GEHA
GEHA Benefit Plan — Standard Option
FEHB Offered in 2027|GEHA|Traditional|PPO
Also listed as: GEHA
Premium
biweekly · employee paysSelf Only
$86.75biweekly · employee pays
vs 2026+$0.00 0.0%
Lowest$44.93 (2013)
Highest$86.75 (2026)
Since 2013+93.1%
Self Plus One
$186.51biweekly · employee pays
vs 2026+$0.00 0.0%
Lowest$111.35 (2016)
Highest$186.51 (2026)
Since 2016+67.5%
Self & Family
$231.45biweekly · employee pays
vs 2026+$0.00 0.0%
Lowest$102.19 (2013)
Highest$231.45 (2026)
Since 2013+126.5%
Premium history
SharePeriodRate type
Year by year
follows the chart's share, period and rate-type selection| Year | Self Only | Δ | Self Plus One | Δ | Self & Family | Δ | Listed as |
|---|
Changelog
- 2012Tracked since 2012Earliest plan year in the data set.
- 2016Self Plus One enrollment addedOPM introduced the Self Plus One enrollment type government-wide in 2016.
- 2018Renamed“GEHA Benefit Plan” → “GEHA”
- 2020Renamed“GEHA” → “GEHA Benefit Plan”
- 2025Largest increase: +14.5%Self Only employee share went from $70.15 to $80.32.
Full rate schedule
Plan yearIn-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | $500 | $1,000 | $1,000 |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | $500 | $1,000 | $1,000 |
| Annual out-of-pocket maximum | $8,000 | $16,000 | $16,000 |
| Prescription out-of-pocket maximum | $8,000 | $16,000 | $16,000 |
- Type of accountNot Applicable
- Medicare Part D EGWP Prescription Drug Out-of-Pocket Maximum per enrollee$2,400
- Total Annual Part B Premium Reimbursement Amount Per Enrollee (MAPD)$900
- Tier 0$0 Copayment
- Tier 1$10 Copayment
- Tier 240% Coinsurance
- Tier 360% Coinsurance
- Tier 450% Coinsurance
- Tier 550% Coinsurance
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)Deductible waived
- Deductible waiver (with Medicare Part B as Primary)Deductible waived
- Deductible Waiver with Parts A & BDeductible waived
- Out-of-Pocket Maximum with Parts A & B$8,000
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & BMember Pays Nothing
- Outpatient Hospital Services with Part A25% Coinsurance
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNot applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Part CMember Pays Nothing
- Inpatient Hospital Services with Part CNot applicable
- Outpatient Hospital Services with Part CMember Pays Nothing
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Part C$900 Maximum
- Preventive CareMember Pays Nothing
- Primary Care Office Visit$35 Copayment
- Specialist Office Visit$50 Copayment
- Emergency Care35% Coinsurance
- Urgent Care$50 Copayment
- Doctor Costs for Inpatient Surgery25% Coinsurance
- Hospital Inpatient Cost Per Admission25% Coinsurance
- Hospital Room Costs25% Coinsurance
- Other Inpatient Hospital Costs25% Coinsurance
- Doctor Costs for Outpatient Surgery25% Coinsurance
- Other Outpatient Surgery Costs25% Coinsurance
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)25% Coinsurance
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)$250 Copayment
- Enhanced Lab NetworkMember Pays Nothing
- Applied Behavioral Analysis (ABA)25% Coinsurance
- Chiropractic$35 Copayment
- Occupational Therapy25% Coinsurance
- Physical Therapy25% Coinsurance
- Speech Therapy25% Coinsurance
- Professional Services (Mental Health and Substance Use Disorder)$35 Copayment
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)25% Coinsurance
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)25% Coinsurance
- Diagnosis and Treatment (Infertility Services)25% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)25% Coinsurance
- Artificial Insemination Services (e.g. ICI, IVI, IUI)25% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures25% Coinsurance
- Reconstructive Surgery25% Coinsurance
- Hearing Services25% Coinsurance
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)Member Pays Nothing
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)25% Coinsurance
- Hospice CareMember Pays Nothing
- Home Health Services (Skilled Nursing Care)25% Coinsurance
- Durable Medical Equipment25% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)25% Coinsurance
- Diabetes EducationMember Pays Nothing
- Nutritional CounselingMember Pays Nothing
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture25% Coinsurance
- Chronic Disease Management: Heart DiseaseCovered
- Chronic Disease Management: ObesityCovered
- Chronic Disease Management: HypertensionCovered
- Chronic Disease Management: AsthmaCovered
Out-of-network
2027 plan benefits file| Self Only | Self Plus One | Self & Family | |
|---|---|---|---|
| Annual deductible | $2,000 | $4,000 | $4,000 |
| Medical account contribution | Not applicable | Not applicable | Not applicable |
| Net deductible | $2,000 | $4,000 | $4,000 |
| Annual out-of-pocket maximum | $20,000 | $40,000 | $40,000 |
- Type of accountNot Applicable
- Tier 0$0 Copayment
- Tier 1$10 Copayment
- Tier 240% Coinsurance
- Tier 360% Coinsurance
- Tier 4100% Coinsurance
- Tier 5100% Coinsurance
- Mail Order PharmacyNo
- Deductible waiver (with Medicare Part A as Primary)Deductible waived
- Deductible waiver (with Medicare Part B as Primary)Deductible waived
- Deductible Waiver with Parts A & BDeductible waived
- Out-of-Pocket Maximum with Parts A & B$20,000
- Primary Care Physician Office Visit with Medicare A & B PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Parts A & BMember Pays Nothing
- Inpatient Hospital Services with Parts A & BMember Pays Nothing
- Outpatient Hospital Services with Part A50% Coinsurance
- Outpatient physician services (with Medicare Part B as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Parts A & BNot applicable
- Requirement for Part B ReimbursementNot applicable
- Deductible Waiver with Part CNot applicable
- Out-of-Pocket Maximum with Part CNot applicable
- Primary Care Physician Office Visit with Medicare Advantage (Part C) PrimaryMember Pays Nothing
- Specialty Physician Office Visit with Part CMember Pays Nothing
- Inpatient Hospital Services with Part CNot applicable
- Outpatient Hospital Services with Part CMember Pays Nothing
- Outpatient physician services (with Medicare Advantage Part C as Primary)Member Pays Nothing
- Part B Premium Reimbursement with Part CNot applicable
- Preventive Care50% Coinsurance
- Primary Care Office Visit50% Coinsurance
- Specialist Office Visit50% Coinsurance
- Emergency Care35% Coinsurance
- Urgent Care50% Coinsurance
- Doctor Costs for Inpatient Surgery50% Coinsurance
- Hospital Inpatient Cost Per Admission50% Coinsurance
- Hospital Room Costs50% Coinsurance
- Other Inpatient Hospital Costs50% Coinsurance
- Doctor Costs for Outpatient Surgery50% Coinsurance
- Other Outpatient Surgery Costs50% Coinsurance
- Diagnostic Tests or Procedures (e.g., Blood Tests, X-rays, Urinalysis, Ultrasounds)50% Coinsurance
- Diagnostic Tests or Procedures (e.g., CT scans, MRIs, PET Scans)50% Coinsurance
- Enhanced Lab NetworkNot applicable
- Applied Behavioral Analysis (ABA)50% Coinsurance
- Chiropractic50% Coinsurance
- Occupational Therapy50% Coinsurance
- Physical Therapy50% Coinsurance
- Speech Therapy50% Coinsurance
- Professional Services (Mental Health and Substance Use Disorder)50% Coinsurance
- Inpatient Hospital (Mental Health and Substance Use Disorder Services)50% Coinsurance
- Outpatient Hospital (Mental Health and Substance Use Disorder Services)50% Coinsurance
- Diagnosis and Treatment (Infertility Services)50% Coinsurance
- Fertility Preservation Procedures (e.g., iatrogenic infertility) (Infertility Services)50% Coinsurance
- Artificial Insemination Services (e.g. ICI, IVI, IUI)50% Coinsurance
- Assisted Reproductive Technology (ART) (e.g., IVF, GIFT, ZIFT) (Infertility Services)Member Pays All Charges
- Surgical Procedures50% Coinsurance
- Reconstructive Surgery50% Coinsurance
- Hearing Services50% Coinsurance
- Hearing Aids (external)Covered
- Prenatal Care, Screening for Gestational Diabetes, Delivery, and Postpartum Care (Maternity Care)50% Coinsurance
- Hospital Stay--Vaginal Birth, Cesarean Birth (Maternity Care)50% Coinsurance
- Hospice CareMember Pays Nothing
- Home Health Services (Skilled Nursing Care)50% Coinsurance
- Durable Medical Equipment50% Coinsurance
- Outpatient Rehabilitation (Skilled Nursing Care Facility)50% Coinsurance
- Diabetes EducationMember Pays Nothing
- Nutritional Counseling50% Coinsurance
- Routine Dental Exams and Cleaning for AdultsCovered
- Routine Dental Exams and Cleaning for ChildrenCovered
- Routine Eye ExamsNot Covered
- Eye Exams for Medical Condition or Non-Surgical TreatmentCovered
- EyeglassesNot Covered
- Contact LensesNot Covered
- Acupuncture50% Coinsurance
- Chronic Disease Management: Heart DiseaseNot Covered
- Chronic Disease Management: ObesityNot Covered
- Chronic Disease Management: HypertensionNot Covered
- Chronic Disease Management: AsthmaNot Covered
Offered nationwide.
Service area description
| State | Description |
|---|---|
| Nationwide | Nationwide |
Service area over time
| Year | States / areas listed |
|---|---|
| 2027 | Nationwide |
| 2026 | Nationwide |
| 2025 | Nationwide |
| 2024 | Nationwide |
| 2023 | Nationwide |
| 2022 | Nationwide |
| 2021 | Nationwide |
| 2020 | Nationwide |
| 2019 | Nationwide |
| 2018 | Nationwide |
| 2017 | Nationwide |
| 2016 | Nationwide |