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The plan of choice of Medicare enrollees.

High Option 2020

View the 2019 High Option Plan

A smart pick if you take brand-name prescription drugs.

New: A $600 Medicare Part B premium reimbursement.

You work hard to maintain your health and live a healthy lifestyle. In 2020, count on GEHA’s High Option plan to support you on your wellness journey.

Maybe you depend on brand-name prescription medications. Maybe you’re a Medicare A&B enrollee looking for a $600 reimbursement to help with your Medicare Part B premium payments. Maybe you’ve simply reached that point in life where you’re willing to spend a little more for a premium plan that gives you the confidence to live life to its fullest. High Option was designed with you in mind.

When you enroll in GEHA’s High Option, you’ll get:

  • Comprehensive prescription coverage that works with Medicare.
  • Get a $2,500 hearing-aid allowance.

More High Option highlights:

  • Combines a $600 reimbursement for Medicare Part B premiums with a cost-share waiver, making High Option the plan of choice of Medicare enrollees.
  • Low out-of-pocket costs when you need care.
  • Similar to other plans, you get worldwide coverage that lets you travel abroad worry-free.

2020 Rates

These rates do not apply to all enrollees. If you are in a special enrollment category, please refer to the FEHB Program website or contact the agency or Tribal Employer that maintains your health benefits enrollment.

Self OnlySelf Plus OneSelf and Family
Non-Postal biweekly$105.42$246.51$304.39
Postal biweekly – Category 1$102.14$239.51$296.80
Postal biweekly – Category 2$92.32$218.50$274.04
Monthly (retirees)$228.41$534.11$659.51

Costs for services in 2020

The table below summarizes your in-network cost for medical benefits with GEHA High Option. For complete information, refer to the GEHA Plan Brochure.

Copays

CopayWhat you pay in-network
Primary physician office visit$20
Specialist$20
MinuteClinic (where available)$10
Urgent care$35
Routine eye exam$5 through EyeMed

Other services

ServiceWhat you pay in-network
Preventive lab servicesNothing with Lab Card
Well-child visit; up to age 22Nothing
Adult routine screeningNothing
Preventive dental careBalance after GEHA pays $22/visit, twice yearly

Maternity care

ServiceWhat you pay in-network
Routine provider careNothing
Inpatient careNothing

Out-of-pocket maximums and yearly deductibles

Self OnlySelf Plus OneSelf and Family
Calendar-year deductible (in-network)$350$700$700
Out-of-pocket-maximum (in-network)$5,000$10,000$10,000

Prescriptions

The table below summarizes your cost for prescription drugs with GEHA’s High Option. For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure.

To find a drug cost based on your benefit plan and prescription dosage, check your drug costs.

Retail pharmacy – 30-day supply

In-networkOut-of-network
Generic$10 copay$10 copay‡# plus difference between plan and drug cost
Preferred brand-name25%, up to $150 max‡¤25%, up to $150 max‡¤#
Non-preferred brand-name40%, up to $200 max‡¤40%, up to $200 max‡¤#

Mail service pharmacy – 90-day supply

In-networkOut of-network
Generic$20n/a
Preferred brand-name25%, up to $350 max¤n/a
Non-preferred brand-name40%, up to $500 max¤n/a