What's new in 2023 for GEHA medical plans
Medical benefits designed for the unique needs of federal employees.
Changes to all five GEHA medical plans
- Preventive colorectal cancer screening covered at age 45
- Prediabetes screening covered at age 35
- Diabetes education no longer limited to 10 hours per year
- Wigs/cranial prostheses covered with a $350 allowance after a cancer diagnosis
Changes to Elevate
- On Elevate, the out-of-pocket maximum in-network is now $8,500 for Self Only, and $17,000 for Self Plus One or Self and Family, per calendar year
- The Elevate specialist visit copay is increasing from $25 to $30
Changes to HDHP
- For HDHP out-of-network services, the deductible and out-of-pocket maximum will accumulate separately from in-network services. In-network costs will no longer apply to out-of-network amounts.
Changes to Standard
- On Standard, there is an out-of-network deductible of $700 for Self Only and $1,400 for Self Plus One or Self and Family. The Standard in-network deductible remains the same, $350 for Self Only and $700 for Self Plus One or Self and Family.
- The Standard primary care physician copay is increasing from $15 to $20
- The Standard specialist visit copay is increasing from $30 to $35
- On Standard, prescription copay maximums apply per each 30-day supply at retail locations. (Maximums no longer follow Mail Order amounts.)
Changes to Elevate Plus
- Elevate Plus will have a $150 deductible for Self Only, and a $300 deductible for Self Plus One or Self and Family. Deductible will apply to certain inpatient and outpatient benefits with a 15% coinsurance.
- Elevate Plus primary care provider copay is increasing from $25 to $30
- Elevate Plus specialist visit copay is increasing from $40 to $45
- There will be no plan perk offered to Elevate Plus subscribers
Changes to High
- On High, QuestSelect (formerly Lab Card) is not required; you'll pay $0 at all in-network outpatient lab locations
- High plan's Medicare Part B premium reimbursement increased from $800 to $1,000
View what's new for GEHA's 2023 dental plans.
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