HDHP 2024
The economical plan for savvy savers whose focus is on future medical needs
Highlights:
- Low premium with lower-than-expected deductible
- Triple tax advantaged Health Savings Account (HSA)*
- New for 2024: $1,000/$2,000 GEHA contribution makes your costs even lower
- Unlimited telehealth visits, including mental health, with MDLIVE1,2
- 5% out-of-pocket after deductible
- Routine vision and preventive dental benefits included
- Our fastest growing FEHB plan! Popular plan for healthy individuals who don't frequent the doctor but have coverage when they need it.
* Investment products are not FDIC insured, are not a deposit or other obligation of or guaranteed by HSA Bank and are subject to investment risks. The information provided is for informational purposes only. It should not be considered legal or financial advice. You should consult with a professional to determine what may be best for your individual needs.
2024 HDHP rates
| Pay frequency | Self Only | Self Plus One | Self and Family |
|---|---|---|---|
| Biweekly — employed | $71.45 | $153.62 | $188.78 |
| Monthly — retired | $154.81 | $332.84 | $409.02 |
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 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 GEHA Plan Brochure.| Medical benefit | What you pay |
|---|---|
| Unlimited telehealth visits, including mental health, with MDLIVE | $01,2 |
| Maternity; preventive prenatal and postnatal office visits | 0%1 |
| Maternity; childbirth/delivery professional services | 0%1 |
| Maternity; childbirth/delivery facility services | 0%1 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Preventive dental care, twice yearly | $0 |
| Vision coverage; eye exam and additional benefits | $5 |
| Primary care physician office visit | 5%1 |
| Mental health office visit | 5%1 |
| Specialist care office visit | 5%1 |
| Urgent care facility visit | 5%1 |
| ER visit | 5%1 |
| Hospital care; inpatient and outpatient | 5%1 |
| MinuteClinic visit (where available) | 5%1 |
| Lab services | 5%1 |
| Other diagnostic services | 5%1 |
| Professional surgical services | 5%1 |
| Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year | 5%1 |
| Acupuncture; up to 20 visits per year | 5%1 |
2 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the plan allowance.
Deductible and out-of-pocket maximum (in-network)
1Net deductible: This 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.
Prescription benefits1,2,3
The table below summarizes your cost for prescription drugs with GEHA’s HDHP. For details on specialty drugs that are injected or infused, check the GEHA Plan Brochure.| Prescription benefit | What you pay in-network |
|---|---|
| 30-day retail generic | 25% of plan allowance, after deductible* |
| 30-day retail preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 30-day non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
| 90-day mail service generic | 25% of plan allowance, after deductible* |
| 90-day mail service preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 90-day mail service non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
| 30-day specialty CVS exclusive generic and preferred brand-name | 25% of plan allowance, after deductible*¤ |
| 30-day specialty CVS exclusive non-preferred brand-name | 40% of plan allowance, after deductible*¤ |
*Under the High Deductible Health Plan (HDHP), your deductible is $1,600 for Self Only coverage, and $3,200 for Self Plus One or Self and Family coverage. With the exception of preventive care, vision and dental, you must pay the full deductible before GEHA pays for your health care. You can use funds in your health savings account or health reimbursement arrangement to cover your deductible and other medical expenses.
¤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.
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.
2024 Medical Benefits Guide
Highlights that are special to HDHP
Vision benefits
Health Rewards3
$0 telehealth visits4
For information on year-round savings for GEHA dental members, visit Savings for GEHA dental members.
3 HDHP + HSA members can use their rewards on qualified dental and vision care expenses until they meet their deductible. Then, all eligible medical and pharmacy expenses qualify, too.
4 HDHP members who have met their deductible will be charged by MDLIVE, but GEHA will reimburse the member 100% of the plan allowance.
This is a brief description of the features of the GEHA High Deductible Health Plan (HDHP). Before making a final decision, please read the Plan’s Federal brochure RI 71-014. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.
