2023 GEHA Medicare Benefits - Learn how GEHA's five medical plans work with your Medicare benefits.
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2023 GEHA Medicare Benefits Learn how GEHA’s five medical plans work with your Medicare benefits. geha.com/Medicare | 800.262.4342
What’s inside
03 Welcome
04 Medicare and GEHA
05 Compare premiums
06 Elevate and Medicare
08 HDHP and Medicare
10 Standard and Medicare
12 Elevate Plus and Medicare
14 High and Medicare
16 Vision discounts and benefits for GEHA plans
16 GEHA’s hearing aid benefit
17 Extras if you choose Elevate
18 Get help choosing the right plan
19 Definitions and terms
02 2023 GEHA Medicare benefits
Welcome
Now that you’re retired, let’s get to work
We believe health care isn’t one size fits all, and our plans are designed with that in mind. For
more than 85 years, GEHA (Government Employees Health Association, Inc.) has provided
medical plans designed exclusively for federal employees and military retirees.
Medicare is federal health insurance available for eligible individuals ages 65 and over or
individuals under 65 with certain disabilities and medical conditions. Medicare has different
parts (referred to as Parts A, B, C and D) designed to address your health care needs.
GEHA offers our medical plans as supplemental (extra) coverage for
what Medicare may not cover.
Elevate HDHP Standard Elevate Plus High
and Medicare and Medicare and Medicare and Medicare and Medicare
With a variety of
plans that work with NOV DEC
Medicare Parts A & B,
GEHA is here for you
Open Season
begins on Monday, November 14,
in retirement or as you and concludes on
Monday, December 12.
prepare to retire.
2023 GEHA Medicare benefits 03Medicare and GEHA
All GEHA medical plans work with Medicare Parts A & B
With a GEHA medical plan to supplement your Medicare coverage, a sudden hospital stay, a
prolonged illness or a major surgical procedure won’t overwhelm your budget.
Compare how GEHA plans work with Medicare
Elevate HDHP Standard Elevate High
and and and Plus and and
Plan service Medicare Medicare Medicare Medicare Medicare
NEW! $1,000 Medicare
Part B premium
reimbursement
100% medical coverage
(copays and deductibles
waived) with Medicare
A & B primary
Hearing aid benefit1
Coverage for in-network
and out-of-network care2
Coverage for care outside
of the United States
Non-preferred
drug coverage3
Mail service pharmacy
Choice of plan perk4
1 Although hearing aid benefits are only available on Standard, Elevate Plus and High plan, hearing aid discounts are available on all plans. Learn more at
geha.com/Hearing
2 Though the Elevate Plus plan on its own does not provide out-of-network medical coverage, when it’s combined with Medicare and the provider accepts Medicare
assignment, out-of-network cost shares are waived. There are no out-of-network pharmacy benefits for Elevate and Elevate Plus.
3 With High plan, when Medicare A & B is primary, you pay a lower coinsurance for preferred and non-preferred brand medications.
4 These benefits are neither offered nor guaranteed under contract with the FEHB program, but are made available to Subscribers who become a member of GEHA’s
Elevate medical plan.
This is a brief description of the features of Government Employees Health Association, Inc.'s medical plans. Before making a final decision, please read the GEHA
Federal brochures which are available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.
04 2023 GEHA Medicare benefitsCompare premiums
If you are a retired federal employee, you can sign up for a GEHA medical plan by completing OPM
form 2809, available through the Office of Personnel Management at opm.gov
Self Only premium and enrollment code Retired – monthly
254 Elevate and Medicare $109.83
341 HDHP and Medicare $150.30
314 Standard and Medicare $149.01
251 Elevate Plus and Medicare $185.84
311 High and Medicare $229.10
Self Plus One premium and enrollment code Retired – monthly
256 Elevate and Medicare $257.47
343 HDHP and Medicare $323.15
316 Standard and Medicare $320.39
253 Elevate Plus and Medicare $406.55
313 High and Medicare $527.56
Self and Family premium and enrollment code Retired – monthly
255 Elevate and Medicare $313.46
342 HDHP and Medicare $397.11
315 Standard and Medicare $392.00
252 Elevate Plus and Medicare $454.64
312 High and Medicare $659.52
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 which
maintains your health benefits enrollment.
Free e-books and videos
Learn more about your options with Medicare and GEHA at geha.com/Medicare
2023 GEHA Medicare benefits 05Elevate and Medicare
Learn all about this plan at geha.com/Elevate
• GEHA’s lowest premium plan
• Low copays for non-traditional care, like chiropractic and acupuncture
• Engaging digital wellness hub powered by Rally® Health
Premium and enrollment code Retired – monthly
254 Self Only $109.83
256 Self Plus One $257.47
255 Self and Family $313.46
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 which maintains your health benefits enrollment.
Health care style: How often you use your plan: Prescription benefit need:
a wellness-focused and
cost-conscious plan for
those without an extensive
Low Average High Low Average High
prescription need
How this plan pays you back:
• Earn Wellness Pays rewards up to $500 (Self Only) or $1,000 (Self Plus One or Self and Family) annually.
Rewards dollars can be used for qualified medical expenses such as copays, and medical, dental and
vision expenses. geha.com/WellnessPays
• Subscribers can select from an annual plan perk. Options include a 12-month Daily Burn virtual fitness
subscription, a $125 gift card for DICK’S Sporting Goods or REI, or your choice of Fitbit device including a
12-month Fitbit Premium Membership. geha.com/PlanPerk
Yearly deductible in-network1 You pay
Self Only $500
Self Plus One or Self and Family $1,000
1 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.
Out-of-pocket maximum in-network1,2 You pay
Self Only $8,500
Self Plus One or Self and Family $17,000
1 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.
2 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of
covered services. This is a combined maximum for both medical care and prescriptions.
06 2023 GEHA Medicare benefitsMedical benefits with Medicare A & B primary in-network1 You pay
Unlimited telehealth visits, including mental health, with MDLIVE
Preventive care; adult routine screenings $0
Vision coverage; eye exams2
Primary physician office visit
Mental health office visit
MinuteClinic® where available
$10
Chiropractic care (manipulative therapy), including X-rays;
up to 12 visits per year
Acupuncture; up to 20 treatments per year
Specialist care office visit $30
Urgent care facility $50
ER visit
Hospital care; inpatient and outpatient
X-rays and other diagnostic services 25%3
Lab services
Outpatient professional surgical services
Inpatient professional surgical services $250
1 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.
2 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a
GEHA medical plan and their eligible family members.
3 Calendar year deductible applies.
Prescription benefits in-network1,2,3 You pay
30-day retail generic $4
30-day retail preferred brand-name 50% ($500 max)
30-day retail non-preferred brand-name 100%
30-day specialty CVS exclusive generic and preferred brand-name 50% ($500 max)
30-day specialty CVS exclusive non-preferred brand-name 100%
1 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.
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 To provide a low premium, this plan does not include mail-order prescriptions or out-of-network pharmacy coverage, and it has a limited pharmacy network.
Find a pharmacy at geha.com/Find-Care
2023 GEHA Medicare benefits 07HDHP and Medicare
Learn all about this plan at geha.com/HDHP
• Low premiums with a lower net deductible than many traditional plans
• GEHA contributes to your HRA. Use your HRA money to reduce your net
deductible or reimburse Medicare premiums.
Premium and enrollment code Retired – monthly
341 Self Only $150.30
343 Self Plus One $323.15
342 Self and Family $397.11
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 which maintains your health benefits enrollment.
Health care style: How often you use your plan: Prescription benefit need:
for the analytical health
care consumer, focused
on savings Low Average High Low Average High
How this plan pays you back:
• Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health
Rewards geha.com/HealthRewards
• GEHA contributes $900 (Self Only) or $1,800 (Self Plus One or Self and Family) to your HRA
GEHA HRA
Yearly deductible in-network1 Annual deductible contribution You pay2
Self Only $1,500 $900 $600
Self Plus One or Self and Family $3,000 $1,800 $1,200
1 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.
2 The net deductible is the remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan
benefits begin.
Out-of-pocket maximum in-network1,2 You pay
Self Only $5,000
Self Plus One or Self and Family $10,000
1 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.
2 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of
covered services. This is a combined maximum for both medical care and prescriptions.
08 2023 GEHA Medicare benefitsMedical benefits with Medicare A & B primary in-network1 You pay
Unlimited telehealth visits, including mental health, with MDLIVE $02,3
Preventive care; adult routine screenings
$0
Preventive dental care, twice yearly
Vision coverage; eye exams $5
Primary physician office visit
Mental health office visit
Specialist care office visit
Urgent care facility
ER visit
Hospital care; inpatient and outpatient
MinuteClinic® where available 5%2
Lab services
X-rays and other diagnostic services
Professional surgical services
Chiropractic care (manipulative therapy), including X-rays;
up to 20 visits per year
Acupuncture; up to 20 treatments per year
1 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.
2 Calendar year deductible applies.
3 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the Plan Allowance.
Prescription benefits in-network1,2,3 You pay
30-day retail generic 25%
30-day retail preferred brand-name 25%4
30-day retail non-preferred brand-name 40%4
90-day mail service generic 25%
90-day mail service preferred brand-name 25%4
90-day mail service non-preferred brand-name 40%4
30-day specialty CVS exclusive generic and preferred brand-name 25%4
30-day specialty CVS exclusive non-preferred brand-name 40%4
1 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.
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 Calendar year deductible applies.
4 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.
This is a brief description of the features of HDHP. Before making a final decision, please read the Plan’s Federal brochure available at geha.com/PlanBrochure
2023 GEHA Medicare benefits 09Standard and Medicare
Learn all about this plan at geha.com/Standard
• Traditional coverage with affordable premiums
• Good choice for Medicare A & B primary members who take
generic prescriptions
• You pay $0 for deductibles, copays and coinsurance whether your provider is
in-network or out-of-network even outside the United States
• You pay $0 for inpatient and outpatient hospital services, surgeries and office visits
• $2,500 hearing aid benefit and additional discount
Premium and enrollment code Retired – monthly
314 Self Only $149.01
316 Self Plus One $320.39
315 Self and Family $392.00
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 which maintains your health benefits enrollment.
Health care style: How often you use your plan: Prescription benefit need:
traditional care and
coverage to stay on a
healthy path Low Average High Low Average High
How this plan pays you back:
• Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health
Rewards geha.com/HealthRewards
Yearly deductible with Medicare A & B primary1 You pay
Self Only $0
Self Plus One or Self and Family $0
1 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.
Out-of-pocket maximum in-network1,2 You pay
Self Only $6,500
Self Plus One or Self and Family $13,000
1 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.
2 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of
covered services. This is a combined maximum for both medical care and prescriptions.
10 2023 GEHA Medicare benefitsMedical benefits with Medicare A & B primary in-network1,2 You pay
Unlimited telehealth visits, including mental health, with MDLIVE
Preventive care; adult routine screenings
Lab, X-ray and diagnostic test services
MinuteClinic® where available
Primary physician office visit
Mental health office visit
Specialist care office visit
$0
Urgent care facility
ER visit
Hospital care; inpatient and outpatient
Professional surgical services; inpatient and outpatient
Outpatient professional High Tech Imaging (MRI, CT, PET, etc.)
Chiropractic care (manipulative therapy), including X-rays;
up to 20 visits per year
Vision coverage; eye exams3 $5
Preventive dental care, twice yearly 50%
1 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.
2 With Medicare A & B primary, go to any provider that accepts Medicare assignment.
3 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a
GEHA medical plan and their eligible family members.
Prescription benefits in-network1,2 You pay
30-day retail generic $10
30-day retail preferred brand-name 50% ($200 max3)
30-day retail non-preferred brand-name 50% ($300 max3)
90-day mail service generic $20
90-day mail service preferred brand-name 50% ($500 max3)
90-day mail service non-preferred brand-name 50% ($600 max3)
30-day specialty CVS exclusive generic and preferred brand-name 50% ($250 max3)
30-day specialty CVS exclusive non-preferred brand-name 50% ($400 max3)
1 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.
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 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.
2023 GEHA Medicare benefits 11Elevate Plus
and Medicare
Learn all about this plan at geha.com/ElevatePlus
• You pay $0 deductibles, copays and coinsurance for medical care
in-network or out-of-network
• Engaging digital wellness hub powered by Rally Health
• $1,500 hearing aid benefit and additional discounts
Though Elevate Plus plan on its own does not provide out-of-network coverage, when it's combined with Medicare
and the provider accepts Medicare assignment, out-of-network cost shares are waived.
Premium and enrollment code Retired – monthly
251 Self Only $185.84
253 Self Plus One $406.55
252 Self and Family $454.64
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 which maintains your health benefits enrollment.
How often you use your plan: Prescription benefit need:
Health care style:
health-focused
and proactive
Low Average High Low Average High
How this plan pays you back:
• Earn Wellness Pays rewards up to $500 (Self Only) or $1,000 (Self Plus One or Self and Family) annually.
Rewards dollars can be used for qualified medical expenses such as copays, and medical, dental and
vision expenses. geha.com/WellnessPays
Yearly deductible with Medicare A & B primary1 You pay
Self Only $0
Self Plus One or Self and Family $0
1 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.
Out-of-pocket maximum in-network1,2 You pay
Self Only $6,000
Self Plus One or Self and Family $12,000
1 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.
2 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of
covered services. This is a combined maximum for both medical care and prescriptions.
12 2023 GEHA Medicare benefitsMedical benefits with Medicare A & B primary in-network1,2 You pay
Unlimited telehealth visits, including mental health, with MDLIVE
Preventive care; adult routine screenings
Lab, X-ray and diagnostic test services
MinuteClinic® where available
Primary physician office visit
Mental health office visit
Specialist care office visit
$0
Urgent care facility
ER visit
Hospital care; inpatient and outpatient
Chiropractic care (manipulative therapy), including X-rays;
up to 15 visits per year
Professional surgical services; inpatient and outpatient
Vision coverage; eye exams3
1 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.
2 With Medicare A & B primary, go to any provider that accepts Medicare assignment.
3 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a
GEHA medical plan and their eligible family members.
Prescription benefits in-network1,2,3 You pay
30-day retail generic $10
30-day retail preferred brand-name $804
30-day retail non-preferred brand-name 50%4
90-day mail service generic $20
90-day mail service preferred brand-name $2004
90-day mail service non-preferred brand-name 50%4
30-day specialty CVS exclusive generic and preferred brand-name 40% ($500 max4)
30-day specialty CVS exclusive non-preferred brand-name 50%4
1 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.
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 This plan has no out-of-network pharmacy coverage, and has a limited pharmacy network. Find a pharmacy at geha.com/Find-Care
4 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.
2023 GEHA Medicare benefits 13High and Medicare
Learn all about this plan at geha.com/High
• Comprehensive brand-name and specialty prescription coverage
• NEW! $1,000 Medicare Part B premium reimbursement. geha.com/MRA
• You pay $0 for deductibles, copays and coinsurance whether your provider
is in-network or out-of-network, even outside the United States
• You pay $0 for inpatient and outpatient hospital services, surgeries and
office visits
• $2,500 hearing aid benefit and additional discount
Premium and enrollment code Retired – monthly
311 Self Only $229.10
313 Self Plus One $527.56
312 Self and Family $659.52
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 which maintains your health benefits enrollment.
How often you use your plan: Prescription benefit need:
Health care style:
maximum coverage and
dependable support Low Average High Low Average High
Low Average High Low Average High
How this plan pays you back:
• NEW! $1,000 Medicare Part B premium reimbursement
• Adults ages 18 and over can earn up to $250 (maximum $500 per household) per year in Health Rewards.
geha.com/HealthRewards
Yearly deductible with Medicare A & B primary1 You pay
Self Only $0
Self Plus One or Self and Family $0
1 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.
Out-of-pocket maximum in-network1,2 You pay
Self Only $5,000
Self Plus One or Self and Family $10,000
1 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.
2 The out-of-pocket maximum is the maximum amount of coinsurance, copays and deductibles you pay for all family members before GEHA begins paying for 100% of
covered services. This is a combined maximum for both medical care and prescriptions.
14 2023 GEHA Medicare benefitsMedical benefits with Medicare A & B primary in-network1,2 You pay
Unlimited telehealth visits, including mental health, with MDLIVE
Preventive care; adult routine screenings
Lab, X-ray and diagnostic test services
MinuteClinic® where available
Primary physician office visit
Mental health office visit
Specialist care office visit $0
Urgent care facility
ER visit
Hospital care; inpatient and outpatient
Professional surgical services; inpatient and outpatient
Chiropractic care (manipulative therapy), including X-rays;
up to 20 visits per year
Vision coverage; eye exams3 $5
Balance after
Preventive dental; twice yearly GEHA pays
$22 per visit
1 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.
2 With Medicare A & B primary, go to any provider that accepts Medicare assignment.
3 These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a
GEHA medical plan and their eligible family members.
Prescription benefits in-network1,2 You pay
30-day retail generic $103
30-day retail preferred brand-name 20% ($150 max3,4)
30-day retail non-preferred brand-name 35% ($200 max3,4)
90-day mail service generic $15
90-day mail service preferred brand-name 15% ($350 max4)
90-day mail service non-preferred brand-name 30% ($500 max4)
30-day specialty CVS exclusive generic and preferred brand-name 15% ($150 max4)
30-day specialty CVS exclusive non-preferred brand-name 30% ($200 max4)
1 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.
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 Costs for initial prescription and first refill. You pay 50% for third and additional refills at retail for 30-day supply. For long-term prescriptions, use mail order or
your local retail CVS Pharmacy store (90-day supply) for greater cost savings.
4 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.
2023 GEHA Medicare benefits 15Vision discounts and benefits
for GEHA plans
With all GEHA medical plans, you get discounts on eye exams, frames and lenses through EyeMed.®
The EyeMed network includes Independent Provider Network, LensCrafters, Pearle Vision, Target Optical,
contactsdirect.com, glasses.com and more. Members also save on LASIK at participating US Laser
Network locations.
Learn more at geha.com/Vision
The HDHP plan includes additional vision benefits. Learn more: geha.com/HDHPVision
Elevate and Elevate Standard and High HDHP
Vision services in-network Plus you pay1 you pay1 you pay
Eye exams; retail price $0 $5 $5
$0 under $100 plus
Frames; retail price 60% of price 60% of price
80% over $100
Eyeglass lenses, standard
plastic, single vision; Up to $50 Up to $50 $10
retail price
Contact lens, conventional; $10 under $110 plus
85% of price 85% of price
retail price 85% over $100
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 a GEHA
medical plan and their eligible family members.
GEHA’s hearing aid benefit
• All five GEHA plans offer access to discounted pricing with TruHearing.®1 Save up to 30% to 60% off
hearing aids. Some average more than $2,600 in savings per pair.
• Three GEHA plans — Standard, Elevate Plus and High — offer a hearing aid benefit. This benefit is per
person, every 36 months for adults. TruHearing discount pricing can be combined with the hearing aid
benefit for even greater savings.
Standard GEHA pays Elevate Plus GEHA pays High GEHA pays
$2,500 $1,500 $2,500
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 a GEHA
medical plan and their eligible family members.
16 2023 GEHA Medicare benefitsExtras if you choose Elevate
Elevate subscribers can choose
among three options annually
to support a healthy lifestyle.
It pays to be a GEHA Elevate plan member.
This plan includes an exclusive plan perk
option to support a healthy lifestyle.
It’s quick and easy for Elevate
subscribers to claim their plan perk.
Sign up for a geha.com account (or
log in to your existing account) and
update your contact preferences.
Choice of one Fitbit device including a
12-month Fitbit Premium Membership.
12-month Daily Burn virtual
fitness subscription.
GEHA’s unique position as a nonprofit member
association allows us to offer this bonus plan
perk exclusively for the Elevate plan. We
$125 gift card for DICK’s Sporting Goods
don’t have stockholders, which means our
or REI.
priority is putting money back into supporting
our members.
For more information, visit These products and services are neither offered nor guaranteed under contract
with the FEHB Program, but are made available to eligible Subscribers who
geha.com/PlanPerk become members of the GEHA Elevate medical plan
Only Subscribers in the 50 United States and the District of Columbia are
eligible at this time.
2023 GEHA Medicare benefits 17Get help choosing
the right plan
GEHA has a plan for every stage of your
life. We are here to help you discover
which plan is the right fit for you.
Book an appointment Call us
Meet one-on-one with a GEHA Benefits Talk to a GEHA Benefits Adviser
Adviser to help answer your questions. Monday – Friday, 7 a.m. – 7 p.m. Central time.
geha.com/Meet 800.262.4342
Chat online Watch on-demand webinars
Chat or text with a GEHA Benefits Adviser Learn how to find a plan that’s right for you
in real time Monday – Friday, 7 a.m. – 7 p.m. with an on-demand webinar.
Central time.
geha.com/BenefitsWebinars
geha.com
Plan recommender tool Compare plans
Answer a few questions to see a plan that Easily compare GEHA’s five medical plans.
matches your individual or family needs.
geha.com/CompareMedical
geha.com/Select-A-Plan
For more information about FEHB plans, visit the U.S. Office of Personnel Management at opm.gov/Healthcare-Insurance
18 2023 GEHA Medicare benefitsDefinitions and terms
We know some terms can be confusing. As you work your way through this guide, these definitions may help.
Term Definition
Calendar year deductible What you pay each year before the plan begins to pay out benefits.
The percentage you pay for a covered health care service, after you’ve met
Coinsurance
your deductible.
Copay A fixed amount you pay for a service or prescription.
Portion of monthly HDHP premium that GEHA contributes to a health savings
GEHA contribution
account (HSA) or health reimbursement arrangement (HRA).
A health care provider who is a part of GEHA’s provider network. These providers
In-network provider
agree to limit what they will charge you.
The remaining amount after you subtract the annual GEHA contribution from the
Net deductible (HDHP)
annual deductible. This is your out-of-pocket cost before plan benefits begin.
The maximum amount you pay each year for coverage. Includes copays,
Out-of-pocket maximum deductibles and coinsurance, but not premiums. Once the limit is met, the plan
pays the remainder of your covered health care expenses for the rest of the year.
Cost of health care goods and services after subtracting the insurance company’s
Plan allowance negotiated discount. For complete details see the definition of “Plan allowance” in
Section 10 of any GEHA plan brochure. geha.com/PlanBrochure
PPO A preferred provider organization.
Premium What you pay monthly or biweekly for coverage.
Prescription benefits What you pay as a copay or percentage of coinsurance for medication.
This is a brief description of the features of Government Employees Health Association, Inc.’s medical plans. Before making a final decision, please read the GEHA Federal
brochures which are available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.
2023 GEHA Medicare benefits 19STANDARD
US POSTAGE
PAID
GEHA
PO Box 21542 | Eagan, MN 55121-9930
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Ready to enroll?
If you are a retired federal employee, you can sign up for
a GEHA medical plan by completing OPM form 2809,
available through the Office of Personnel Management.
opm.gov | 800.332.9798
This is a brief description of the features of Government Employees Health Association, Inc.‘s medical plans. Before making a final decision, please read the GEHA Federal brochures which are
available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.
Download the plan brochure
For information and changes to GEHA’s medical plans, see our three plan brochures – RI 71-006 (High and Standard), RI 71-014 (HDHP) and RI 71-018 (Elevate and Elevate Plus) – which are
available at geha.com/PlanBrochure
Notice of Summary of Benefits and Coverage (SBC): Availability of Summary Health Information: The Federal Employees Health Benefit (FEHB) program offers numerous health benefits plans
and coverage options. Choosing a health plan and coverage option is an important decision. To help you make an informed choice, each FEHB plan makes available a Summary of Benefits and
Coverage (SBC) about each of its health coverage options, online and in paper. The SBC summarizes important information in a standard format to help you compare plans and options. GEHA’s
SBCs are available on the internet at geha.com/SBC. Paper copies are also available, free of charge, by calling 800.821.6136.
To find out more information about plans available under the FEHB program, including SBCs for other FEHB plans, please visit opm.gov/Insure
geha.com | 800.262.4342
©2022-2023 Government Employees Health Association, Inc. All rights reserved. Please recycle.
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