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New for 2025: G.E.H.A Prescription Drug Plan

A Medicare PDP / EGWP that provides even greater prescription benefits.

a pharmacist smiles as he give a customer her prescription

Announcing a new G.E.H.A Prescription Drug Plan/EGWP, a Medicare PDP/EGWP that provides comprehensive prescription benefits.

Your ability to get the prescriptions that you need is important to your health. This additional coverage means that you may receive even greater savings on your prescriptions at no additional cost to your current premiums.

G.E.H.A members don't have to do anything to enroll in the G.E.H.A Prescription Drug Plan/EGWP. You will be auto enrolled if you are an annuitant in G.E.H.A's PSHB plans or G.E.H.A's FEHB Standard or High plan — and you have Medicare Parts A and/or B for the 2025 Plan Year. The G.E.H.A Prescription Drug Plan/EGWP is offered by SilverScript^® Insurance Company, which is affiliated with CVS Caremark^®, G.E.H.A's current pharmacy benefit manager.

Who qualifies for G.E.H.A Prescription Drug Plan/EGWP?

All G.E.H.A PSHB retirees with Medicare Parts A and/or B who live in the US
All G.E.H.A. FEHB retirees with Standard or High with Medicare Parts A and/or B who live in the US

Will I receive a new/separate prescription ID card?

New members will receive a member ID card to use at the pharmacy in a separate mailing. This card will not be active until January 1, 2025.

Not interested in the G.E.H.A Prescription Drug Plan/EGWP?

G.E.H.A PSHB retirees with Medicare Parts A and/or B who cancel their enrollment will not have prescription drug coverage with PSHB.
G.E.H.A FEHB retirees with Standard or High with Medicare Parts A and/or B who cancel their enrollment will be transitioned back to their base FEHB plan or commercial prescription drug plan.

If you would like to cancel your enrollment in the G.E.H.A Prescription Drug Plan/EGWP, please call 1-833-250-3241 (TTY: 711), 24 hours a day, 7 days a week, by December 31, 2024. Members who cancel their enrollment will receive a confirmation letter in approximately ten days. FEHB retirees who cancel their enrollment by December 31, 2024, can access their prescription benefits from their base FEHB plan starting January 1, 2025.

Here are some key benefits to the EGWP prescription benefit program:

Save on the amount you pay for Part D medications annually with a $2,000 out-of-pocket max
Benefit from even more prescription drug coverage compared to your original coverage
$35 monthly cap on insulin
$0 copay for vaccinations and Affordable Care Act (ACA) preventive medications

Examples include: breast cancer preventive meds, smoking cessation products or birth control.

Access to more than 63,000 pharmacies nationwide and mail-order prescriptions

Check PDP drug costs

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9	$20 ²
Tier 2 – Preferred brand	25% ($200 max) ¹	25% ($500 max) ^1,2
Tier 3 – Non-preferred brand	50% ($300 max) ¹	50% ($600 max) ^1,2
Tier 4 – Specialty	33% ($250 max) ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9	Mail order 90-day supply $20 ²	Tier 2 – Preferred brand	Retail 30-day supply 25% ($200 max) ¹	Mail order 90-day supply 25% ($500 max) ^1,2	Tier 3 – Non-preferred brand	Retail 30-day supply 50% ($300 max) ¹	Mail order 90-day supply 50% ($600 max) ^1,2

1 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.
2 Tier 2 and 3 mail order prescriptions are more cost-effective when filled through CVS Caremark Mail Service.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9	$15 ²
Tier 2 – Preferred brand	20% ($150 max) ¹	15% ($350 max) ^1,2
Tier 3 – Non-preferred brand	35% ($200 max)¹	30% ($500 max) ^1,2
Tier 4 – Specialty	15% ($150 max) ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9	Mail order 90-day supply $15 ²	Tier 2 – Preferred brand	Retail 30-day supply 20% ($150 max) ¹	Mail order 90-day supply 15% ($350 max) ^1,2	Tier 3 – Non-preferred brand	Retail 30-day supply 35% ($200 max)¹	Mail order 90-day supply 30% ($500 max) ^1,2

1 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.
2 Tier 2 and 3 mail order prescriptions are more cost-effective when filled through CVS Caremark Mail Service.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9	$20²
Tier 2 – Preferred brand	25% ($200 max) ¹	25% ($500 max) ^1,2
Tier 3 – Non-preferred brand	50% ($300 max) ¹	50% ($600 max) ^1,2
Tier 4 – Specialty	33% ($250 max) ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9	Mail order 90-day supply $20²	Tier 2 – Preferred brand	Retail 30-day supply 25% ($200 max) ¹	Mail order 90-day supply 25% ($500 max) ^1,2	Tier 3 – Non-preferred brand	Retail 30-day supply 50% ($300 max) ¹	Mail order 90-day supply 50% ($600 max) ^1,2

1 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.
2 Tier 2 and 3 mail order prescriptions are more cost-effective when filled through CVS Caremark Mail Service.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9	$15²
Tier 2 – Preferred brand	20% ($150 max) ¹	15% ($350 max)^1,2
Tier 3 – Non-preferred brand	35% ($200 max)¹	30% ($500 max)^1,2
Tier 4 – Specialty	15% ($150 max)¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9	Mail order 90-day supply $15²	Tier 2 – Preferred brand	Retail 30-day supply 20% ($150 max) ¹	Mail order 90-day supply 15% ($350 max)^1,2	Tier 3 – Non-preferred brand	Retail 30-day supply 35% ($200 max)¹	Mail order 90-day supply 30% ($500 max)^1,2

1 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.
2 Tier 2 and 3 mail order prescriptions are more cost-effective when filled through CVS Caremark Mail Service.

Retail 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$9	$20
Tier 2 – Preferred brand	$47 ¹	$141 ¹
Tier 3 – Non-preferred brand	50% ¹	50% ¹
Tier 4 – Specialty	33% ($500 max) ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $9	Mail order 90-day supply $20	Tier 2 – Preferred brand	Retail 30-day supply $47 ¹	Mail order 90-day supply $141 ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 50% ¹	Mail order 90-day supply 50% ¹

1 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 30-day supply	Mail order 90-day supply
Tier 1 – Generic	$3	$9
Tier 2 – Preferred brand	25% ($500) ¹	25% ($1,500) ¹
Tier 3 – Non-preferred brand	25% ($500) ¹	25% ($1,500) ¹
Tier 4 – Specialty	33% ($500 max) ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply $3	Mail order 90-day supply $9	Tier 2 – Preferred brand	Retail 30-day supply 25% ($500) ¹	Mail order 90-day supply 25% ($1,500) ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 25% ($500) ¹	Mail order 90-day supply 25% ($1,500) ¹

1 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 30-day supply	Mail order 90-day supply
Tier 1 – Generic	20%	20%
Tier 2 – Preferred brand	25% ¹	25% ¹
Tier 3 – Non-preferred brand	40% ¹	40% ¹
Tier 4 – Specialty	25% ¹	N/A

	Retail 30-day supply	Mail order 90-day supply
	Tier 1 – Generic	Retail 30-day supply 20%	Mail order 90-day supply 20%	Tier 2 – Preferred brand	Retail 30-day supply 25% ¹	Mail order 90-day supply 25% ¹	Tier 3 – Non-preferred brand	Retail 30-day supply 40% ¹	Mail order 90-day supply 40% ¹

1 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.

Questions about Medicare Part D or any documents you receive from G.E.H.A and SilverScript?

Call the G.E.H.A and SilverScript Customer Care Line, 24 hours a day, 7 days a week.

Call: 1-833-250-3241

TTY: 711

Questions about your G.E.H.A benefits?

If you have any questions regarding your G.E.H.A Medicare plan benefits, please call G.E.H.A Customer Care.

Call: 1-877-454-0238

TTY: 1-800-735-2966

This is a brief description of the features of Government Employees Health Association, Inc.'s medical plans. Before making a final decision, please read the GEHA Federal brochures. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures.

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New for 2025: G.E.H.A Prescription Drug Plan

A Medicare PDP / EGWP that provides even greater prescription benefits.

Announcing a new G.E.H.A Prescription Drug Plan/EGWP, a Medicare PDP/EGWP that provides comprehensive prescription benefits.

G.E.H.A FEHB EGWP Prescription Drug Plan benefits

G.E.H.A PSHB EGWP Prescription Drug Plan benefits

Questions about Medicare Part D or any documents you receive from G.E.H.A and SilverScript?

Questions about your G.E.H.A benefits?