do your > government employees possible health association, … · 2019. 11. 14. · do your ....
TRANSCRIPT
DO YOUR POSSIBLE
> Government Employees Health Association, Inc.• 82+ years.• One of the largest medical and
dental plan carriers exclusively for federal employees.
• More than 2 million members.• Extensive nationwide network of
doctors, dentists, hospitals and other providers.
• We want you to “Do Your Possible” no matter where you are in life.
Company ConfidentialSlide 2 Company ConfidentialSlide 2
$13,801
2019 Agency Benefits Officer webcast
Jason Skinner, GEHA
Coletta Meyer, GEHA
Company ConfidentialSlide 4
Agenda
> Why is shopping for a medical plan so important?
> Finding the best value
> Medical plan options
> Dental plan options
Why is shopping for a medical plan so important?
Company ConfidentialSlide 6 Company ConfidentialSlide 6
So many plans, so many prices
$16,480.88
$2,679.56
$13,801
Company ConfidentialSlide 7
of your annual spending may go to medical care premiums.
Up to
Company ConfidentialSlide 8
Average expenditures
Sources: https://www.iii.org/fact-statistic/facts-statistics-pet-statistics https://www.valuepenguin.com/average-household-budgethttp://www.nytimes.com/2014/12/12/upshot/why-most-people-wont-shop-again-for-health-insurance.html?_r=0 https://www.cabletv.com/blog/how-much-should-i-pay-for-cable-tv/Millman Medical Index, 2015 http://www.healthcaretownhall.com/?tag=milliman-medical-index#sthash.eC6WK8Ys.dpbs
Company ConfidentialSlide 9
Time spent shopping
Sources: http://www.everydayhealth.com/healthy-living/1025/americans-research-cars-more-closely-than-doctors.aspxhttp://www.usatoday.com/story/money/personalfinance/2014/09/04/health-insurance-plans-costs/15032405/
Finding the best value in your health care
Company ConfidentialSlide 11 Company ConfidentialSlide 11
> How healthy is my family?> How important is it to me to keep
my doctors?> Where do I find help when choosing
a plan?> Do I want easy access to care?> How much can I spend on health
care costs?> How do I know if the doctors are good?> What kind of prescriptions does my family
need to use?
Questions to ask yourself
Five medical plan considerations > Quality
> Price
> Convenience
> Service
> Accessibility
Medical plan options
Company ConfidentialSlide 14
GEHA medical plan portfolio
HDHPGEHA’s HDHP pairs a low premium and a lower-than-expected deductible. You pay only 5% of medical services after your deductible is met.
StandardWith affordable
premiums,GEHA’s Standard
Option medical plan provides dependable
benefits and coverage.
HighGEHA’s High Option is a smart pick if you
take brand-nameprescription drugsand have Medicare
as your primary coverage.
Company ConfidentialSlide 15
ElevateElevate prioritizes your health with
convenient access to care and a low
premium.
HDHP Standard Elevate PlusElevate Plus has no
in-network deductible and
copays for most common medical
expenses.
High
GEHA medical plan portfolio
GEHA’s HDHP pairs a low premium and a lower-than-expected deductible. You pay only 5% of medical services after your deductible is met.
With affordable premiums,
GEHA’s Standard Option medical plan provides dependable
benefits and coverage.
GEHA’s High Option is a smart pick if you
take brand-nameprescription drugsand have Medicare
as your primary coverage.
$900SELF ONLY
$1800 SELF PLUS ONE
SELF AND FAMILY
High Deductible Health Plan (HDHP)> A lower than expected deductible> You pay only 5% of non-preventive
medical services after your deductible is met
> Low cost premium> Vision benefits are included> You pay nothing for in-network
preventive dental treatment> GEHA deposits $900 or $1,800 into
your HSA or HRA
Standard Option
> Comprehensive care, with a low in-network deductible and low premium
> You can visit your primary care doctor for only a $15 copay each visit
> $10 copay for 30-day supply generic medication
> Free 24/7 online doctor visits> You pay nothing for routine, in-network
maternity care> 100% of preventive care costs when you
see an in-network provider
High Option > You get $600 reimbursement to apply
to your Medicare Part B premiums if you are enrolled in Parts A and B
> When Medicare A and B are primary, your deductible and coinsurance is waived
> Low out-of-pocket costs when you need care
> A smart choice if you take brand-name prescription drugs
> This includes free 24/7 online doctor visits
> 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.
> No preauthorization required for physical, occupational or speech therapy, on all GEHA medical plans.
> Expanded online doctor visits now includes coverage for dermatology care and behavioral health visits.
> 100% contraceptive coverage now limited to generics under the preventive benefit on all GEHA medical plans.
What’s new in 2020
What's new in 2020
Two new plans:> Elevate
> Elevate Plus
geha.com/ElevateLearn
Elevate NEW!
> GEHA’s lowest premium> You earn rewards for your healthy
activities. Your rewards can add up to $500 annually (or a maximum of $1,000 annually for two family members)
> 12 visits per year for acupuncture and chiropractic for a $10 copay
> This includes free 24/7 online doctor visits
> $10 copay for your primary care physician
geha.com/Elevate
Elevate Plus NEW!
> Co-pays for most common services> There is NO in-network deductible> This includes free 24/7
online doctor visits> You pay nothing for many types of
surgeries at any of our nationwide Centers of Excellence.
> Access to GEHA's digital wellness platform, where you'll go to earn rewards and access engaging tools and resources.
geha.com/ElevatePlus
Heal> On-demand doctor
house calls> GEHA’s Elevate and
Elevate Plus medical plan members have access to Heal’s caring, qualified doctors, 8 a.m. to 8 p.m., 7 days a week, 365 days a year.
Keep up-to-date with the latest locations at heal.com/Cities
DispatchHealth> For GEHA’s Elevate or Elevate Plus
medical plan members, DispatchHealth brings medical care to your home for the cost of an urgent care visit.
> Avoid unnecessary expenses and trips to the emergency room.
> Let DispatchHealth’s qualified medical teams travel to you the next time you are sick or injured —7 days a week, 365 days a year.
DispatchHealth is only available in certain markets, check availability at dispatchhealth.com
Get rewarded for your commitment to healthy living with tools and incentives that make it easy and fun to live healthier.
Get rewarded with Elevate and Elevate Plus:
> Health survey $100
> Preventive services $50 - $150
> Complete an online coaching program$150
> Complete an online doctor visit with MDLIVE$50
> Achieve Stride step goal:$10/month
> Complete six Rally Missions: $100
> Complete Real Appeal, a weight management program:$250
> Complete Quit for Life, a smoking cessation program: $250
Included benefits and savings
> Vision coverage & discounts geha.com/Vision
> Hearing aid savings geha.com/Hearing
> Online doctor visit geha.com/MDLIVE
> 24-hour Health Advice Line geha.com/Healthline
Included benefits, all plans:
> Gym discounts geha.com/Fitness
> Electric toothbrush geha.com/Toothbrush
> Teeth whitening smilebrilliant.com/GEHA
> Medical alert system geha.com/LifeAlert
MD LIVE> Online doctor visits with MDLIVE
We make seeing a doctor, therapist or dermatologist simple, fast and uncomplicated.
> Get care now or schedule an appointment for later, without having to travel to the doctor’s office and at $0 cost to you.*
*If deductible is met, HDHP member will be charged by MDLIVE but GEHA will then reimburse the member 100% of the billed charge.
One Medical> GEHA medical plan members, in
Washington D.C. Metropolitan area, have access to exceptional primary care through One Medical — included with your GEHA membership.
Company ConfidentialSlide 30
Compare plan benefits
geha.com/Compare
Company ConfidentialSlide 31
Deductibles & out-of-pocket maximums
Standard and High Option
This is a brief description of the features of GEHA’s Elevate and Elevate Plus medical plans. Before making a final decision, please read the plan’s federal brochure IR 71-018. All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure.
Company ConfidentialSlide 33 Company ConfidentialSlide 33
So many plans, so many prices
$7,914.14
$4,043.52
$3,901.04
$4,685.98
High option
Elevate Plus
Standard option
HDHP
$3,445.26Elevate
Compare plan pricing
$16,480.88
$2,679.56
Do you have any tools to help me choose a
medical plan?
> Which medical plan might be right for you?geha.com/Select-A-Plan
> Provider search geha.com/Find-Care
> Check drug costsinfo.caremark.com/GEHA
Medicare + GEHA
> With Medicare A & B, GEHA’s Standard and High Option plans offer:
> Deductibles, copays and coinsurance waived whether your provider is in- or out-of-network.
> Covered inpatient and outpatient hospital services, surgeries and office visits, at no cost to you.
> Coverage when you’re out of the country, where Medicare does not cover you.
> 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.
GEHA dental plan options
> Standard option
> High option
Two dental plan options with affordable premiums:
What’s new in 2020> Unlimited annual maximum benefits.
The High Option annual benefit maximum increased to unlimited per person for a combined Class A, B and C services.
> Bitewing X-rays. X-rays are covered once per calendar year for adults 23 and older.
> 24 new CDT dental procedures codes, including D9613 — for the “infiltration of sustained-release therapeutic drug” —added to combat the opioid epidemic.
Compare plan benefits
HighOption
Average biweekly change
in your share
Self Only $0.88 increase
Self Plus One $1.72 increase
Self and Family $2.58 increase
Standard Option
Average biweekly change
in your share
Self Only $0.34 increase
Self Plus One $0.66 increase
Self and Family $.99 increase
> See any dentist, no deductible
High and Standard Option
> Free preventive care, in-network
> Orthodontia paid at 70%
> No waiting period for most procedures
> Vision included – no additional premium
> Large, nationwide network
> Medical-alert emergency response
> Electric toothbrush discount
> Hearing aid discount> At home teeth whitening
Additional dental member benefits
How do I enroll in a GEHA dental plan?
Do you have any toolsto help me choose a
dental plan?
> Choose and compare plans toolgehadental.com/Choose
> Dental Procedure Pricing toolgehadental.com/Pricing
Enroll in a GEHA dental plan
> Log on to benefeds.com
> Or call Benefeds toll-free:877.888.3337TTY: 877.889.5680
Health and wellness resources
Follow us on social media
Sign up for our e-newsletters: geha.com/Healthy
Download our e-books: geha.com/Library
Watch our videos: geha.com/Videos
Enrollment information: geha.com/Enroll
Jason Skinner, GEHA
Coletta Meyer, GEHA
> Why is shopping for health care so important?
> Finding the best value
> Medical Plan Options
> Dental Plan Options
Thank you!
gehapossible.com
This is a brief description of the features of GEHA’s Elevate and Elevate Plus medical plans. Before making a final decision, please read the plan’s federal brochures IR 71-006, IR 71-014 and IR 71-018. All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure.