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High

Welcome to your medical plan page

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What’s new in 2022

  • High plan’s Medicare Part B premium reimbursement has increased to $800.
  • High members pay the specialist $20 copay for chiropractic care. This includes X-ray coverage. The cost share will be waived for High plan members with Medicare A and B primary.
  • Nutritional counseling is covered at 100% in-network.
For a complete list of plan changes, download the plan brochure.
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High coverage


Yearly deductible in-network1

Plan type What you pay
Self Only $350
Self Plus One $700
Self and Family $700

Out-of-pocket max in-network1,2

Plan type What you pay
Self Only $5,000
Self Plus One $10,000
Self and Family $10,000

Your medical benefits

Benefit What you pay
$0
$10
  • Primary physician office visit
  • Specialist care; office visit
  • Chiropractic care; (manipulative therapy), including X-rays; up to 20 visits per year
$20
$35
  • Lab services (other than Lab Card)
10%
  • Emergency care; medical  
  • Hospital care; outpatient
  • Professional surgical services
  • X-ray services
  • Other diagnostic services
  • Acupuncture; up to 20 treatments per year
10%2
  • Hospital care; inpatient
$100 per admission plus 10%
  • Preventive dental care; twice yearly
Balance after GEHA pays $22 per visit

Your prescription benefits

In-network benefits.1 Visit geha.com/Prescriptions to learn more.2

30-day retail prescription What you pay
Generic
Preferred brand-name
Non-preferred brand-name
$103
25%
($150 max3,4)
40% ($200 max3,4)
90-day mail service prescription What you pay
Generic
Preferred brand-name
Non-preferred brand-name
$20
25%
($350 max4)
40% ($500 max4)
30-day specialty CVS exclusive What you pay
Generic
Preferred brand-name
Non-preferred brand-name
25% ($150 max)
25% ($150 max4)
40% ($200 max4)

Medicare + High coverage


Yearly deductible with Medicare A & B primary 1

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 $5,000
Self Plus One $10,000
Self and Family $10,000

High + Medicare medical benefits

With Medicare A & B primary, go to any provider that accepts Medicare assignment1

Benefit What you pay
$0
  • Preventive dental care
Balance after GEHA pays $22 per visit

Your prescription benefits

In-network benefits.1 Visit geha.com/Prescriptions to learn more.2

30-day retail prescription What you pay
Generic
Preferred brand-name
Non-preferred brand-name
$103
20%
($150 max3,4)
35% ($200 max3,4)
90-day mail service prescription What you pay
Generic
Preferred brand-name
Non-preferred brand-name
$15
15%
($350 max4)
30% ($500 max4)
30-day specialty CVS exclusive What you pay
Generic
Preferred brand-name
Non-preferred brand-name
15% ($150 max)
15% ($150 max4)
30% ($200 max4)

Included benefits



Pharmacy benefits

Retail pharmacy

Fill your prescriptions at more than 66,000 in-network pharmacies nationwide including CVS, RiteAid, Walgreens, Walmart and more.
VISIT CVS.COM

Mail service pharmacy

Have medications delivered to your door with CVS Caremark Mail Service Pharmacy. Many non-specialty drugs qualify for 90-day refills.
LEARN MORE

Estimate medication costs

Visit our check drug costs tool, hosted by CVS Caremark, to evaluate your medication costs.
LEARN MORE

CVS ExtraCare Health Benefit

Receive a 20% discount on eligible CVS Health Brand health-related items by using the ExtraCare Health Benefit.
VISIT CVS.COM

Your exclusive discounts

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Vision discount1,2

With all GEHA medical plans, you get low copays on eye exams and discounts on frames and lenses through EyeMed.™ The EyeMed network includes LensCrafters, Target Optical, independent eye doctors and top optical retailers. 
LEARN MORE
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Medical alert discount1

Get free activation, plus a 10% monthly discount, for responsive emergency help.
LEARN MORE
Hearing aid icon 

Hearing aid discount1,3

Receive TruHearing discounted pricing on hearing aids and save 30% to 60%, averaging more than $2,500 per pair. High plan members also receive a $2,500 hearing aid benefit.
LEARN MORE
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Electric toothbrush discount1,4

Save more than 70% off a premium electric toothbrush by cariPRO.™
LEARN MORE
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Teeth whitening discount1

Receive a 20% discount off the lowest published price on all Smile Brilliant home teeth whitening products. Includes custom-fitted trays, whitening gel and desensitizing gel.
LEARN MORE

Find care




Choose the right care

Free Health Advice Line
Talk to a nurse 24/7/365.
MinuteClinic©
Local care for minor issues.
Telehealth
Unlimited $0 visits with MDLIVE.
Urgent care
Convenient local care option.
Primary and specialty care
Non-emergency doctor care.
Emergency room
Life threatening issues.
Call 9-1-1

Other care resources

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Maternity resources

Count on GEHA’s maternity program for answers to your questions about pregnancy, prenatal care and your GEHA benefits.
LEARN MORE
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Your care team

Your care team will help move you toward your health goals by assisting with lifestyle choices, medications, health care providers, educational materials and more.
CALL 888.216.8246 ext. 3984
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Second Opinion

When it comes to making medical decisions, such as if a surgery is right for you, you want to be sure. Request a second opinion to learn more about your treatment options.
GET A SECOND OPINION

Health Rewards


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How it works

This program gives two adult members per household (age 18+) the opportunity to earn up to $250 each (maximum $500 per household per year) in Health Rewards for participating in activities that promote healthy behavior.
EARN YOUR REWARDS
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Your Health Rewards card

After completing your first eligible rewards activity, you’ll automatically receive a Health Rewards prepaid debit card in the mail. You can use this reloadable card at pharmacies and health care providers to pay for eligible goods, services and prescriptions.
ACTIVATE YOUR ACCOUNT
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Redeeming your rewards

You can spend your available rewards on all 213(d) qualified medical expenses – such as eyeglasses or contacts, orthodontics, doctor visits and dental care – using your Health Rewards prepaid debit card.
USE YOUR REWARDS

Our Benefits Advisers are available Mon. – Fri. from 7 a.m. – 7 p.m. Central time and are ready to answer your questions.
If you’re a current GEHA member and need help, call 800.821.6136 (medical) or 877.434.2336 (dental).

Resources


Plan documents

Topic
Resource
2022 High Plan Brochure Download (PDF)
2022 High 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