suggested for you

High 2022

Highlights:

  • Comprehensive prescription coverage
  • Low copays for doctor visits
  • $2,500 hearing aid benefit

How this plan pays you back:

  • NEW! $800 Part B Medicare premium reimbursement
  • Earn up to $250 (maximum $500 per household) in Health Rewards annually

View the 2021 High Option plan page

2022 High rates*


Self Only Self Plus One Self and Family
Biweekly – employed $104.86 $244.76 $302.25
Monthly – retired $227.20 $530.31 $654.87



Costs (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 $0
Preventive care; adult routine screenings $0
Well-child visit; up to age 22 $0
Maternity; routine care $0
Emergency care; accidental (must be within 72 hours) $0
Hospital care; inpatient maternity $0
Lab Card services $0
MinuteClinic (where available) $10
Primary physician office visit $20
Specialist care; office visit $20
Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year $20
Urgent care $35
Lab services (other than Lab Card) 10%
Emergency care; medical 10%1
Hospital care; outpatient 10%1
Professional surgical services 10%1
X-ray services 10%1
Other diagnostic services 10%1
Acupuncture; up to 20 treatments per year 10%1
Hospital care; inpatient $100 per admission plus 10%
Preventive dental care, twice yearly Balance after GEHA pays $22 per visit

Deductible and out-of-pocket max (in-network)


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) $5,000 $10,000 $10,000

Prescription benefits

The table below summarizes your cost for prescription drugs with GEHA’s High Option. Members with Medicare A & B primary have even lower out-of-pocket costs for preferred and non-preferred brand-name prescriptions.

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.

For complete benefit information, including details on specialty drugs that are injected or infused, refer to the GEHA Plan Brochure.

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
Preferred brand-name 25% ($150 max)‡¤ 25% ($150 max)‡¤
Non-preferred brand-name 40% ($200 max)‡¤ 40% ($200 max)‡¤

Mail service pharmacy – 90-day supply


What you pay in-network What you pay out of-network
Generic $20 No benefit
Preferred brand-name 25% ($350 max)¤ No benefit
Non-preferred brand-name 40% ($500 max)¤ No benefit




Highlights that are special to High



2021 geha medical benefits guide cover image

2022 Medical Benefits Guide


Review this guide with all our plans, including rates, costs, extra services, and side-by-side comparisons

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