G.E.H.A Prescription Drug Plans for members with Medicare

Your health matters — and so does making your prescriptions more affordable. With this added coverage, you may receive even greater savings on your prescriptions without paying anything extra beyond your current G.E.H.A premiums.

PSHB members: Your G.E.H.A health plan with Medicare coverage includes prescription benefits provided by Aetna Medicare Rx (offered by SilverScript Employer PDP sponsored by G.E.H.A).

FEHB members: You currently receive prescription benefits through your G.E.H.A health plan, administered by CVS Caremark. Alternatively, you have the option to enroll in the G.E.H.A Prescription Drug Plan (PDP)/EGWP provided by Aetna Medicare Rx (offered by SilverScript Employer PDP sponsored by G.E.H.A). This plan may offer greater prescription savings with no change to your G.E.H.A premiums. However, you are not being automatically enrolled in the SilverScript plan, and you are not required to make any changes. If you are satisfied with your current G.E.H.A prescription coverage administered by CVS Caremark, no action is needed. If you would like to enroll in the SilverScript plan, you will need to take steps to do so.

Who qualifies for G.E.H.A Prescription Drug Plan (PDP)/EGWP with SilverScript?
All G.E.H.A Standard or High plan retirees, with Medicare Parts A and/or B, who live in the United States.

Your new prescription ID card
Here’s what to expect with your ID cards in 2026:

PSHB members:

• If you are newly enrolled in a G.E.H.A health plan and have Medicare coverage, your G.E.H.A medical ID card will not have pharmacy benefits listed on the card. Instead, you will receive a separate SilverScript pharmacy ID card in the mail.
• If you had G.E.H.A SilverScript coverage in 2025, you may continue to use your current SilverScript ID card for the 2026 plan year.

FEHB members:

• If you stay with your current plan, your G.E.H.A medical ID card will have CVS Caremark pharmacy benefits listed on the card.
• If you enroll in SilverScript, your G.E.H.A medical ID card will not have pharmacy benefits listed on the card. Instead, you’ll receive a separate SilverScript pharmacy ID card in the mail. Starting in 2026, bring both cards to the pharmacy.

How to enroll in the SilverScript plan

Call G.E.H.A at 1-855-676-7120. Customer Care is available Monday–Friday from 8 a.m.–8 p.m. Eastern time. It will take 2–3 weeks to process your request. However, once the Centers for Medicare & Medicaid Services (CMS) approves, your SilverScript prescription coverage will be effective on the first day of the following month. New PDP/EGWP members will receive a prescription ID card to use at the pharmacy approximately 10 days prior to the effective date. Your CVS Caremark coverage will remain in effect until the day before your SilverScript plan is effective.

Key benefits the SilverScript prescription coverage includes:

• $2,100 maximum out-of-pocket each year for Part D medications
• $35 maximum per month for insulin
• $0 copay for:
  • Vaccines and Affordable Care Act (ACA) preventative medications
    • Examples include breast cancer prevention drugs, smoking cessation products, and blood pressure medications
  • Access to over 63,000 pharmacies nationwide and mail-order prescriptions

If you choose to change your enrollment to SilverScript, keep in mind:

• Medicare Income-Related Monthly Adjustment Amount (IRMAA): The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your premium to enroll in and maintain Medicare prescription drug coverage. This additional premium is assessed only to those with higher incomes and is adjusted based on the income reported on your IRS tax return. If you have questions, please call CMS at 1-800-772-1213 (TTY 1-800-325-0778).
• Late Enrollment Penalty (LEP):  If you go without creditable prescription drug coverage for 63 days or more after your initial enrollment period, you will face a permanent fee added to your drug plan premium called the Late Enrollment Penalty (LEP).
• FEHB members: Your current G.E.H.A prescription plan with CVS Caremark for FEHB meets Medicare’s coverage requirements. If you switch to SilverScript, you may need to show proof of this coverage to avoid a late enrollment penalty (LEP). For questions, call SilverScript at 1-833-250-3241.

How to disenroll from the SilverScript plan:

If you change your mind and no longer want to be enrolled in SilverScript, you will need to disenroll in one of these ways:

1. Complete the disenrollment form found on our website: geha.com/PDP-Disenroll
2. Call SilverScript at 1-833-250-3241 to request a disenrollment form
3. Mail your signed letter or disenrollment form to:
   SilverScript Insurance Company
   P.O. Box 30016
   Pittsburgh, PA 15222

Members who cancel their SilverScript enrollment will receive a confirmation letter in about 10 days that includes information regarding your disenrollment date. This change may trigger an additional medical or prescription ID card to be sent.

• PSHB members: You will no longer have prescription drug benefits through G.E.H.A.
• FEHB members: Your prescription drug benefits will transition from SilverScript back to your G.E.H.A High or Standard plan.

Want to re-enroll into SilverScript later?

Call 1-833-250-3241 (TTY: 711), 24 hours a day, 7 days a week. Re-enrollment takes up to 2 weeks to process.

This is a brief description of the features of Government Employees Health Association, Inc.'s health plans Please read the Plans Federal brochure available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.