The November 14, 2018, Open Season chat with GEHA’s medical and dental experts has concluded. The transcript is available below and will remain online for several weeks.
Welcome to the United States! You should have received an enrollment card from the medical benefits plan that you selected. If you are unable to find the card, the benefit officer in your agency should be able to assist. Most medical plans, including GEHA, offer a provider search feature on their website.
GEHA has access to the FEHB plans brochures to reference their guidelines and covered services. If the FEHB plan does not include dental benefits at all or the service completed is not on their covered service list or if the FEHB plan has a stipulation that indicates a plan dentist must provider or arrange your care and the dentist is out of network, often times these are situations when GEHA can process claims without a denial from the FEHB plan. It is good practice to submit the claim to have receipt of the claim within the timely filing limits and if more information is needed to complete the review, GEHA will respond with a letter explaining what is needed.
You must submit the claim by December 31 of the year after the year you received the service. A service completed in 2016 must have been submitted by December 31, 2017, to avoid a timely filing denial. The FEHB plan will pay benefits first when applicable.
If you are 50 years or older, Shingrix is covered for a zero copay, under either the prescription benefit or the medical benefit. Shingrix is not covered for ages younger than 50. Please check with your pharmacy to verify availability.
Thanks for being a long-time GEHA member! You don't need to do anything differently this Open Season. If you are a federal employee or retiree and you are currently enrolled in a FEDVIP dental plan and do not wish to make any changes with your selection, then you do nothing during Open Season. Your existing plan will automatically continue into 2019.
If you have additional questions about enrollment, please contact BENEFEDS at 877.888.3337.
GEHA's FEDVIP plans cover two routine prophylaxis per calendar year, and this is listed under Class A Basic benefit level.
Our plans also cover periodontal maintenance when performed following active periodontal treatment, and this service is listed under the Class B Intermediate benefit level.
Routine prophylaxis and periodontal maintenance are limited to a combined total of four per calendar year.
Please contact GEHA Customer Care at 877.434.2336 to speak with a Customer Care associate for more information.
Yes. Starting in 2019, 3-D mammograms are now covered at 100% under all GEHA medical plans.
Per the GEHA pharmacy benefit for 2019, Humalog is covered with appropriate prior authorization. GEHA's combined medical/pharmacy deductible for each plan is as follows:
For more, visit our Prescriptions overview.
Thank you for your question. Under the FEDVIP Dental Plan, your dependents are covered until age 22 regardless of student status. GEHA does offer a Connection Dental Plus option that covers dependents of members until age 26. Please visit geha.com/cdplus for more information.
Yes. In fact, our HDHP offers the most robust dental and vision benefits of our three FEHB medical plans. Through our HDHP, you pay nothing for preventive dental including two annual check-ups as well as $150 toward your annual X-ray.
Additionally, you receive robust vision benefits including low copays for eye exam and eyeglass/contact lenses. You also receive a $100 allowance toward frames.
You do not need to do anything. Your enrollment for both FEHB medical plans and FEDVIP dental plans will be automatically renewed for 2019 if you do nothing during Open Season.
Thanks for continuing with GEHA next year!