HDHP 2022
Highlights:
- Low premiums with a low net-deductible
- Reduce out-of-pocket expenses and enjoy a triple tax advantage with a health savings account (HSA)^
- Use your HSA money to reduce your net deductible or save it and let it grow tax-free in your account^
How this plan pays you back:
- GEHA contributes $900 (Self Only) or $1,800 (Self Plus One or Self and Family) to your HSA
- Earn up to $250 (maximum $500 per household) in Health Rewards annually
2022 HDHP rates*
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Biweekly – employed | $63.21 | $135.90 | $167.00 |
| Monthly – retired | $136.95 | $294.44 | $361.83 |
*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 (what you pay in-network)
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, check the GEHA Plan Brochure.| What you pay | |
|---|---|
| Unlimited telehealth visits, including behavioral health, with MDLIVE | $01,2 |
| Maternity, routine care | 0%1 |
| Hospital care; inpatient maternity | 0%1 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Preventive dental care, twice yearly | $0 |
| Primary physician office visit | 5%1 |
| Specialist care; office visit | 5%1 |
| Urgent care | 5%1 |
| Emergency care | 5%1 |
| Hospital care; inpatient and outpatient | 5%1 |
| MinuteClinic (where available) | 5%1 |
| Lab services | 5%1 |
| Other diagnostic services | 5%1 |
| Professional surgical services | 5%1 |
| Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year | 5%1 |
| Acupuncture; up to 20 treatments per year | 5%1 |
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.
Deductible and out-of-pocket max (in-network)
Prescriptions – 30-day supply
The table below summarizes your cost for prescription drugs with GEHA’s HDHP. For details on specialty drugs that are injected or infused, check the GEHA Plan Brochure.| 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
| 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
2022 Medical Benefits Guide
Highlights that are special to HDHP
Vision Benefits
Health Rewards
$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.
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