MEDICAREBENEFITSgeha.com/Medicare

Learn more with free e-books & videosLearn more about your options with Medicare and GEHA, download free e-books and view informative videos at:

geha.com/Medicare

With GEHA’s Standard Option or High Option plan, a sudden hospital stay, a prolonged illness or a major surgical procedure won’t overwhelm your budget.

X $600 Medicare Part B premium reimbursement: New in 2020 for the High Option only, this reimbursement will help with your Medicare Part B premium payments.

X Waived deductibles, copays and coinsurance: GEHA waives deductibles, copays and coinsurance whether your provider is in- or out-of-network.

X No cost to you: For covered inpatient and outpatient hospital services, surgeries and office visits, your cost is nothing.

X Care wherever you are: If you need medical care while you’re outside the United States, copays and deductibles are still waived.

X Comprehensive prescription coverage: GEHA’s Standard and High Option plans include quality prescription coverage. High Option members have reduced copays for covered prescriptions.

X Added coverage: GEHA members also get vision coverage and $2,500 toward hearing aids (every three years).7

GEHA works with Medicare A & B.

Medicare + GEHA

How to enrollIf you are a retired federal employee, you can sign up for a GEHA medical plan by completing OPM form 2809, available through the Office of Personnel Management. Learn more at geha.com/Enroll

OPM Open Season online system:retireefehb.opm.gov

OPM Open Season Express:800.332.9798

7 See endnotes on page 8.This is a brief description of the features of GEHA medical plans. 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.

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Medical benefits: What you pay

Medicare A & B with Standard Option

Medicare A & B with High Option

Preventive care; adult routine screenings Nothing Nothing

Preventive lab services Nothing Nothing

Primary care physician; office visit Nothing Nothing

Specialist care; office visit Nothing Nothing

Online doctor visits Nothing Nothing

Urgent care Nothing Nothing

MinuteClinic® (where available) Nothing Nothing

Emergency care Nothing Nothing

Hospital care; inpatient Nothing Nothing

Hospital care; outpatient Nothing Nothing

Preventive dental care 50% of allowance, twice yearly

Balance after GEHA pays $22 / visit, twice yearly

Compare plan pricing

When Medicare A & B is primary, GEHA’s Standard Option and High Option plans help cover expenses not covered by Medicare.

Learn more at geha.com/Medicare

Learn more at geha.com/Medicare | Questions? Call 800.262.4342

With Medicare A & B, GEHA’s Standard and High Option plans offer: X Deductibles, copays and coinsurance waived whether your provider is in- or out-of-network.

X Covered inpatient and outpatient hospital services, surgeries and office visits, at no cost to you.

X Coverage when you’re out of the country, where Medicare does not cover you.

2020 rates*

Retirees monthlySelf Only Self Plus One Self and Family

Standard Option $131.18ENROLL CODE 314

$282.05ENROLL CODE 316

$336.96ENROLL CODE 315

High Option $228.41ENROLL CODE 311

$534.11ENROLL CODE 313

$659.51ENROLL CODE 312

Compare plan benefits

Up to $600 in reimbursements per calendar year. This amount may be used on Medicare Part B premium payments, for High Option plan members enrolled in Medicare Parts A & B.

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*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.

This is a brief description of the features of Government Employees Health Association, Inc.’s medical plans. Before making a final decision, please read GEHA federal brochure RI 71-006 available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure.

Retail: You’ve got optionsTo pay less, get your prescriptions filled in person at any in-network location. Your options include any retail CVS Pharmacy location, but you don’t have to go to a retail CVS Pharmacy to pay in-network prices.

Save more with mail orderWith CVS Caremark’s Mail Service Pharmacy, you can save money and have your routine prescriptions delivered to your home, postage-paid, within about 14 days from the time you submit your prescription.

Check drug costs in advanceDon’t be surprised at the pickup counter. Check drug costs to estimate what you’ll pay based on your GEHA medical plan and prescription dosage. Check your drug costs here:

info.caremark.com/GEHA

Compare prescription benefitsLearn more3 at geha.com/Prescriptions

Visit geha.com/Find-Care to find in-network locations including Rite Aid, Walmart, Walgreens, Costco, Kroger, Meijer, Safeway, Albertson’s, Publix, Giant and many more.

Mail service pharmacy2

What you pay in-network

Medicare A & B with Standard Option

Medicare A & B with High Option

90-day supply

Generic $20 $15

Preferred brand-name medication 50% ($500 max4) 15% ($350 max4)

Non-preferred brand-name medication 50% ($600 max4) 30% ($500 max4)

Specialty prescription2

What you pay in-network

Medicare A & B with Standard Option

Medicare A & B with High Option

30-day supply; CVS exclusive5

Generic and preferred brand-name medication 50% ($250 max4) 15% ($150 max4)

Non-preferred brand-name medication 50% ($400 max4) 30% ($200 max4)

Retail pharmacy2

What you pay in-network

Medicare A & B with Standard Option

Medicare A & B with High Option

30-day supply

Generic $10 $10 copay6

Preferred brand-name medication 50% ($200 max4) 20% ($150 max4,6)

Non-preferred brand-name medication 50% ($300 max4) 35% ($200 max4,6)

2,3,4,5,6 See endnotes on the back cover.

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Vision coverage & discounts

X $5 copay for Standard and High Option for routine eye exams at qualified EyeMed™ providers. X For out-of-network exams, EyeMed reimburses you up to $45 per covered member per year. X No limit on the number of glasses or contacts purchased each year with savings on LASIK and PRK. X Access to thousands of EyeMed providers, including LensCrafters, Pearle Vision, Target, JCPenney

Optical and independent eye doctors.

Contact lenses Your in-network cost

Conventional 85% of the retail price

Disposable No discount

Learn more at geha.com/Vision

Discounts for Standard Option and High Option Your in-network cost

Eye exam; with dilation as necessary $5

Eyeglass frames 60% of the retail price

Included benefits & savings

Eyeglass lenses Your in-network cost

Standard plastic, single vision Up to $50

Standard plastic bifocal Up to $70

Standard plastic trifocal Up to $105

Standard progressive lens Up to $135

Premium progressive lens 80% of the retail price

Eyeglass lens options Your in-network cost

UV treatment $15

Tint (solid and gradient) $15

Standard plastic scratch coating $15

Standard polycarbonate $40

Standard anti-reflective coating $45

Photochromatic / transitions plastic 80% of the retail price

Premium anti-reflective 80% of the retail price

Other add-ons 80% of the retail price

Additional pairs Your in-network cost

Eyeglasses (complete pair) Up to 60% of the retail price

Contacts (conventional lenses) Up to 85% of the retail price

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 complete information, see GEHA Plan Brochure RI 71-006 at geha.com/PlanBrochure5

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Health Advice Line As a GEHA medical plan member, you can talk with a nurse for free, 24/7.

geha.com/Healthline

Online doctor visits As a GEHA medical plan member, you can receive care via phone or video 24/7using online doctor visits from MDLIVE 24/7. Includes dermatologists.

geha.com/MDLIVE

Biometric screening7

Spot the early warning signs of serious conditions such as heart disease and diabetes with this easy test. You can have a free confidential screening at home, at work or at one of 2,300 Quest Diagnostics locations nationwide.

geha.com/Screenings

Gym discount With GEHA’s Connection Fitness® program, all GEHA medical plan members can access more than 10,000 Active&Fit Direct™ participating fitness centers nationwide for $25 a month (plus a $25 enrollment fee and applicable taxes). Search for gyms and track your progress online.

geha.com/Fitness

Medical alert system GEHA members and extended family are eligible for discounted services from Life Alert®, the industry leader in responsive emergency care. Members receive free activation, plus a 10% monthly discount.

geha.com/LifeAlert

Electric toothbrush1

GEHA members receive an exclusive discount of more than 70% off premium electric toothbrushes by cariPRO™.

geha.com/Toothbrush

Teeth whitening Receive a 20% discount on the lowest published price on all Smile Brilliant home teeth whitening products. This includes custom-fitted trays, whitening gel and desensitizing gel.

smilebrilliant.com/GEHA

Learn how to enroll at geha.com/Enroll | Questions? Call 800.262.4342

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 complete information, see GEHA Plan Brochure RI 71-006 at geha.com/PlanBrochure

Examples of common hearing aid product ranges

Products given as examples onlyAverage retail price

TruHearing price

Plan benefit You pay

Starkey Muse iQ i1000 $3,410 $1,950 $2,500 Nothing

TruHearing Advanced 19 $4,890 $2,500 $2,500 Nothing

Widex Beyond 220 $4,260 $2,500 $2,500 Nothing

Oticon Opn 3 $4,830 $2,790 $2,500 $290

ReSound LiNX 3D 5 $4,950 $3,190 $2,500 $690

Hearing aid savings X For Standard and High Option plans, enjoy a hearing aid benefit of $2,500 with no deductible. X Benefit is per person, every three years for adults — and annually for dependents up to age 22. X In addition, GEHA members and their extended family members can also take advantage of

TruHearing’s discounted pricing. Most people see savings of 30% to 60%, averaging more than $2,100 per pair.

Learn more at geha.com/Hearing

1,7 See endnotes on the back cover.

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S Helpful resources

Helpful tools Description Learn moreFind a provider Search our nationwide network for a doctor

or medical facility near you.geha.com/Find-Care

Online decision tool Take our quiz to see which GEHA medical plan might be the best fit for your lifestyle.

geha.com/Select-A-Plan

Urgent care Get the care you need, anytime, at any in-network urgent care facility near you.

geha.com/Find-Care

Pharmacy program Verify drug costs based on your benefit plan and prescription dosage.

info.caremark.com/GEHA

MinuteClinic® Get basic care in many retail CVS Pharmacies, no appointment needed.

cvs.com/MinuteClinic/Clinic-Locator

Plan resources Description Learn moreCustomer Care Contact GEHA with questions about

your plan benefits or coverage.800.262.4342

Medical plans Details on GEHA’s medical plans and supplemental benefits.

geha.com/Rates

Medicare plans Discover how GEHA plans offer extra coverage with your Medicare plan.

geha.com/Medicare

Overseas information Information about medical coverage when you’re outside of the United States.

geha.com/OutsideUSA

Enrollment help Tips for new enrollees or members who are changing plans.

geha.com/Enroll

The National Active and Retired Federal Employees Association

Dedicated to helping federal employees and retirees manage their benefits.

narfe.org

U.S. Office of Personnel Management

Official information for federal employees eligible for FEHB plans.

opm.gov/Healthcare-Insurance

If you have questions after reviewing this benefits guide, the online tools, phone numbers and websites below are great places to find helpful answers.

If you’re stuck or overwhelmed, call 800.262.4342 and talk to one of our helpful Customer Care advisers.

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geha.com/MedicareQuestions? Call 800.262.4342

/gehahealth /company/gehahealth

WHAT’S NEW X Up to $600 in reimbursements per calendar year. This amount may be used on Medicare

Part B premium payments, for High Option plan members enrolled in Medicare Parts A & B.

X Expanded online doctor visits now includes coverage for dermatology care in addition to previously available coverage for non-emergency medical and behavioral health consultations.

X Increased coinsurance maximums for Standard Option, from $200 to $250 for generic and preferred brand specialty drugs, and from $300 to $400 for non-preferred brand specialty drugs.

For details on all of the changes for 2020, see “Section 2: Changes for 2020” in plan brochure RI 71-006, which is available at geha.com/PlanBrochure

This is a brief description of the features of Government Employees Health Association, Inc.’s medical plans. Before making a final decision, please read GEHA federal brochure RI 71-006 available at geha.com/PlanBrochure. All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure.

For complete information, see GEHA Plan Brochure RI 71-006 at geha.com/PlanBrochure© 2019 Government Employees Health Association, Inc. All rights reserved. Please recycle.

1 The cariPRO™ premium electric toothbrush removes seven times more plaque than a regular brush, is completely waterproof, and comes with a two-year manufacturer’s warranty. Replacement brush heads with high-quality DuPont™ bristles are also available at this exclusive, members- only price.

2 For out-of-network benefits, see GEHA’s Standard and High Option plan brochure RI 71-006, available online at geha.com/PlanBrochure

3 Refer to geha.com/Prescriptions for formulary and specialty coverage for specific medications.

4 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.

5 Over 30-day specialty copay based on days of therapy. The drug cost share is two times the copay for drugs that provide 60 days’ worth of therapy and three times the copay for drugs that provide 90 days’ worth of therapy.

6 Costs for initial prescription and first refill. You pay 50% for third and additional refills at retail for 30-day supply. For long-term prescriptions, use mail order or your local retail CVS Pharmacy store (90-day supply) for greater cost savings.

7 These 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.

Endnotes

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