HDHP
Welcome to your medical plan page
What’s new in 2022
- HDHP members pay the specialist 5% coinsurance for chiropractic care after the deductible is met. This includes X-ray coverage.
- Nutritional counseling is covered at 100% in-network for HDHP members. This coverage is subject to the deductible when the counseling is not preventive.
HDHP coverage
Yearly deductible in-network1,2
| Plan type | Yearly deductible | GEHA HSA3 contribution | Yearly net deductible |
|---|---|---|---|
| Self Only | $1,500 | - $900 | = $600 |
| Self Plus One | $3,000 | - $1,800 | = $1,200 |
| Self and Family | $3,000 | - $1,800 | = $1,200 |
Out-of-pocket max in-network4
| Plan type | What you pay |
|---|---|
| Self Only | $5,000 |
| Self Plus One | $10,000 |
| Self and Family | $10,000 |
1 Net deductible: This is the remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin.
2 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 71-014 (HDHP).
3 Most people qualify for an HSA. Those who don’t are enrolled in an HRA; this group includes Medicare enrollees and those who have non-HDHP coverage elsewhere. Find out which one you’re eligible for at geha.com/IRS969
4 The out-of-pocket max 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 |
|---|---|
|
$02,3 |
|
$02 |
|
$0 |
|
5%2 |
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 71-014 (HDHP).
2 Calendar year deductible applies.
3 If deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charge.
Your prescription benefits
In-network benefits.1,2
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
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 71-014 (HDHP).
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 Calendar year deductible applies.
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 + HDHP coverage
Yearly deductible in-network1,2
| Yearly deductible | GEHA HSA3 contribution | Yearly net deductible1 | |
|---|---|---|---|
| Self Only | $1,500 | - $900 | = $600 |
| Self Plus One | $3,000 | - $1,800 | = $1,200 |
| Self and Family | $3,000 | - $1,800 | = $1,200 |
Out-of-pocket max in-network4
| Plan type | What you pay |
|---|---|
| Self Only | $5,000 |
| Self Plus One | $10,000 |
| Self and Family | $10,000 |
1 Net deductible: This is the remaining amount after you subtract the annual GEHA contribution from the annual deductible. This is your out-of-pocket cost before plan benefits begin.
2 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 71-014 (HDHP).
3Most people qualify for an HSA. Those who don’t are enrolled in an HRA; this group includes Medicare enrollees and those who have non-HDHP coverage elsewhere. Find out which one you’re eligible for at geha.com/IRS969
4The out-of-pocket max 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.
HDHP + Medicare medical benefits
With Medicare A & B primary in-network1,2
| Benefit | What you pay |
|---|---|
|
$02,3 |
|
$0 |
|
5%2 |
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 71-014 (HDHP).
2 Calendar year deductible applies.
3 If deductible is met, high deductible health plan (HDHP) member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charge.
Your prescription benefits
In-network benefits.1,2
| 30-day retail prescription | What you pay |
|---|---|
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
| 90-day mail service prescription | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
| 30-day specialty CVS exclusive | What you pay |
| Generic Preferred brand-name Non-preferred brand-name |
25%3 25%3,4 40%3,4 |
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 71-014 (HDHP).
2 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.
3 Calendar year deductible applies.
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
Understanding an HSA (Health Savings Account)
If you qualify for an HSA you will receive a welcome kit in the mail from HSA Bank. Most people qualify for an HSA.1 You can learn more about HSA eligibility at geha.com/IRS969. Investing your HSA money not only helps you save for future financial security, it offers some major tax advantages, too. All GEHA HSA contributions are pre-tax and are not taxed when you withdraw them for qualified medical expenses.2Your HSA has a triple tax advantage:
Tax-free contributions
that lower your taxable income.
Tax-free interest
that grows your account over time.
Tax-free withdrawals
for qualified medical expenses.2
How an HSA is funded
GEHA's contribution is prorated based on the effective date of your HDHP enrollment.
| Plan type | GEHA monthly contribution |
|---|---|
| Self Only |
$75 monthly ($900 annual max) |
| Self Plus One |
$150 monthly ($1,800 annual max) |
| Self and Family |
$150 monthly ($1,800 annual max) |
How you can use the money in your HSA
- Use the funds for current medical expenses, which lowers your yearly deductible.
- Keep any unused money in an interest-bearing savings account or invest in stocks, bonds and mutual funds and use those funds for future medical expenses.
-
You may make additional contributions up to the IRS-allowed annual maximum. Total 2021 HSA contributions, including GEHA's monthly contributions, cannot exceed:
- $3,600 for Self Only, $7,200 for Self Plus One or Self and Family
- Plus $1,000 in "catch up" contributions for individuals age 55+
- At age 65, you can use the funds in this account like you would an IRA.
- For a list of qualified medical expenses, visit irs.gov/Pub502
Benefits of an HSA
- You own the account and can take it with you when you change plans, change jobs or retire.
- Any unused money rolls over year to year.
- Accounts are provided by HSA Bank with access to investment services.
- You can make additional tax-deductible deposits.
- Enjoy tax-free withdrawals for qualified medical expenses.
- GEHA pays your account setup fee and monthly maintenance fee.
To learn more, visit geha.com/HSA
1 Most people qualify for an HSA. Those who don't are enrolled in an HRA; this group includes Medicare enrollees and those who have non-HDHP coverage elsewhere. Find out which one you're eligible for at geha.com/IRS969
2 See IRS Publications 502 and 969 for more information regarding qualified
medical expenses, health savings accounts and health reimbursement
arrangements.
Investment products are not FDIC insured, are not a deposit or other
obligation or guaranteed by HSA Bank, and are subject to investment risks. The
information provided is for informational purposes only. It should not be
considered legal or financial advice. Consult with a professional to determine
what may be best for your individual needs.
Understanding an HRA (Health Reimbursement Arrangement)
If you do not qualify for an HSA, you will receive a health reimbursement arrangement (HRA) notification in the mail from GEHA. You can also determine if you are eligible for an HRA or HSA at at geha.com/IRS969. As you receive medical care, available funds in your HRA will be used tax-free to pay for qualified out-of-pocket expenses. You can use HRA funds to reimburse payment of Medicare Part B premiums. Our plan allows unused HRA funds to carry over from year to year. You will forfeit the money in your HRA if you leave federal employment or switch health insurance plans. If you retire, or remain covered under your HDHP, you may continue to accumulate and use funds in your HRA.How an HRA is funded
For those who don't qualify for an HSA, the full annual HRA deposit is available for qualified medical expenses incurred on or after your effective date.| Plan type | GEHA lump sum contribution1 |
|---|---|
| Self Only |
$900 |
| Self Plus One |
$1,800 |
| Self and Family |
$1,800 |
Features of an HRA
- Unused money rolls over year over year.
- No additional personal contributions are allowed.
- Tax-free withdrawals for qualified medical expenses.
- No account fees.
- You do not own the account.
- If you leave federal employment or change to another medical plan, including one of GEHA's other medical plans, the money in the HRA is forfeited.
- For a list of qualified medical expenses, visit irs.gov/Pub502
1 If you joined outside of Open Season the lump sum is prorated.
Pharmacy benefits
Retail pharmacy
Mail service pharmacy
Estimate medication costs
CVS ExtraCare Health Benefit
Your exclusive discounts
Vision benefit & discount1
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 cariPROTM 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
1Calendar year deductible applies. If deductible is met, high deductible health plan (HDHP) members will be charged by MDLIVE, but GEHA will then reimburse 100% of the billed charges.
Other care resources
Maternity resources
Your care team
Second Opinion
Health Rewards
How it works
HDHP members who are also enrolled in an HSA may only use their card for qualified dental and vision expenses until the yearly plan deductible has been satisfied.
Your Health Rewards card
Redeeming your rewards
Resources
Plan documents
| Topic |
Resource |
|---|---|
| 2022 HDHP Plan Brochure | Download (PDF) |
| 2022 HDHP 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 HDHP plan. Please read the Plan's Federal brochure (RI 71-014). All benefits are subject to the definitions, limitations, and exclusions set forth in the Federal brochure.