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Traditional coverage & affordable premiums.

Standard Option 2021

View the 2020 Standard Option plan

Traditional coverage. Affordable premiums.

A dependable plan that is there when you need it.

Why you might like Standard Option:

  • $15 copay for in-network primary care visits, $30 copay for in-network specialist visits.
  • Pay $0 for routine, in-network maternity care.
  • Pay $0 for unlimited telehealth visits, including pediatricians, licensed behavioral health therapists and dermatologists, through MDLIVE.
  • Plan works well with Medicare.

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.

Self Only Self Plus One Self and Family
Non-Postal biweekly $62.66 $134.73 $164.85
Postal biweekly – Category 1 $60.16 $129.35 $158.26
Postal biweekly – Category 2 $52.01 $111.83 $136.83
Retirees monthly $135.77 $291.92 $357.17


Costs for services in 2021

The table below summarizes your in-network cost for medical benefits with GEHA Standard Option. 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 $15
Specialist care; office visit $30
Urgent care $35
Emergency care 15%1
Hospital care; inpatient and outpatient 15%1
Hospital care; inpatient maternity $0
Professional surgical services 15%1
Lab Card services $0
Lab services (non-Lab Card) 15%
Other diagnostic services 15%1
Chiropractic care (spinal manipulation therapy) Balance after GEHA pays $20 per visit, up to 20 visits per year
Chiropractic X-rays Balance after GEHA pays $25 per year
Preventive dental care, twice yearly 50%
Acupuncture; up to 20 treatments per year 15%1

Yearly deductible & out-of-pocket max


Self Only Self Plus One Self and Family
Yearly deductible (what you pay in-network) $350 $700 $700
Out-of-pocket-max (what you pay in-network) $6,500 $13,000 $13,000

Prescriptions

The table below summarizes your cost for prescription drugs with GEHA’s Standard Option. 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 $10 $10, plus difference between plan allowance and cost of drug
Preferred brand-name 50%, up to $200 max¤ 50%, up to $200 max, plus difference between plan allowance and cost of drug**¤
Non-preferred brand-name 50%, up to $300 max¤ 50%, up to $300 max, plus difference between plan allowance and cost of drug**¤

Mail service pharmacy – 90-day supply


What you pay in-network What you pay out-of-network
Generic $20 No benefit
Preferred brand-name 50%, up to $500 max¤ No benefit
Non-preferred brand-name 50%, up to $600 max¤ No benefit


Key plan features

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HEALTH REWARDS

Up to $250 in incentives for Standard Option members who complete simple and convenient health screenings.
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VISION COVERAGE

Get in-network routine eye exams for $5 and discounts on eyewear.
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PREGNANCY AND CHILDBIRTH

GEHA maternity benefits include discounts on breast pumps and rewards for visiting your provider.