Predictable costs and no in-network deductible.
Elevate Plus 2021
Predictable costs and no in-network deductible.
Copays for common medical expenses and includes out-of-network medical coverage.
Why you might like Elevate Plus:
- Earn up to $500 for Self Only or $1,000 for Self Plus One and Self and Family through Wellness Pays rewards for healthy activities. (Collectively, GEHA members have already earned more than $1 million over the last six months through Wellness Pays.)
- $0 out-of-pocket costs for common surgeries and concierge care coordinator through BridgeHealth.
- $20 copays for chiropractic and acupuncture visits.
- Digital tools to help you navigate your health care experience.
2021 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.
Costs for services in 2021
The table below summarizes your in-network cost for medical benefits with GEHA's Elevate Plus plan. 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 the GEHA Plan Brochure.| What you pay in-network | |
|---|---|
| Unlimited telehealth visits with MDLIVE | $0 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Maternity; routine preventive care | $0 |
| MinuteClinic (where available) | $10 |
| Primary physician office visit | $20 |
| Specialist care; office visit | $35 |
| Urgent care | $50 |
| Emergency care | $150 |
| Hospital care; inpatient including maternity | $200 per day up to $1,000 per admission |
| Hospital care; outpatient | $200 per day per facility |
| Inpatient professional surgical services | $200 |
| Outpatient professional surgical services | $150 |
| Lab services | $0 |
| Other diagnostic services | $501 |
| Chiropractic care (spinal manipulation therapy) | $20 per visit, up to 15 visits per year |
| Chiropractic X-rays | $0 |
| Acupuncture; up to 20 treatments per year | $20 |
1You pay 25% for advanced outpatient diagnostic tests such as, CT Scans and MRI’s. Refer to GEHA’s 2021 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete list.
Prescriptions
The table below summarizes your cost for prescription drugs with GEHA’s Elevate Plus plan. For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure.
For added convenience and management of medications, your GEHA prescription benefits include access to presorted multi-dose packets. Presorted packets can be delivered to your home or, if available, picked up at a retail location.
To find a drug cost based on your benefit plan and prescription dosage, check your drug costs.
Retail pharmacy – 30-day supply
| What you pay in-network | What you pay out-of-network | |
|---|---|---|
| Generic | $5 | You pay 100% of all charges |
| Preferred brand-name | $80 copay¤ | You pay 100% of all charges |
| Non-preferred brand-name | 40% of allowance¤ | You pay 100% of all charges |
Mail service pharmacy – 90-day supply
| What you pay in-network | What you pay out-of-network | |
|---|---|---|
| Generic | $12 | n/a |
| Preferred brand-name | $200 or the cost of the drug, whichever is less¤ | n/a |
| Non-preferred brand-name | 40% of allowance¤ | n/a |
¤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.
Key plan features
DIGITAL HEALTH CARE
$0 TELEHEALTH VISITS
SURGICAL CONCIERGE
GEHA supplemental benefits are neither offered nor guaranteed under contract with the FEHB, but are made available to all enrollees and family members who become members of a GEHA medical plan. For information on year-round savings for GEHA dental members, visit Savings for GEHA dental members.