Standard 2022
Highlights:
- Affordable premiums
- Some of the lowest copays for in-network primary care and specialist visits
How this plan pays you back:
- Earn up to $250 (maximum $500 per household) in Health Rewards annually
2022 Standard rates*
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Biweekly – employed | $62.66 | $134.73 | $164.85 |
| Monthly – retired | $135.77 | $291.92 | $357.17 |
*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 (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 |
| Hospital care; inpatient maternity | $0 |
| Lab Card services | $0 |
| MinuteClinic (where available) | $10 |
| Primary physician office visit | $15 |
| Specialist care; office visit | $30 |
| Urgent care | $35 |
| Lab services (other than Lab Card) | 15% |
| Emergency care | 15%1 |
| Hospital care; inpatient and outpatient | 15%1 |
| Professional surgical services | 15%1 |
| X-ray and other diagnostic services | 15%1 |
| Acupuncture; up to 20 treatments per year | 15%1 |
| Preventive dental care, twice yearly | 50% |
| Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year | $30 |
| Outpatient professional High Tech Imaging (MRI, CT, PET, etc.) | $100 |
| Outpatient facility High Tech Imaging (MRI, CT, PET, etc.) | $150 |
1Calendar year deductible applies.
Prescriptions – 30-day supply
The table below summarizes your cost for prescription drugs with the Standard plan. 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 the Standard plan, use this handy check your drug costs tool.| In-network | 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
| In-network | 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 |
¤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.
**Retail fills eligible for a greater than a 30-day supply will be subject to the 50% coinsurance up to the maximum of $500 for preferred or $600 for non-preferred.
Highlights that are special to Standard
Health Rewards
Up to $250 in incentives for Standard Option members who complete simple and convenient health screenings.
Pregnancy and Childbirth
GEHA maternity benefits include discounts on breast pumps and rewards for visiting your provider.
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 Standard Option medical plan. Before making a final decision, please read the Plan’s Federal brochure RI 71-006. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.
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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Need help choosing a plan? Let's talk
Our Benefits Advisers are available Mon. – Fri. from 7 a.m. – 7 p.m. Central time and are ready to answer your questions.
If you’re a current GEHA member and need help, call 800.821.6136 (medical) or 877.434.2336 (dental).
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Let's explain the process.
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 Elevate Plus medical plan. Before making a final decision, please read the Plan's Federal brochure RI 71-006. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.