GEHA Insurance

Government Employees Health Association (GEHA) Insurance offers health care insurance plans for federal employees, federal retirees and their families. All plans offer health care savings; however, each plan has unique benefits and copay arrangements.

GEHA Insurance was founded after the Great Depression in 1937 and continues to provide health care benefits to over 420,000 members worldwide. It is the second largest national health plan providing health, dental, vision and wellness care for federal employees, federal retirees and their families through a very large provider network.

This PPO network includes 4,600 hospitals and 850,000 health providers worldwide. One of the most popular features of the GEHA program is that a member can choose to use a network provider or they can still receive savings on services from a provider who is outside of the GEHA network.

One of the key features of being insured with a GEHA health plan is the wide variety of savings which you can take part in for both your medical and dental needs. The various plans offered provide savings on routine office visits, occasional health needs and preventive health care needs. Insured members receive savings on:

• Doctor visits
• Preventive dental care
• Lab tests and services
• Routine medical screenings
• Maternity care by physicians and hospitals
• Well-child care until age 22
• Accidental injury care
• Eye exams, lenses, frames, contact lenses and LASIK surgery
• Generic and brand name drugs
• Gym memberships and home exercise equipment

GEHA Insurance offers four affordable health plans:

The Standard Option is designed to provide health and dental care savings with affordable premiums and low copays. For example, insured members receive:

• $10 office visit copays for primary care
• No annual deductible for prescription drugs
• No costs for most outpatient laboratory testing which is ordered by a physician
• $5 copays for generic drugs
• 50 percent copays on brand name drugs
• 50 percent coverage of semi-annual dental care

The GEHA High Option is designed for the member who is willing to pay a higher premium in exchange for more coverage for hospital stays and lower copays on brand name drugs and dental services. The plan provides insured members with benefits such as:

• $10 office visit copays for primary care
• No annual deductible for prescription drugs
• No costs for most outpatient laboratory testing which is ordered by a physician
• No costs for hospital room and board
• $5 copays for generic drugs
• 25 percent copays on brand name drugs
• Partial payment of dental care bills

The GEHA Health Savings Advantage is a health plan with a high-deductible level. The plan is designed to work with a health savings account (HSA), providing tax savings while the member builds a savings account to pay for future health care costs.

There are two parts to the program:

• The High Deductible Health Plan provides unlimited preventative care for adults with 100 percent of the bill paid to in-network doctors. If the member receives care from a health care provider outside of the GEHA Insurance network, only a portion of the bill is covered by GEHA. The member pays a deductible for the first $1,500 each year or $3,000 for the member plus their family.
• A Health Savings Account (HSA) is established by the member. GEHA will make monthly deposits into the HSA. GEHA contributes $720 annually for the member or $1,440 for the member plus their family. Members earn tax-free interest on the funds. They can withdraw from the account anytime to pay for health care expenses such as doctor visits and prescriptions. At the end of the year any unused funds will roll over to the next year.

All of the GEHA insurance plans can easily be used with Medicare benefits to enlarge the health coverage available to the GEHA member. Medicare recipients are not limited to in-network health providers and hospitals. They have the option to select any health care provider for their health care needs. Their total costs are covered for doctor visits, hospitalization, surgery and lab services regardless of whether the provider is inside or outside of the GEHA network.

GEHA Insurance also offers health advice and information through their Nurse Advice Line. Members can call the toll-free telephone number 24 hours a day, everyday, and speak with a registered nurse. The nurse can help members decide the best way to care for their particular health issues and to decide if they should see a physician or seek emergency care. The Nurse Advice Line also has over 1,000 pre-recorded messages on health topics.

All benefits, copays and plan features mentioned above reflect those offered in the 2010 GEHA insurance plans. Current information on benefits and premiums as well as enrollment information can be obtained on www.geha.com..

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