Elevate Plus
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What’s new in 2024
- Elevate Plus will have a $200 deductible for Self Only, and a $400 deductible for Self Plus One or Self and Family.
- New infertility coverage available only for artificial insemination (AI). Coverage for drugs associated with AI and in vitro fertilization (IVF limited to 3 cycles annually). Preauthorization is required. Member must meet the Plan’s definition of infertility.
- Up to $150 allowance for in-network childbirth classes provided by a covered provider or facility
- In-network out-of-pocket maximums are increasing from $6,000 to $7,000 for Self Only and from $12,000 to $14,000 for Self Plus One or Self and Family
Elevate Plus coverage
Yearly deductible
| Yearly deductible in-network1,2 | You pay |
|---|---|
| Self Only | $200 |
| Self Plus One or Self and Family | $400 |
Out-of-pocket maximum
| Out-of-pocket maximum in-network1,3 | You pay |
|---|---|
| Self Only | $7,000 |
| Self Plus One or Self and Family | $14,000 |
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 This plan has no out-of-network coverage.
3 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.
Your medical benefits
| Medical benefits in-network1,2 | You pay |
|---|---|
|
$0 |
| $10 | |
|
$30 |
|
$45 |
| $50 | |
|
$504 |
|
15%5 |
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 This plan has no out-of-network coverage.
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.
4 You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA’s 2024 plan brochure RI 71-018 (Elevate and Elevate Plus).
5 Calendar year deductible applies.
Your prescription benefits
| Prescription benefits in-network1,2,3 | You pay |
|---|---|
| 30-day retail generic | $10 |
| 30-day retail preferred brand-name | $80 4 |
| 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.
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.
Medicare + Elevate Plus coverage
Yearly deductible
| Yearly deductible in-network1,2 | You pay |
|---|---|
| Self Only | $0 |
| Self Plus One or Self and Family | $0 |
Out-of-pocket maximum
| Out-of-pocket maximum in-network1,3 | You pay |
|---|---|
| Self Only | $7,000 |
| Self Plus One or Self and Family | $14,000 |
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.
2This plan has no out-of-network coverage.
3The 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.
Elevate Plus and Medicare medical benefits
| Medical benefits with Medicare A & B primary in-network1,2 | You pay |
|---|---|
|
$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.
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.
Your prescription benefits
| 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.
Included benefits & discounts
Pharmacy benefits
Retail pharmacy
Estimate medication costs
Your exclusive discounts
Vision discounts1
Medical alert discount1
Hearing aid discount1
Electric toothbrush discount1,2
Teeth whitening discount1
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.
2 The cariPRO® premium toothbrush removes seven times more plaque than a regular brush, is completely waterproof and comes with a two-year manufacturer’s warranty. Replacement brush heads with high-quality DuPontTM bristles are also available at this exclusive, member-only price.
Find care
Choose the right care
For helpful instructions on how to find in-network primary, specialty and urgent care using GEHA’s Find Care tool, watch this video.
More care resources
Maternity resources
Your team of health professionals
New for 2024: Infertility benefits
Order your complimentary maternity resource kit
Childbirth classes
Order your breast pump
To see if your preferred breast pump is available from an in-network provider, visit
Wellness Pays rewards
How it works
- Earn rewards on Rally.® Register on our Rally digital wellness platform to self-manage your health goals, earn rewards, enroll in digital coaching and more.
- Earn rewards automatically. When you complete a healthy behavior like your annual physical or preventive screenings, you’ll automatically receive a reward deposit after GEHA receives notification of your activity.
Redeeming your rewards
You can use your Wellness Pays reloadable debit card during checkout at both your doctor’s office and major retail locations for qualified expenses like copays, medical, dental and vision. Your reward dollars accumulate year-over-year up to a maximum balance of $2,500 Self Only, $5,000 Self Plus One and Self and Family.
Resources
Plan documents
| Topic |
Resource |
|---|---|
| 2024 Elevate Plus Plan Brochure | Download (PDF) |
| 2024 Elevate Plus Member Guide | Browse the e-book |
| 2024 Medical Benefits Guide | Browse the e-book |
| 2024 Summary of Benefits Coverage | Download (PDF) |
Helpful resources
| Topic |
Resource |
|---|---|
| Create your GEHA web account | geha.com/Register |
| Complete your Enrollment Questionnaire | geha.com/EQ |
| Talk with GEHA Customer Care | geha.com/Contact |
| Use the Find Care Tool | geha.com/Find-Care |
| View the frequently asked questions | geha.com/FAQs |
| Access the GEHA App | Visit the App Store or Google Play |
This is a brief description of the features of the Elevate Plus medical plan. Before making a final decision, please read the Plan's Federal brochure (RI 71-018)available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.