you don't sign up when first eligible. For more details or a cost breakdown, please click here.

Yes. G.E.H.A offers access to Medicare Part D coverage through two different plan offerings:

• A Medicare Advantage Plan with comprehensive pharmacy coverage and benefits, with lower copays and cost sharing, along with other valuable health plan extras
• A Prescription Drug Plan that provides comprehensive prescription benefits

The G.E.H.A PDP / EGWP Plan is available to retired members enrolled in a G.E.H.A Postal Service Health Benefits (PSHB) Standard, High or HDHP plan, as well as Federal Employees Health Benefits (FEHB) members enrolled in a Standard or High plan. Members must have Medicare Part A and/or Part B coverage to enroll.

PSHB members are automatically enrolled in the EGWP plan. If you opt-out of this plan, without enrolling in the G.E.H.A Medicare Advantage plan, you will no longer have prescription drug coverage within the PSHB Program. FEHB members are not automatically enrolled but may choose to enroll during Open Season.

For members who pair Medicare coverage with their G.E.H.A plan and receive prescription coverage through a separate PDP, Medicare is the primary payer for medical services, and G.E.H.A is the secondary payer.

The PDP is the sole payer for prescriptions. Members carry three ID cards to coordinate coverage: their Medicare red, white and blue card for primary medical coverage, their G.E.H.A health plan card for secondary medical coverage, and their CVS Silverscript (PDP) card for all prescription coverage needs.

The UnitedHealthcare^® G.E.H.A Group Medicare Advantage (PPO) Plan combines medical and prescription drug coverage into one plan with one ID card, serving as the only payer for all services.

This Medicare Advantage plan is available to all PSHB and FEHB members enrolled in a G.E.H.A Standard or High plan. Members must have Medicare Part A & B as primary coverage to enroll.