The November 15, 2016, chat with GEHA President Julie Browne has concluded. The transcript is available below and will remain online for several weeks.

For more information about GEHA, please visit the GEHA health home page or the GEHA dental home page, or give us a call at 800.821.6136


Greenbelt, Maryland Will this chat be available after today?
Julie Browne: Yes, we'll leave the chat transcript right here on this website at least until the end of Open Season. Thanks for your interest in GEHA.

Bethlehem, Pennsylvania (GEHA HDHP Option, Connection Dental Federal (FEDVIP) High): Please explain your GEHA vision plan and compare to other plans.
Julie Browne:

If you are a GEHA health plan member or dental plan member, you get vision coverage for no additional premium. With all of our plans, you pay a low $5 copay for an annual eye exam at an EyeMed participating provider. The EyeMed network includes thousands of network providers: LensCrafters, Pearle Vision, Sears Optical, Target Optical, JCPenney Optical and private practitioners. There's no limit on the number of discounted glasses or contacts purchased each year.

To locate a participating EyeMed provider in your area, click Find a Vision Provider or call 866.804.0982.


Pensacola, Florida (Connection Dental Federal (FEDVIP) High): I'm planning to spend time in Costa Rica upon my retirement next year, and I would like info on filing dental claims from there.
Julie Browne: Congratulations on your upcoming retirement! The good news is that if you travel outside the United States, your GEHA Connection Dental Federal coverage travels with you. You'll receive the same dental plan benefits even when you receive covered services from qualified providers in Costa Rica.

For details on how to receive prompt reimbursement of your claims from Costa Rica, click Outside the United States.

St. Louis, Missouri (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): Hi my question is does GEHA pay for home health care? And for certain types of apparatus such as roller walkers?
Julie Browne:

Thank you for your question.  GEHA covers 50 in-home intermittent nursing visits per person per calendar year, not to exceed one visit up to two hours when a Registered Nurse (RN) or a Licensed Practical Nurse (LPN) provides the serves that your attending physician orders and the physician identifies the specific professional skills required by the patient and the medical necessity for skilled services.  

GEHA also covers Durable Medical Equipment (DME) that is prescribed by your attending physician and is medically necessary and is primarily and customarily used only for a medical purpose and is generally useful only to a person with an illness or injury and serves a specific therapeutic purpose in the treatment of a treatment of an illness or injury.  Covered services are based on GEHA's review for medical necessity.  See page 46 of the 2017 Plan Brochure for further details.


Poolesville, Maryland (GEHA Standard Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) Standard): Does GEHA cover the cost for shingles vaccinations? Thank you.
Julie Browne:
GEHA does cover the shingles vaccination at $0 for ages 60 and older. For ages between 50-59 the vaccination is covered with a copayment and ages 0-49 the vaccine is not covered.

Hannastown, Pennsylvania (GEHA High Option, Connection Dental Federal (FEDVIP) High): If someone already has dental and eye care can they expand to the health care?
Julie Browne: Yes. If you are already a FEDVIP member, you can certainly join one of GEHA's FEHB plans before Open Season ends on December 12. 

To find the GEHA health plan that fits you best, visit Plans & Benefits.

Woodworth, Louisiana Where are the temporary cards located on your webpage?
Julie Browne:

You can print temporary ID cards at our website, gehadental.com. You'll first register for a member web account. You'll be asked for your Member ID number and your Group ID number (AA). Please contact Customer Service at 800.821.6136 to order your permanent ID cards.

Thank you for your question.


Edgewater, Florida (GEHA Standard Option): Are flu shots covered?
Julie Browne: GEHA covers influenza vaccinations for all ages at $0.

Ft Worth, Texas (GEHA Standard Option): Are there any plans to add Silver Sneakers to the health plans?
Julie Browne:

Thanks for your question. We have researched Silver Sneakers. Compared with other options, it is not currently a cost-effective choice for our membership. In part, this is because our national membership is so large. As with all benefits, we look for good value while also working to control costs and the premiums members pay. We will continue to look at this option in the future.

All GEHA health plans include our Connection Fitness® program by GlobalFit at no additional cost to our members or their covered dependents. With Connection Fitness, you receive discounts at more than 7,000 gyms nationwide. You can shop for your new gym with a free Guest Pass to try participating clubs before joining. To learn more about the Connection Fitness program, visit geha.com./fitness.


South Hackensack, New Jersey (GEHA High Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) High): What does "coinsurance" mean? I don't understand class B -- what percentage do  I have to pay?
Julie Browne:
Coinsurance is the percentage of GEHA's allowance that you must pay for your care. We base this percentage on either the billed charge or the plan allowance, whichever is less.

For our High Option FEDVIP plan, your coinsurance is as follows:
  • Class A – nothing. Class A includes basic services: exams, cleanings and X-rays.
  • Class B – 20%. Class B includes intermediate services: fillings, extractions and periodontal maintenance.
  • Class C – 50%. Class C includes major services such as root canals, bridges, and dentures.
  • Class D – 30%. Class D is orthodontia for children and adults.

For our Standard Option FEDVIP plan, your coinsurance is as follows:
  • Class A – nothing
  • Class B – 45%
  • Class C – 65%
  • Class D – 30%

Merritt Island, Florida (GEHA HDHP Option): I have tried to get prescription prices before ordering, as I have come to find out there is quite a difference between mail order and retail for some prescriptions. However, CVS won't give a retail price until they order the prescription and run the insurance, which then they will not allow you to reject for excessive pricing. Why can't we compare?
Julie Browne:

On GEHA's Prescriptions webpage (geha.com/prescriptions), there is Check Drug Cost tool that allows you to compare the cost between mail order and retail. If you prefer, you may call GEHA's dedicated prescription benefit line at 844.443.4279 to speak with a Customer Care Representative who can assist you with a cost estimate.


Fort Worth, Texas (GEHA Standard Option): What is in-house home screening?
Julie Browne:

GEHA has partnered with ExamOne, a Quest Diagnostics Company, to offer free biometric screenings to GEHA health plan members.  You can schedule your biometric screening to be completed by a health examiner in the comfort of your home, at work, or at a Quest Diagnostic Patient Service Center.  Your screening will include readings for blood pressure, height, weight, hemoglobin A1C (a screening for diabetes), cholesterol and blood creatinine (a screening for kidney disease).  To schedule your free screening, call our health screening partner, ExamOne, at  888. 234.1314.



Minneapolis, Minnesota (GEHA High Option): I was just told by my dentist that my routine preventive cleaning and X-rays were not covered because they have to file my health insurance first. I reviewed the GEHA policy online. Your company clearly states it covers 100% of preventive dental care (cleaning, certain X-rays and routine dental exams). It mentions nothing about filing my medical insurance. My medical insurance does not have any statement they cover preventive dental care, only preventive medical care. So why am I being denied dental benefits that are clearly stated as covered on my plan? Why do I have to ask my health insurance to cover my routine preventive dental care?
Julie Browne:

The Federal Employees Dental and Vision Insurance Program (FEDVIP) requires the FEHB plan to be primary over the FEDVIP plan. This is called Coordination of Benefits. Many FEHB plans have limited preventive benefits.  When we are secondary, our payment will be the lesser of 1) our regular benefit or 2) The remaining balance which when added to the primary carrier's payment will not exceed the dentist billed amount or the negotiated rate.  For complete details on Coordination of Benefits, see page 12 of the 2017 brochure.

If your FEHB plan does not have any dental benefits, please send us their denial and we will pay our regular benefit.


Sanford, North Carolina (GEHA Standard Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) Standard): Prescription. I have Medicare AB&D. For D , Prescriptions I Have Humana. Humana is primary. GEHA is secondary. The preferred provider for Humana is Wall Mart / Sam's club which I use. GEHA now has CVS. If I continue to use Sam's club- How much will GEHA cover for tier 4 drugs? Specifically Crestor - 20 mg? Celecobix 200mg. I feel your brochure is confusing as compared to the past. You were clear in the past - 50% on prescriptions. Now I can't tell. Thank you.
Julie Browne:

WalMart & Sam's Club pharmacies are in network - this is ideal. 

GEHA prescription reimbursement secondary logic payment is the lesser of:
• what GEHA would have paid in the absence of other primary coverage
• or, the balance due after the primary carrier’s payment.                                  

In many cases, you will have zero costs depending upon how much the primary pays and the pharmacy is able to transmit not only the primary claim electronically, but also the secondary claim - be sure to provide both your primary and secondary membership cards to the pharmacy.  If you have additional questions, or to request a specific pricing, please contact a Customer Care Representative at 844.443.4279.  


St Paul, Minnesota (GEHA Standard Option): We are paying $500 copay on my insulin! Would Medicare D be helpful to take along with GEHA? Any other ideas?
Julie Browne:

Your cost under a Medicare D Prescription Drug Plan would be determined by the plan you join. You may research Medicare D Prescription Plans and their benefits by going to www.medicare.gov/part-d. Should you decide to enroll in a Medicare D Prescription Plan your GEHA Prescription Plan would provide secondary coverage. You may experience cost savings for your medicines by obtaining a 90 day supply at CVS Caremark Mail Service or a participating Extended Day Supply Network Pharmacy.

Please contact a Customer Care Representative for any questions related to your prescription plan at 844.4.GEHA.Rx or 844.443.4279.


Newport, North Carolina (GEHA Standard Option): What will Standard Option Self Plus One cost me monthly in 2017?
Julie Browne: The monthly premium for GEHA's Standard Option FEHB plan Self Plus One is $250.90. You can click to see all of the 2017 FEHB Premiums.

Canandaigua, New York (GEHA Standard Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) High): What are the changes for 2017?
Julie Browne: We have worked hard to provide enhancements that give you more of what you need to live healthier in 2017, including:
  • The Health Rewards program lets you earn up to $250 to be used for eligible medical services and care items.
  • The Health Savings Advantage high-deductible health plan has a lower catastrophic limit.
  • The High Option dental plan now has an annual benefit of $35,000 per person and there’s no waiting period for Class D orthodontic services.
Also new is GEHAtotal. With GEHAtotal we take the worry out of buying Life Insurance, Short-Term Income Protection and Accident Expense Protection.

For additional changes, please refer to your 2017 FEHB plan brochure or your 2017 FEDVIP plan brochure.

Saint Louis, Missouri (Connection Dental Federal (FEDVIP) Standard): How will dental claims be paid - in the same way they were paid through 1/1/16 or in the way they were paid 1/1/16 through 6/30/16?
Julie Browne:

Under the Connection Dental Federal plans, when we are the secondary payor, our payment will be the lesser of our regular benefit or the remaining balance which when added to the other carrier's payment will not exceed the dentist billed amount or negotiated rate. 

We are no longer coordinating to our allowable as we did for services rendered from 010116 until 063016.  We have resumed coordinating to the billed amount for out-of-network providers.


Los Angeles, California (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): I am interested in dental implantation or getting full dentures. Does my GEHA insurance cover these mentioned procedure or items? I would very much appreciate your response to my question.
Julie Browne:

Under the Connection Dental Federal plans, both full dentures and implants are covered under Class C services.  Implants are limited to a maximum payable benefits of $2,500 per calendar year.

It might be best to have your dentist submit a pre-estimate to get pre-approval by us.  That way you will know if the service are covered and exactly how much you will be responsible for paying.  Be sure to include X-rays and any other information that may help our review.


Berea, Ohio (Connection Dental Federal (FEDVIP) High): I am currently enrolled in High Option. If I downgrade to Standard Option, how will it affect the hearing and vision portion of the benefit. (i.e., decrease amount of payment?)
Julie Browne: Hello! The EyeMed Vision Care plan and the TruHearing plan would not change as related to your FEDVIP GEHA dental plan whether you choose the High Option or Standard Option coverage. Thank you.

Alexandria , Virginia (GEHA HDHP Option, Connection Dental Federal (FEDVIP) High): Now that I am 65, why should I sign up for Medicare part B? If I don't sign up, will my current GEHA benefits change?
Julie Browne:

After age 65, you can continue to use your HSA funds tax-free for eligible medical expenses. At this age, you also have the option to use funds in your HSA for any reason, even for non-medical expenses, though you will pay taxes on those withdrawals at your normal tax rate.

When you enroll in Medicare, you are no longer eligible for an HSA. You will automatically transition to a health reimbursement arrangement (HRA) the month prior to the month of your 65th birthday, unless you notify GEHA that you will not be enrolled in Medicare Part A, B or D.


Missoula, Montana (Connection Dental Federal (FEDVIP) High): Does GEHA cover brand-name meds (as opposed to generic) when doctor and patient agree medically necessary?
Julie Browne:
GEHA does cover both brand and generic medications. 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.

Denver, Colorado (GEHA High Option, Connection Dental Federal (FEDVIP) High): I have both the high plan for dental and vision and the high plan for self plus one health insurance. I am not clear as to the correct way to present these insurances to doctors and prescription eyeglasses stores when I need to get either a new eye exam or glasses. Should I start with the vision plan insurance as primary and then give them the GEHA health plan as secondary? Is it allowed and proper to offer both insurances to health care providers?
Julie Browne: You pose an excellent question. If you have enrolled in a FEDVIP vision plan it would be the primary plan for vision expenses and you should present that card first. GEHA's EyeMed coverage is a supplemental plan. You may submit your vision exam expenses to EyeMed after the primary plan has paid. Be sure to include the itemized bill and receipt showing payment of the bill along with the EOB from the primary carrier and a completed EyeMed claim form. Thank you.

St. George, Utah (Connection Dental Federal (FEDVIP) High): Good morning. I was wondering if you have a missing tooth clause for dental? Thanks.
Julie Browne: Good morning! No, we do not have a missing tooth clause.

Austin, Texas (Connection Dental Federal (FEDVIP) Standard): Hi, My wife and I use GEHA for dental and vision. Should I add our 10 month old baby? Do babies need to be added for dental and vision? If not at what age will it be a good idea? Also do I have to wait for open season to add baby? Thanks in advance. R Ruiz
Julie Browne:

Thank you for your question and what a good one. You have a couple of options when adding your dependent child. Typically children begin developing their baby teeth when they are two to three years old. It is ideal to begin exposing them to the dentist at an early age. You can either add them at this year's open enrollment or you can wait and add them at the next open enrollment.

The only time you can add them outside of open enrollment is within 60 days of their birth or if there is another life event.

To find out more information on how to add a dependent at Open Season, please contact BENEFEDS. You may contact them by calling them at 877.888.3337 or visiting their website at BENEFEDS.com.


Tipton, Missouri (GEHA Standard Option): Does my plan pay 100% for preventive tests such as colonoscopies and mammograms?
Julie Browne: Yes. GEHA health plans provide benefits for a comprehensive range of preventive care and professional services for adults age 22 and over, including:
  • colonoscopies (surgeon and facility charges) every 10 years, ages 50-75; and
  • routine mammograms, covered for women as follows:
    • Ages 35-39, once every 5 years
    • Ages 40-64, one per calendar year
    • Ages 65 and older, one every two consecutive calendar years
Please note: 3D mammograms are not considered routine preventive care screening tests.

For a full list of covered preventive services, please see the "Preventive care, adult" section in your plan brochure.

Columbia, Missouri (GEHA Standard Option): I heard from a coworker that GEHA is now offering new products - life, disability and accident insurance. How can I find out more?
Julie Browne: For GEHA members who are not yet retired, GEHAtotal products can help you protect your financial health. You can enroll at any time during the year, and there's no waiting period. The GEHAtotal website includes an online assessment tool that can give you a recommendation tailored to your needs.

Waxahachie, Texas (GEHA Standard Option): I don't have a question. I would like to say that GEHA have been great and I have been with them for many years. Thanks for the great service.
Julie Browne: Thank you for your kind words. We love our long-term members and hope to continue serving you for many more years.

Pendleton, Indiana (GEHA Standard Option): Will we get any help for our hearing aid purchases?
Julie Browne:

GEHA members save 30-60% off the average retail price of hearing aids with TruHearing, making it affordable to address your unique hearing needs.  GEHA also offers you a hearing aid allowance of $2,000 or $2,500, depending on your specific health plan.  You can apply your allowance to the cost of hearing aids through TruHearing to further minimize your out-of-pocket cost.

Go to page 94 of the 2017 Brochure and www.TruHearing.com for more information.

Thank you!



Mobile, Alabama (GEHA HDHP Option): Re the Health rewards program, why does the program limit the majority of your potential rewards ($175)to the current over-priced and limited choices? It would be a lot more rewarding to receive the full potential reward value of $250 in a Visa card as opposed to the existing limit of $75.
Julie Browne:  We have worked hard to provide enhancements that give you more of what you need to live healthier in 2017, including:
  • The Health Rewards program lets you earn up to $250 to be used for eligible medical services and care items.
  • The Health Savings Advantage high-deductible health plan has a lower catastrophic limit.
  • The High Option dental plan now has an annual benefit of $35,000 per person and there’s no waiting period for Class D orthodontic services.
Also new is GEHAtotal. With GEHAtotal we take the worry out of buying Life Insurance, Short-Term Income Protection and Accident Expense Protection.

For additional changes, please refer to your 2017 FEHB plan brochure or your 2017 FEDVIP plan brochure.

Hansville, Washington (GEHA Standard Option, Connection Dental Federal (FEDVIP) High): I turn 65 in about 9 months. I am concerned about paying double for my health insurance, as I begin paying for Medicare. What benefit would you give when Medicare is the primary payor?
Julie Browne: When Medicare is the primary carrier, GEHA will waive their deductible and coinsurance and pay the Medicare and deductible and coinsurance for all covered services.

Riva, Maryland (GEHA HDHP Option, Connection Dental Federal (FEDVIP) Standard): How does GEHA HDHP interact with Medicare and how long are you able to continue to contribute to your HSA? If you retain your HDHP when retired but are not yet eligible for Medicare will contributions continue to your HSA or will the individual be able to contribute the full amount? What happens to your HSA when you take Medicare as your primary health insurance? If you take part A and not part B can you still use the HSA?
Julie Browne:

You are eligible for an HSA after age 65 until you are enrolled in Medicare Part A, B, C or D (prescription drug program). After age 65, you can continue to use your HSA funds tax-free for eligible medical expenses. At this age, you also have the option to use funds in your HSA for any reason, even for non-medical expenses, though you will pay taxes on those withdrawals at your normal tax rate.

When you enroll in Medicare, you are no longer eligible for an HSA. You will automatically transition to a health reimbursement arrangement (HRA) the month prior to the month of your 65th birthday, unless you notify GEHA that you will not be enrolled in Medicare Part A, B or D.


Chinle, Arizona (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): I have a question about the costs of coverage that GEHA provides. I wear glasses. How much of the costs does GEHA vision cover?
Julie Browne:

Free to all GEHA High and Standard Option Plan member, you receive vision exam coverage for no additional premium. Through Connection Vision powered by EyeMed, you and your covered family members each pay only $5 for an annual routine eye exam when you use a qualified EyeMed participating provider. Or, if you seek services from a non-participating provider, you can be reimbursed up to $45 for your annual eye exam.

At participating EyeMed locations, GEHA members also receive discounts off the retail price of lenses, frames, specialty items (such as tints, lightweight plastics, scratch-resistant coatings), as well as LASIK and PRK.

For a list of participating locations, select Connection Vision on the GEHA website at geha.com/vision. You will receive a separate vision ID card from EyeMed to use these services. You can also contact EyeMed at 877.808.8538.


DC, Maryland (Connection Dental Federal (FEDVIP) High): 1) I will need braces to correct an issue. Is that something that can be covered under the dental plan if I am an older adult? Is so, what would the copayment or percentage that I could be responsible for pay? 2) What has now been added to the plan that was not on it previously?
Julie Browne:

Our orthodontic benefit is as follows: There is a 70% benefit with a $2,500 lifetime maximum. This means the total amount paid out for orthodontic treatment would not exceed $2,500 for a lifetime. There is a 12 month waiting period on our Standard Option plan.  There is no waiting period for the High Option. There are no changes to the plan from last year to this year.

Please remember, if you see a network provider for any services, they have agreed to discount the difference between their fee and the allowable amount for any given service.  If you see a provider out-of-network, he can charge the member the difference and it is considered out-of-pocket costs.

We always recommend having predetermination done with any extensive treatment. This is not a guarantee of benefits. To know the allowable amounts for orthodontics, we recommend submitting for a pre-determination.

If you have any additional questions, please contact us at 877.434.2336.


Glendale, Arizona (GEHA High Option): GEHA really does have awesome options and comparable pricing compared to other coverages. What honestly makes this GEHA better than its competitors besides pricing? 
Julie Browne:

Thank you. We agree that are plans are awesome, but are not allowed to provide a direct comparison of our plans against others. To help with your selection, here are GEHA tools you might try: GEHA Keypath, and How to Choose a Health Plan. In addition, the OPM website can help you compare health plans and the BENEFEDS website can help you compare dental plans.



Albuquerque, New Mexico (GEHA Standard Option): Why does GEHA not offer discounts with the YMCA and other local health clubs that include Silver Sneakers or senior programs?
Julie Browne: GEHA promotes healthy lifestyles and fitness. Any GEHA health plan member can take advantage of our Connection Fitness program, which includes discounts on gym memberships. You can call 800.821.6136 or visit geha.com/fitness to find a participating facility.

Montgomery, Alabama (Connection Dental Federal (FEDVIP) High): Will I be able to keep my dental plan when I retire?
Julie Browne: Yes. Your GEHA FEDVIP enrollment should continue automatically into retirement. According to BENEFEDS, "you shouldn't need to take any action; most payroll offices inform BENEFEDS when an employee retires."

For more information, click Retirement on BENEFEDS.com.

Appleton, Wisconsin (GEHA High Option): How can I get a copy of my insurance card that I can use for prescriptions?
Julie Browne: You may visit geha.com and register as a GEHA member. Your Member Dashboard includes one-click buttons that generate a temporary ID card. It's handy if you need an extra copy of your GEHA ID card for a family member, or if you've misplaced your own ID card. The temporary ID cards expire 30 days after printing. If you need a new permanent ID card, please email csgehainbox@geha.com or call Customer Service at 800.821.6136.

Orange Park, Florida (GEHA Standard Option): I am on Medicare and my current health plan allows me to obtain my 90 day supply of maintenance medications either through mail order or directly from my local CVS pharmacy. Using our local CVS is very convenient because I can talk directly to a pharmacist if I have questions. In the GEHA plan, only High Option members can receive a 90-day supply from a local CVS/pharmacy. Not having this option under the standard plan is preventing me from signing up with GEHA. Why is this option not available to Medicare members on the standard plan?
Julie Browne:
The Standard Option does allow for 90 day supply fills from a CVS retail pharmacy. The Standard Option has the Retail 90 Network, which means that you can fill a 90 day supply prescription at any participating pharmacy within the Retail 90 Network, you are not limited to just CVS/Caremark.

Issaquah, Washington (GEHA Standard Option): If I am changing my previous plan to GEHA, how are my prescriptions transferred on 1/1/17?
Julie Browne:
If you are new to GEHA and CVS/caremark, you may require new prescriptions from your prescriber to have your medications filled under the GEHA benefit. If your previous plan also used CVS/caremark as the pharmacy benefit manager (PBM), then you can contact a Customer Care Representative at 844.4.GEHA.Rx or 844.443.4279 to have any open refills transferred.

Chicago, Illinois If I switch from High Option to Standard Option will my options for dentists be the same?
Julie Browne: The PPO network of providers will not change when you switch from the High Option to the Standard Option FEDVIP dental plan. When making your appointment, be sure to confirm with the provider's office that they still participate with the networks indicated on your GEHA ID card. GEHA makes every effort to maintain accurate information, but cannot be responsible for any errors or omissions.

Naples, Florida (GEHA Standard Option): Why isn't a reduced premium offered once GEHA becomes the secondary provider when I enroll in Medicare as the primary?
Julie Browne: FEHB laws do not allow for a FEHB plan to charge different premiums to members enrolled in the same plan option, regardless of other coverage. However, when Medicare A & B are primary, GEHA pays 100% of covered hospital and medical expenses after Medicare. You pay no deductible or copays for hospital and medical benefits with GEHA Standard Option or High Option.

Bowie, Maryland (Connection Dental Federal (FEDVIP) High): What is the waiting period for new GEHA Connection Dental Federal FEDVIP customers, and what are the limits regarding procedures and costs?
Julie Browne: Thank you so much for your question.  We only have a waiting period on Orthodontic services on the Standard Plan for FEDVIP.  This is the only waiting period that applies on either of the FEDVIP dental plans.  If you have any additional questions, please contact our Customer Service at 877.434.2336. 

Lacey, Washington (GEHA Standard Option): I am 78-year-old Federal retiree. I have Medicare Parts A & B. If I switched from Standard to High option, what would I gain in benefits? Would it be worth the extra premiums?
Julie Browne:

High Option offers a greater pharmacy benefit than the Standard Option. If you take brand-name medications, it might be beneficial to compare the cost of your drugs under both the High and Standard Options. You can then make a more educated cost comparison between the cost savings on switching to the High Option and the additional premium cost.

If you wish to compare your drug costs between both plans, please contact CVS/Caremark customer service at 844.443.4279 or GEHA Customer Service at 800.821.6136.


Seoul Korea, Other (GEHA Standard Option): I live overseas and I am enrolled in GEHA and Medicare, Part B. Medicare does not provide coverage overseas, so do I need to maintain my Medicare enrollment and continue to pay premiums for Medicare Part B.
Julie Browne: Although Medicare part B does not cover your overseas claims, GEHA does consider your overseas claims. When Medicare A & B are primary, GEHA pays 100% of covered hospital and medical expenses after Medicare. You pay no deductible or copays for hospital and medical benefits with GEHA Standard Option or High Option. If you no longer carried Medicare part B, you would then become responsible for any deductibles, copays, and coinsurance associated with having the GEHA plan only.

Waverly, Illinois (GEHA High Option): We must have a health insurance plan that covers Applied Behavior Analysis (ABA) Therapy for our autistic son! Will any health insurance plans cover ABA in January?
Julie Browne:

As of 2017, GEHA has included benefits for ABA therapy. It requires a diagnosis of ASD (Autism Spectrum Disorder) by a qualified provider. It is available to children, ages 12 months through age 17 and coverage is for a total of 680 hours per year. Please refer to the 2017 plan brochure (pages 41-42) for complete information.

Thank you!


Southport, North Carolina (Connection Dental Federal (FEDVIP) Standard): Does this plan include vision and LASIK?
Julie Browne:

Thank you for your question. All GEHA Connection Dental Federal High or Standard Option plan members receive vision exam coverage for no additional premium. Through Connection Vision® powered by EyeMed, you and your covered family members each pay only $5 for an annual routine eye exam when you use an EyeMed participating provider. Or, if you seek services from a non-participating provider, you can be reimbursed up to $45 for your annual routine eye exam.

At participating EyeMed locations, GEHA members also receive discounts off the retail price of lenses, frames, specialty items (such as tints, lightweight plastics, scratch-resistant coatings), as well as LASIK and PRK.

For a list of participating locations, visit gehadental.com/vision.


Cleveland, Ohio (Connection Dental Federal (FEDVIP) Standard): Where do I have to go to get a flu shot?
Julie Browne:

Flu shots can be administered by your physician’s office or at a participating retail pharmacy.


Leesburg, Virginia (GEHA HDHP Option): Can you please clarify if GEHA covers testosterone replacement therapy for men?
Julie Browne:
GEHA does cover testosterone products with a prior authorization approval. For more specific information regarding your treatment, please contact a Customer Care Representative at 844.4.GEHA.Rx or 844.443.4279.

Memphis, Tennessee (GEHA HDHP Option, Connection Dental Federal (FEDVIP) High): Is vision still included with Dental.
Julie Browne:

If you are enrolled in a Federal Employees Dental/Vision Insurance Program (FEDVIP) Dental Plan, your FEHB plan will be First/Primary payor of any Benefit payments and your FEDVIP plan is secondary to your FEHB plan. See Section 9, Coordinating benefits with other coverage.

This Plan also provides vision care benefits through EyeMed Vision Care, and provides dental coverage. You do not have to meet the deductible before using these services.

  • Eye exam including dilation as necessary is covered after a $5 exam copay for in network and reimbursed up to $45 for out-of-network benefits.
  • Standard contact lens fit and follow-up In-Network, you pay no more than $55. Out of network, you pay full retail price.
  • Premium contact lens fit and follow-up In-Network, you pay no more than 90% of retail price. Out of network, you pay full retail price.
  • Any available frame at provider location. In-Network Covered in full if retail price of the frame selected is $100 or less. For frames costing more than $100, you pay 80% of retail price over $100. Out of network: Covered in full if retail price of the frame selected is $100 or less. For frames costing more than $100, you pay 80% of retail price over $100.

For more information please see the 2017 plan brochure.


College Park, Maryland I'd like to get my EOBs by email instead of in the mail. When will you offer this?
Julie Browne:
This has been a popular question for a while, and I'm happy to report that GEHA started offering electronic explanation of benefits (EOBs) a few weeks ago. Here's how to opt in to receive your EOB notifications by email:

2. Click the “Update Info & Preferences” link on the left side of your dashboard page.
3. Scroll down to “Communication Preferences” and select “Email.”

When you choose electronic EOBs, you no longer receive hard-copy EOBs in the mail. Instead, you will receive an email when a health or dental claim is processed. A link from the email will take you to a sign-in page for your Member Dashboard, where you can access a PDF of the EOB. You can opt back in to hard-copy EOBs any time.

Carson City, Nevada (GEHA Standard Option): I'm turning 65 in March and getting a lot of literature for Medicare. Do I need Medicare with GEHA insurance? If I do, I think Plan B is best for me. Also, my wife doesn't turn 65 till 2018. How will this affect her with GEHA coverage? Will my rate of coverage change due to Medicare? Thank you.
Julie Browne:

The GEHA website has good information about Medicare and GEHA, including a brochure to help you understand how GEHA can help you cover health care expenses not covered by Medicare. If you elect to enroll in Medicare Part B and are retired, Medicare will become your primary payor. GEHA will remain primary for your wife until she reaches age 65.



Greenwood, Arkansas (GEHA Standard Option): If not needing to change my plan; do I need to do anything ??
Julie Browne: If you are wanting to stay with the same coverage/option for 2017, you do not need to do anything. Your coverage will remain the same.

Florence, Mississippi (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): I'm thinking of changing to GEHA from another carrier and was wondering if Paxil is covered?
Julie Browne: Paxil is covered. It is a brand-name medication, but there is a less-expensive generic version (paroxetine) available.

With brand-name drugs, GEHA Standard Option members pay the generic copay plus the difference in cost between the brand name and the generic.

GEHA provides a prescription cost estimator at info.caremark.com/geha. Simply visit this site, enter your prescription drug name and get an estimate of what you should pay, out-of-pocket, for your medication.

Kansas City, Missouri How do I find out if GEHA covers my membership ship in a specific gym?
Julie Browne: All GEHA health plans include the Connection Fitness program by GlobalFit.  Discounts on gym memberships at many fitness clubs nationwide offer discounts on new memberships.  To register for GEHA's Connection Fitness program by GlobalFit, or to find more information, go to globalfit.com/geha or call 800.294.1500.

Hot Springs Village, Arkansas (GEHA Standard Option): If TruHearing is not available where I live can we use other hearing aid companies to get the deductible?
Julie Browne: Hello! Your GEHA Standard Option health plan does not require you to use a TruHearing provider to get your hearing aid benefit. You will need to submit a claim to the health plan after making your purchase. Thank you.

Syracuse, Utah (GEHA Standard Option): I had an in-home screening last week. How do I get the results?
Julie Browne:

You should receive your results by mail in 2-3 weeks. If after 3 weeks they have not arrived, you can call ExamOne at 888.889.3691 from 8 a.m.-5:30 p.m. Central Time to request another copy be mailed.  Results cannot be given over the phone. Thank you!


Coquille, Oregon (GEHA Standard Option): I am nearly 73. My present hearing aids need replacing. I have lost one and the other isn't operating efficiently. They are 3 years old. My hearing is getting worse and need more powerful model. I am tuned up as high as these go. (Says my hearing specialist) Question: Am I eligible for hearing aid benefits? Even if I find my lost hearing aid, it needs to be replaced. How often can I replace my hearing aids and still be covered? Lastly, what is the benefit allowed?
Julie Browne:

When you are enrolled in the Standard Option, your external hearing aid benefit has increased to $2,000 every three years if you are an adult, or $2,000 annually for your child up to age 22.


Rosiclare, Illinois (GEHA Standard Option): I have GEHA's Standard Option health plan and want to see if it covers the HPV vaccine for my children, and if it covers nicotine patches for smoking cessation for my spouse?
Julie Browne:
GEHA does cover the HPV vaccine at $0 for ages between 9-26 years of age. Smoking cessation is also covered at $0 as part of ACA preventive services.

Columbia, South Carolina (GEHA Standard Option): How do I order replacement ID cards?
Julie Browne: If you need a new permanent ID card, please email csgehainbox@geha.com or call Customer Service at 800.821.6136. For a temporary ID card, you can register for a web account on the GEHA website. Log in to your account to generate a temporary card, which expires 30 days after printing.

Cape Coral, Florida (Connection Dental Federal (FEDVIP) High): When does Open Season start so we can upgrade our dental program?
Julie Browne:
Open Season for the 2017 plan year has already started! You have until midnight, Eastern Time, on December 12 to make any FEDVIP changes. But don't wait until the last minute. All federal employees and annuitants can sign up for GEHA Connection Dental Federal by using the BENEFEDS website.

Canfield, Ohio (Connection Dental Federal (FEDVIP) High): Is eye care and hearing care included in my plan?
Julie Browne: Yes! All GEHA members have year-round access to the following benefits* at no additional premium:
  • Connection Vision: Eye exams for only $5 and discounts through an EyeMed preferred provider.
  • Smile Brilliant: New in 2017 -- A safe, affordable way to whiten your teeth from the comfort of your home.
  • Connection Hearing: Enhanced for 2017 -- Save up to $2,500 per pair on hearing aids through TruHearing.
  • Life Alert Response -- This leading medical alert system provides emergency assistance and peace of mind, 24/7/365.
*GEHA supplemental benefits are neither offered nor guaranteed under contract with the FEHB or FEDVIP, but are made available to all enrollees and family members who become members of GEHA.

Silver Spring, Maryland (GEHA Standard Option): As a government retiree, if I like my plan and do not want to make any changes, do I need to do anything to re-enroll, or will I be automatically re-enrolled and premiums will continue to be withheld from my monthly pension payment?
Julie Browne: If you do nothing during Open Season, your FEHB and/or FEDVIP plan will be renewed automatically. Thank you for your continued membership.

Phoenix, Arizona (GEHA High Option, Connection Dental Federal (FEDVIP) High): Will President-Elect Trump's proposed changes in health insurance have any impact on GEHA's insurance plans or costs for 2017?
Julie Browne:

No, we do not expect that the Trump administration will have an impact to GEHA plans in 2017. Rates and benefits were finalized with OPM in late summer. The information included in our 2017 GEHA plan brochures is our annual contract with you and is not subject to change during the plan year.


ANNANDALE, Virginia (GEHA HDHP Option): I have decided to enroll in the GEHA Health Savings Advantage for 2017 (Self plus 1). When I or my wife visit a doctor next year, prior to meeting the deductible ($3,000??), will I pay the full amount charged by the doctor’s office or the discounted GEHA rate? When do I pay? Upon receipt of services or only after I receive a statement from GEHA? I plan on using my HSA funds with HSA Bank to invest with TD Ameritrade. Will GEHA pay the monthly $3 “HSA Investment Service Fee”? Will GEHA pay the $9.99 stock trading fee imposed by TD Ameritrade?
Julie Browne:

 Thank you for your questions.

Out of your regular health plan premium, GEHA deposits a large percentage in your HSA each month – $62.50 for a Self Only enrollment, or $125 for a Self Plus One or Self and Family enrollment. You can also add your own funds to your HSA. Money left in your HSA at the end of the year rolls over and continues to grow.

As you need medical care during the year, you can use the money in your HSA to pay out-of-pocket expenses. After you have paid the plan deductible, traditional health insurance kicks in and GEHA Health Savings Advantage pays 75 percent of prescription costs and 95 percent of the cost for most other care when you see a network provider.

 When you have qualified medical expenses not paid by GEHA, you can pay with funds in your HSA. You are not required to use your HSA funds and may allow the funds to accumulate in your account. To withdraw HSA funds to pay your provider, use a debit card, write a check, make a withdrawal request or transfer funds into your personal account online using free Internet banking (I-banking). Go to Qualified Medical Expenses to see a partial list of expenses that qualify for reimbursement from your HSA.

§ Preventive care

 

GEHA provides unlimited adult preventive care (paid at 100 percent, with no deductible) when you see a PPO doctor. Included are annual physicals, routine adult immunizations, mammograms and cancer screenings. Lab tests as part of your preventive care visit are also covered at 100 percent. GEHA covers well-child visits and immunizations (paid at 100 percent, with no deductible), regardless of provider. For details on covered preventive care, see your GEHA High Deductible Health Plan Brochure.

§ Doctor or hospital

 

You do not have to pay at the time of service when you see a doctor or go to a hospital. Your provider submits your claim to GEHA and then GEHA applies network discounts to the bill. You will receive an explanation of benefits (EOB) form listing “patient responsibility.” Pay that amount to the provider.

§ Prescriptions

 

When you fill prescriptions at a pharmacy, you will pay at the time of purchase. Show your GEHA ID card to get the GEHA negotiated discount, and then pay for the prescription with your HSA debit card, cash, personal check or HSA check. If you pay for the prescription out of personal funds, you may reimburse yourself from your HSA, but be sure to save receipts of all medical expenses reimbursed from the HSA.

§ Dental/Vision

 

Dental and vision services are not subject to the Health Savings Advantage plan deductible. Be sure to show your dental/vision ID card at the time of service to receive discounted services from participating

 

GEHA pays your account set-up fee, charges for your initial debit card(s) and bank administrative fees. Other charges are your responsibility and can include checks ($7.95 for 50) and ATM withdrawals ($2.00). There is no charge when using your debit card at the point of service with a signature (like a credit card) rather than a PIN. A list of fees can be found at www.hsabank.com. You will receive quarterly bank statements via mail and online statements are available through Internet Banking. There is a small charge for requesting mailed monthly bank statements.

Columbus, Ohio (GEHA Standard Option): My legally blind son is turning 26 in the next few months. How can I retain his health plan past that date? He presently has no other means of getting a health coverage. Thank you!
Julie Browne: Children who are incapable of self-support because of a mental or physical disability that began before age 26 are eligible to continue coverage. Contact your human resources office or retirement system for additional information.

Springvale, Maine (GEHA Standard Option, Connection Dental Plus, Connection Dental Federal (FEDVIP) High): I am not sure which of the above coverages I have. How do I find out? Also I need to know where I can find a list of Doctors & Dentists that accept my insurance.
Julie Browne: To find out your current GEHA coverage, you can contact our Customer Service Department at 800.821.6136. The representative will be happy to assist you. To locate a participating provider, go to geha.com/search. If you have any questions, the Customer Service Department can assist you.

Hopkinton , New Hampshire (GEHA Standard Option): Can you obtain a 90 day supply of a prescription at a retail pharmacy under standard option? Do you pay the mail order copay if you have it filled at CVS?
Julie Browne: GEHA Standard Option members have the availability to utilize any of the extended day supply network pharmacies to obtain a 90 day supply of their maintenance medications.  Members would need to utilize CVS/caremark Mail Service to obtain the Mail Service copay.

Olive Branch , Mississippi (GEHA High Option): Can I change my plan from Self Plus One to Self Only online? Thanks,
Julie Browne: It depends on which agency you work for. Your best bet is to consult your Human Resources Office for assistance. If your local Personnel office is unable to help you, you can contact your headquarters benefits counselor for further guidance.

Thomaston, Georgia (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): I would like to enroll in GEHA's Standard Option plan. How do I do it?
Julie Browne: Thank you for your question! You can change coverage from High Option to Standard Option or vice versa. Open Season will occur this year between November 14 – December 12, 2016.

BENEFEDS has been contracted by OPM to oversee enrollment and eligibility and is responsible for enrollments, changes and cancellations. Please email BENEFEDS at Service@BENEFEDS.com or call 877.888.3337 for more information.

If you have any additional questions, please email us at cs.gehadental@geha.com or call Customer Service at 877.434.2336.

Jacksonville, Florida (GEHA Standard Option): Does my 82 year old mother have to do anything if she wishes to have her coverage as it was in 2016?
Julie Browne: If your mother is happy with her current GEHA coverage, she does not need to do anything. Her coverage will remain the same for 2017.

Merritt Island, Florida (GEHA HDHP Option): Is the walk-in clinic feature ($35 per visit, I believe) available to the HDHP members?
Julie Browne:

Outpatient Hospital, Clinic or Ambulatory Surgical Center benefit under the High Deductible Health Plan after the calendar year deductible is 5% of the PPO Plan allowance or 25% of the Plan allowance and any difference between our allowance and the billed amount.



Tucker, Georgia (GEHA Standard Option): Does the plan pay for shingles shots?
Julie Browne: GEHA does cover the shingles vaccination at $0 for ages 60 and older. For ages between 50-59 the vaccination is covered with a copayment and ages 0-49 the vaccine is not covered.

San Antonio, Texas (GEHA Standard Option): My doctor normally just faxes the 90 day prescription information to my current health plan pharmacy. Will my doctor be required to use the CVS prescription form under this health plan?
Julie Browne:

Your doctor may fax CVS Caremark Mail Service directly. Please supply your physician all your identifying information along with the specific medicine information. CVS Caremark Mail Service will follow up with your doctor's office if they have any questions.

Choose one of the following easy ways to start using the CVS Caremark Mail Service Pharmacy:

1. Bring your prescription to a CVS/caremark Extended Day Supply Pharmacy
2. Fill out and send in a mail service order form or print one at caremark.com
3. Visit caremark.com/faststart  or call FastStart at 800.875.0867

Please contact a CVS Customer Care Representative for any questions related to the prescription plan at 844.443.4279.


Amelia, Ohio I am upgrading my GEHA dental plan for 2017. How soon will my benefits take affect?
Julie Browne: All Open Season elections for FEDVIP dental plans will be effective January 1, 2017.

(All Open Season elections for FEHB health plans will be effective on the first day of the first full pay period in January. For annuitants this date will always be January 1.)

Frisco, Texas (Connection Dental Federal (FEDVIP) High): Does GEHA's FEDVIP plans cover vision care like I see on the geha.com website, or do I have to get separate vision care coverage?
Julie Browne: Yes. If you are a GEHA dental plan member (or a GEHA health plan member), you get vision coverage for no additional premium. Through Connection Vision powered by EyeMed, you and your covered family members each pay a $5 copay for an annual eye exam when you use a qualified EyeMed participating provider.

For more information, click Connection Vision.

Anderson, South Carolina (GEHA Standard Option): If we go to Costco for my husband's hearing aids, will the plan pay the same amount as with the suggested dealer? It is my understanding the plan will pay $2,000 in 2017.
Julie Browne: Thank you for the question, that is correct. The benefit limit is per person. When you are enrolled in the Standard Option, your external hearing aid benefit has increased to $2,000 every three years if you are an adult, or $2,000 annually for your child up to age 22. The benefit when you are enrolled in High Option is, your external hearing aid benefit has increased to $2,500 every three years if you are an adult, or $2,500 annually for your child up to age 22.

East Orange, New Jersey what is the cost of prescription drugs under the standard and high option plan
Julie Browne:

Prescription drug costs depends on the type of medication and the manufacture price.  Standard option offers a $10 generic copay and a 50% brand copay. High Option also offers a $10 generic copay and 25% coinsurance for preferred medications/40% for non-preferred medications.  For brand medications, copay maximums apply.  For the cost of a specific medication, have the medication name, strength and quantity available and call 844.443.4279 or use the Check Drug Cost tool that is located on GEHA.com/prescriptions/my-drug-costs.  For more detailed information, please refer to the 2017 FEHB Benefit Plan Brochure, section 5(f).


Loveland, Colorado (GEHA Standard Option, Connection Dental Federal (FEDVIP) Standard): Since I have Medicare and GEHA and Medicare is the prime insurance(pays first) is it fact that if Medicare doesn't pay then GEHA will not pay either?
Julie Browne: If Medicare doesn't pay on a service and it's a covered service under your GEHA plan, GEHA will pay 100% of the allowable amount for all our covered services.

Fort Worth, Texas If we want to keep same plan for 2017 is any action required?
Julie Browne: If you wish to keep the same plan/coverage for 2017, you do not need to do anything. Your coverage will remain the same.

Sun City West, Arizona (GEHA Standard Option): I am 76 years and my wife is 72 years old we have Medicare A&B. My question is changing from Standard Option Family to Standard Option Family plus One Is there any additional changes in the deductible or co-pays. Thank you
Julie Browne: If you change to the Standard Option Family Plus One, your coverage remains the same (deductibles and coinsurance). The only difference is the change in premium

Smithtown, New York (GEHA Standard Option): Will I have to sign up this year if I am staying with the same plan? I take a specialty medication; will my out-of-pocket expense of $200 stay the same? Medicare will be my primary. My understanding is that GEHA pays my deductible as well as the 20% copay. But if Medicare doesn't pay for, say, a hearing aid, will GEHA cover that charge? Thank you for your time. We have been members for a very long time.
Julie Browne:

In regards to the specialty medication, the $200 maximum copay will remain the same for 2017.

Thank you for being members for such a long time.


Powell Butte, Oregon (GEHA Standard Option): Is there a savings to be had by shopping pharmacies? Recently I changed our pharmacy thinking there might be a savings but our portion of the cost was the same, down to the penny. Since GEHA contracts with the pharmacy will it always be the same? What is the best option if the pharmacy gives you a generic that does not produce the same results as a previous generic? Our pharmacy seems to change generic companies a great deal. The last company was In India and I wonder if the quality control is not as good as in American drug companies. Your thoughts?
Julie Browne:

GEHA offers over 70,000 retail pharmacies providing the same discounts based on your plan. You typically experience cost savings by obtaining a 90 day supply at CVS Caremark Mail Service or a participating Extended Day Supply Network Pharmacy.

Under the prescription information on GEHA.com , you can also find helpful drug lists that can assist you in determining if a brand medicine is preferred or non-preferred. Please contact a Customer Care Representative for any questions related to your prescription plan at 844.443.4279.

The safety of your medicine is controlled by the same guidelines and regulations required by your plan regardless of where the medicine is manufactured. The US FDA safeguards the integrity of the drug supply chain through initiatives that help protect consumers from exposure to substandard drugs and ensure that safe and effective drugs reach U.S. consumers.


Philadelphia, Pennsylvania My son is 24. Can I add him to my dental plan, or is he too old? I'm trying to see what would be the best plan for me -- Self and Family or Self Plus One.
Julie Browne:
Thank you for your question!
 
Under the FEDVIP contract, dependent children are covered up to the age of 22. They will then no longer be covered under this plan after that date.
 
We do offer Connection Dental Plus. which allows our members to enroll for themselves and dependents outside of Open Season. Dependent children are covered up to the age of 26. If you are interested, please go to geha.com/cdplus, where you'll find information on how to enroll and the Connection Dental Plus plan brochure.

Please note: The federal employee must be the subscriber. You can also contact us for more information regarding Connection Dental Plus by calling 800.793.9335. 

Carson City, Nevada (GEHA High Option, Connection Dental Federal (FEDVIP) High): Medications: I have seizures and am currently on two generic drugs. I have tried all the generic anti-epileptic drugs and am not controlled as of yet. My doctor will be prescribing a brand-name drug within a few weeks. The cost, it appears, will be $150 for a 30-day supply. I will remain on one anti-epileptic med. Since I have tried all the generics, why can't there be a reduced price on the brand-name drugs?
Julie Browne:

Generic medicines typically have a lower cost than brand name medicines. You typically will experience cost savings for your medicines by obtaining a 90 day supply at CVS Caremark Mail Service or a participating Extended Day Supply Network Pharmacy. On the Prescription page of GEHA.com you can also find helpful drug lists that can assist you in determining if a brand medicine is preferred or non-preferred.

Please contact a Customer Care Representative for any questions related to your prescription plan at 844.443.4279.


Reesville, Ohio (GEHA Standard Option): Are tetanus shots free?
Julie Browne:
Yes, the tetanus vaccine is covered under your GEHA benefit at $0 for all ages.