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Standard medical 2024

A fundamental plan for families of all sizes who want a low deductible and predictable coverage for routine visits

Highlights:

  • Our most family-friendly plan for growing families with 100% maternity coverage
  • New for 2024: $0 copay for one PCP visit and two urgent care visits per year for children under 18
  • New for 2024: Infertility coverage only for artificial insemination (AI). Coverage for drugs associated with AI and in vitro fertilization (IVF limited to 3 cycles annually). Preauthorization is required.
  • Dependable, traditional coverage with affordable premiums for average use
  • Low-cost vision coverage with $5 annual eye exam from EyeMed®*
  • Twice yearly dental cleanings covered at 50%

*These benefits are neither offered nor guaranteed under contract with the FEHB Program but are made available to all Enrollees who become members of GEHA's Standard medical plan and their eligible family members.

2024 Standard rates

Pay frequency Self Only Self Plus One Self and Family
Biweekly — employed $70.15 $150.83 $186.35
Monthly — retired $151.99 $326.79 $403.76

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' 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
Maternity; preventive prenatal and postnatal office visits $0
Maternity; childbirth/delivery professional services $0
Maternity; childbirth/delivery facility services $0
Vision coverage; eye exam1 $5
MinuteClinic (where available) $10
Primary care physician office visit $20
Mental health office visit $20
Specialist care office visit $35
Urgent care facility visit $35
Chiropractic care (manipulative therapy), including X-rays; up to 20 visits per year $35
Lab services other than QuestSelect 15%
ER visit 15%2
Hospital care; inpatient and outpatient 15%2
Professional surgical services 15%2
X-ray and other diagnostic services 15%2
Acupuncture; up to 20 visits per year 15%2
Preventive dental care, twice yearly 50%
Outpatient professional high tech imaging (MRI, CT, PET, etc.) $100
Outpatient facility high tech imaging (MRI, CT, PET, etc.) $150

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

Term Self Only Self Plus One Self and Family
Yearly deductible (what you pay in-network) $350 $700 $700
Out-of-pocket maximum (what you pay in-network) $6,500 $13,000 $13,000

Prescription benefits

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.
Prescription benefit In-network
30-day retail generic $10
30-day retail preferred brand-name 40%, up to $250 max¤
30-day retail non-preferred brand-name 60%, up to $350 max¤
90-day mail service generic $20
90-day mail service preferred brand-name 40%, up to $550 max¤
90-day mail service non-preferred brand-name 60%, up to $650 max¤
30-day specialty CVS exclusive generic and preferred brand-name 50%, up to $250 max¤
30-day specialty CVS exclusive non-preferred brand-name 50%, up to $400 max¤

Highlights that are special to Standard

Health Rewards

Up to two adults ages 18 and over can earn up to $250 (maximum $500 per household) per year.

Vision coverage1

Get in-network routine eye exams for $5 and discounts on eyewear.

 

Pregnancy and childbirth

GEHA maternity benefits include discounts on breast pumps and up to $150 allowance for childbirth classes.

cover image for the 2024 geha medical benefits guide

2024 Medical Benefits Guide


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



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