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

G.E.H.A | January 26, 2026

Learn more about our Medicare PDP/EGWP with SilverScript that provides comprehensive prescription benefits.

Our Medicare Prescription Drug Plan (Employer Group Waiver Plan) provided by SilverScript offers comprehensive prescription benefits. With this added coverage, you may receive greater savings on your prescriptions without paying anything extra beyond your current G.E.H.A premiums.

Key benefits of the G.E.H.A PDP EGWP Plan provided by SilverScript include:

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

Who qualifies for the G.E.H.A PDP EGWP Plan provided by SilverScript?

FEHB Standard or High and PSHB Standard, High or HDHP members who:

  • Have entered retirement status with OPM
  • Have Medicare Parts A and/or B
  • And live in the United States

Enrollment details

PSHB members:

Medicare-eligible PSHB G.E.H.A health plan members receive prescription drug coverage through the G.E.H.A-sponsored SilverScript plan. You do not need to do anything to enroll. If you are new to G.E.H.A and are eligible for Medicare, your G.E.H.A medical ID card will not show pharmacy benefits.

  • Members who are new to G.E.H.A will get a separate SilverScript pharmacy ID card in the mail for the 2026 plan year.
  • 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:

As an FEHB G.E.H.A health plan member with Medicare, your drug coverage is provided by CVS Caremark as part of your G.E.H.A health plan.

You can stay with that coverage or choose the G.E.H.A-sponsored SilverScript plan, which may help you save more on prescriptions.

Enrollment into the SilverScript PDP plan does not change your G.E.H.A premium, but it may affect other costs related to Medicare. Please review the “Important cost considerations related to SilverScript enrollment” section below for more information.

As an FEHB member, you are not enrolled in SilverScript automatically. If you want to keep CVS Caremark, you do not need to do anything. If you want SilverScript, you must enroll.

Your ID card depends on the coverage you choose:

    • If you keep CVS Caremark, your G.E.H.A ID card will still show your pharmacy benefits.
    •  If you choose to elect SilverScript coverage, your G.E.H.A ID card will no longer show pharmacy benefits. You will get a separate SilverScript ID card in the mail.

Steps to enroll in the SilverScript plan: (FEHB members only)

  • Call G.E.H.A at 1-800-821-6136. 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.
    • After the Centers for Medicare & Medicaid Services (CMS) approves your request, your SilverScript coverage starts on the first day of the next month.
    • Newly enrolled SilverScript members will get a pharmacy ID card about 10 days before coverage starts.
    • Your CVS Caremark coverage stays active until the day before SilverScript starts, ensuring you do not face any gaps in coverage.
  • PSHB members who are eligible for Medicare are automatically enrolled in the G.E.H.A-sponsored SilverScript plan and do not need to complete the enrollment process.

Important cost considerations related to SilverScript enrollment:

  • Medicare Income-Related Monthly Adjustment Amount (IRMAA): 
    • The Medicare Income-Related Monthly Adjustment Amount is an extra monthly premium amount some members pay for Medicare Part B & Part D coverage.
    • Only members with higher incomes pay this additional premium amount. Medicare uses your IRS income reporting to determine your income bracket.
    • To learn more about IRMAA income considerations and Medicare’s two-year lookback practices, see 2026 Medicare Parts A & B Premiums and Deductibles.
    • If you have questions or wish to learn more, please call the Social Security Administration 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.
    • If you have questions or wish to learn more, please call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778)
    • FEHB members only: 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. For questions, call SilverScript at 1-833-250-3241.

How to disenroll from the SilverScript plan:

If you no longer wish to be enrolled in the SilverScript plan, you will need to disenroll using any of the following methods:

SilverScript Insurance Company
P.O. Box 30016
Pittsburgh, PA 15222

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

What happens if you disenroll — and what you could lose:

  • PSHB members: Will no longer have prescription drug benefits through G.E.H.A, unless you choose to enroll in a G.E.H.A Medicare Advantage plan.
  • FEHB members: Your prescription drug benefits will automatically transition from SilverScript back to your G.E.H.A High or Standard plan drug coverage provided by CVS Caremark. No action is required on your end to re-enroll into your CVS Caremark coverage.

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 two weeks to process, and may trigger an additional medical or prescription ID card to be sent once completed.

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 G.E.H.A 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.