Elevate Plus 2024
The conventional plan for proactive people who always stay in-network
Highlights:
- Low copays for non-traditional care, like chiropractic and acupuncture
- $200 deductible for Self Only. $400 deductible for Self Plus One and Self and Family. 15% coinsurance for some services.
- Copays for most common services.
- Specialist copay of $50 per visit
- Earn rewards with the Rally® digital health platform
- Mental health benefit, including telehealth, from MDLIVE
- Vision discounts and $0 annual eye exam included with EyeMed1
2024 Elevate Plus rates
| Pay frequency | Self Only | Self Plus One | Self and Family |
|---|---|---|---|
| Biweekly — employed | $102.55 | $232.73 | $253.08 |
| Monthly — retired | $222.19 | $504.25 | $548.34 |
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.| Medical benefit | What you pay |
|---|---|
| Unlimited telehealth visits, including mental health, with MDLIVE | $0 |
| Preventive care; adult routine screenings | $0 |
| Well-child visit; up to age 22 | $0 |
| Lab services | $0 |
| Maternity; preventive prenatal and postnatal office visits | $0 |
| Maternity; childbirth/delivery professional services | $0 |
| Vision coverage; eye exams1 | $0 |
| MinuteClinic visit (where available) | $10 |
| Primary care physician office visit | $30 |
| Mental health office visit | $30 |
| Chiropractic care (manipulative therapy), including X-rays; up to 15 visits per year | $30 |
| Acupuncture; up to 20 visits per year | $30 |
| Specialist care office visit | $50 |
| Urgent care facility visit | $50 |
| X-rays and other diagnostic services | $502 |
| ER visit | 15%3 |
| Maternity; childbirth/delivery facility services | 15%3 |
| Hospital care; inpatient and outpatient | 15%3 |
| Outpatient and inpatient professional surgical services | 15%3 |
1These benefits are neither offered nor guaranteed under contract with the FEHB Program, but are made available to all Enrollees who become members of a GEHA medical plan and their eligible family members.
2You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA's 2024 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete list.
3Calendar year deductible applies.
2You pay $175 ($100 professional fee, $75 facility fee) for advanced outpatient High Tech Imaging such as MRI, CT, PET, etc. Refer to GEHA's 2024 plan brochure RI 71-018 (Elevate and Elevate Plus) for a complete list.
3Calendar year deductible applies.
Prescription benefits
The table below summarizes your cost for prescription drugs with the Elevate Plus plan. This plan has no out-of-network pharmacy coverage. 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 Elevate Plus plan, use this handy check your drug costs tool.
| Prescription benefit | In-network |
|---|---|
| 30-day retail generic | $10 |
| 30-day retail preferred brand-name | $80 copay¤ |
| 30-day retail non-preferred brand-name | 50% of allowance¤ |
| 90-day mail service generic | $20 |
| 90-day mail service preferred brand-name | $200¤ |
| 90-day mail service non-preferred brand-name | 50% of allowance¤ |
| 30-day specialty CVS exclusive generic and preferred brand-name | 40% of allowance ($500 max¤) |
| 30-day specialty CVS exclusive non-preferred brand-name | 50% of allowance¤ |
¤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.
Highlights that are special to Elevate Plus
Digital health care
GEHA's digital platform provides a fun way to stay motivated and earn up to $500 per person.
$0 telehealth visits
Access certified doctors, including pediatricians, licensed mental health therapists and dermatologists.
1 These benefits are neither offered nor guaranteed under contract with the FEHB Program but are made available to all Enrollees who become members of the GEHA Elevate Plus plan and their eligible family members. 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 71-018. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochure.
2024 Medical Benefits Guide
Review this guide with all our plans, including rates, costs, extra services, and side-by-side comparisons
Our Benefits Advisers are available to help new shoppers Mon. – Fri. from 7 a.m. – 7 p.m. Central time.
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