Low premiums paired with a health savings account.
A lower-than-expected deductible. Low premiums. GEHA contributes to an HSA.
Why you might like the HDHP:
- GEHA contributes $900 (Self Only) or $1,800 (Self Plus One or Self and Family) to your HSA, which can reduce the yearly net deductible to $600 or $1,200, respectively.
- Reduce your out-of-pocket expenses with a health savings account (HSA).
- You pay only 5% of medical services after your deductible is met.
- Includes a complete vision benefit along with $0 in-network preventive dental benefits, all with no deductible.
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.
Preventive care covered 100%
Like all GEHA plans, this plan covers 100% percent of preventive care costs if you see an in-network provider. Once you meet your annual deductible GEHA pays 95% of most in-network care.
Savings for the future
If you have an HSA, you can make additional deposits into the account. Your savings can be invested through HSA Bank and continue to grow until you decide to use them.#
GEHA deposits $900 a year for Self Only; $1,800 for Self Plus One or Self and Family into your HSA or HRA.
Possibility to earn tax-free interest
Any HSA money you don’t spend can earn tax-free interest, allowing you to plan for future health expenses all the way through retirement. If you leave your current job or leave federal employment, any money in your account is yours to keep.
Costs for services in 2021The table below summarizes your in-network cost for medical benefits with GEHA's HDHP. 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||$01,2|
|Preventive care; adult routine screenings||$0|
|Well-child visit; up to age 22||$0|
|Maternity, routine care||0%1|
|MinuteClinic (where available)||5%1|
|Primary physician office visit||5%1|
|Specialist care; office visit||5%1|
|Hospital care; inpatient and outpatient||5%1|
|Professional surgical services||5%1|
|Other diagnostic services||5%1|
|Chiropractic care (spinal manipulation therapy)||Balance after GEHA pays $20 per visit, up to 20 visits per year1|
|Chiropractic X-rays||Balance after GEHA pays $25 per year1|
|Preventive dental care, twice yearly||$0, no deductible|
|Acupuncture; up to 20 treatments per year||5%1|
1 Calendar year deductible applies.
2 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.
Out-of-pocket max & yearly deductible
|Self Only||Self Plus One||Self and Family|
|Out-of-pocket-max (what you pay in-network)||$5,000||$10,000||$10,000|
|Yearly deductible (what you pay in-network)||$1,500||$3,000||$3,000|
1Net 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.
The table below summarizes your cost for prescription drugs with GEHA’s HDHP. 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 and preferred brand-name medication||25% of plan allowance, after deductible*¤||25% of plan allowance, after plan deductible,* plus difference between GEHA allowance and the cost of the drug¤|
|Non-preferred brand-name medication||40% of plan allowance, after deductible*¤||40% of plan allowance, after plan deductible,* plus difference between GEHA allowance and the cost of the drug¤|
Mail service pharmacy – 90-day supply
|What you pay in-network||What you pay out-of-network|
|Generic or preferred brand-name medication||25% of plan allowance, after deductible*¤||No benefit|
|Non-preferred brand-name medication||40% of plan allowance, after deductible*¤||No benefit|
*Under the High Deductible Health Plan (HDHP), your deductible is $1,500 for Self Only coverage, and $3,000 for Self Plus One or Self and Family coverage. With the exception of preventive care, vision and dental, you must pay the full deductible before GEHA pays for your health care. You can use funds in your health savings account or health reimbursement arrangement to cover your deductible and other medical expenses.
¤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.
Videos: How an HSA or an HRA works with an HDHP
Key plan features
$0 TELEHEALTH VISITS
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.
This is a brief description of the features of the GEHA High Deductible Health Plan (HDHP). Before making a final decision, 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.