Elevate Plus
Welcome to your medical plan page
What’s new in 2022
- Elevate Plus has no out-of-network medical coverage. You will be responsible for 100% of the cost for out-of-network services. However, emergency services will continue to be covered at in-network benefit levels regardless of whether you go to an in-network or out-of-network hospital.
- GEHA’s unique position as a nonprofit member association allows us to offer a plan perk. We don’t have stockholders, which means our priority is putting money back into supporting our members’ health and wellness. Elevate Plus subscribers now have access to one annual plan perk as part of your GEHA membership.
New! Exclusive plan perk for Elevate Plus subscribers
Elevate plus plan subscribers are eligible annually to choose one plan perk from the following:
Exclusively for Elevate Plus plan subscriber and spouse enrolled in Medicare Part A and/or B primary.
Fitbit tracker including a 12-month Fitbit Premium Membership.
$125 gift card for DICK’S Sporting Goods or REI.
12-month Daily Burn virtual fitness subscription.
*Only subscribers in the 50 United States are eligible at this time.
These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to Subscribers who become a member of GEHA's Elevate or Elevate Plus medical plan.
For a complete list of plan changes, download the plan brochure at geha.com/PlanBrochure
Elevate Plus coverage
Yearly deductible in-network1
| Plan type | What you pay |
|---|---|
| Self Only | $0 |
| Self Plus One | $0 |
| Self and Family | $0 |
Out-of-pocket max in-network1,2
| Plan type | What you pay |
|---|---|
| Self Only | $6,000 |
| Self Plus One | $12,000 |
| Self and Family | $12,000 |
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 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.
Medical benefits in-network1
| Benefit | What you pay |
|---|---|
|
$0 |
| $10 | |
|
$25 |
|
$40 |
| $50 | |
|
$503 |
|
$75 |
|
$200 |
|
$200 |
|
$250 per day up to $1,000 per admission |
|
$250 per day per facility |
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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus).
2 This plan has no out-of-network coverage.
3You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus).
Your prescription benefits
In-network benefits1,2, no out-of-network coverage. Visit geha.com/Prescriptions to learn more.3
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
$10 $804 50%4 |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
$20 $2004 50%4 |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
40% ($500 max) 40% ($500 max)4 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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus).
2 This plan has no out-of-network pharmacy coverage and a limited pharmacy network. Find a pharmacy at geha.com/Find-Care
3Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
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 with Medicare A & B primary
| Plan type | What you pay |
|---|---|
| Self Only | $0 |
| Self Plus One | $0 |
| Self and Family | $0 |
Out-of-pocket max in-network1
| Plan type | What you pay |
|---|---|
| Self Only | $6,000 |
| Self Plus One | $12,000 |
| Self and Family | $12,000 |
1 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.
Medical benefits in-network1
| Benefit | What you pay |
|---|---|
|
$0 |
1 Refer to GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus).
Your prescription benefits
In-network benefits1,2, no out-of-network coverage. Visit geha.com/Prescriptions to learn more.3
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
$10 $80 4 50%4 |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
$20 $2004 50%4 |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
40% ($500 max) 40% ($500 max)4 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. For out-of-network benefits, refer to GEHA’s 2022 plan brochure RI 71-018 (Elevate and Elevate Plus).
2 This plan has no out-of-network pharmacy coverage and a limited pharmacy network. Find a pharmacy at geha.com/Find-Care
3 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
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 & savings
Pharmacy benefits
Retail pharmacy
Mail service pharmacy
Estimate medication costs
CVS ExtraCare Health Benefit
Your exclusive discounts
Vision discount1,2
Medical alert discount1
Hearing aid discount1
Electric toothbrush discount1,4
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 Only when you visit an EyeMed provider.
3 This benefit is per person, every 36 months for adults. TruHearing discount pricing can be combined with the hearing aid benefit for even greater savings.
4 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 DuPont™ bristles are also available at this exclusive, member-only price.
Find care
Choose the right care
Other care resources
Maternity resources
BridgeHealth
Rally Health portal
1 Subject to any eligibility limitations. For more information, see info.bridgehealth.com/GEHA. If Medicare or other coverage is your primary payer, you are not eligible for this program.
Wellness Pays rewards
How it works
Your Wellness Pays Rewards card
Redeeming your rewards
Resources
Plan documents
| Topic |
Resource |
|---|---|
| 2022 Elevate Plus Plan Brochure | Download (PDF) |
| 2022 Elevate Plus Member Guide | Browse the e-book |
| 2022 Medical Benefits Guide | Browse the e-book |
| 2022 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 plan. Please read the Plan's Federal brochure (RI 71-018). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.