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

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.

 

For added convenience and management of medications, prescription benefits include access to presorted multi-dose packets. Packets can be delivered to your home or, if available, picked up at a retail location. To find drug costs with HDHP, use this handy check your drug costs tool.

	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.