When you're looking into health coverage, especially for federal employees and annuitants, GEHA (Government Employees Health Association, Inc.) often comes up. It's a name that signifies a long-standing commitment to providing health benefits, particularly for those in the Postal Service.
If you're a Postal Service employee or annuitant eligible for the Postal Service Health Benefits Program (PSHB), GEHA offers a specific plan for 2025: a Fee-for-Service High Deductible Health Plan (HDHP) that utilizes a Preferred Provider Network. This plan is designed to meet minimum essential coverage and minimum value standards, which is reassuring to know. To become a member, you simply enroll in the plan through the PSHB System. And for 2025, there are no membership dues, which is a nice perk.
For those considering this HDHP, you'll find enrollment codes like 39A for Self Only, 39C for Self Plus One, and 39B for Self and Family. It's always a good idea to check the back cover for rates and page 15 for changes and a summary of benefits. You can also find details about the plan's accreditation on page 12.
Now, let's talk about prescription drug coverage, especially concerning Medicare. GEHA's prescription drug coverage for active employees has been determined by the Office of Personnel Management (OPM) to be 'Creditable Coverage.' What does that mean for you? Essentially, it's expected to pay out as much as standard Medicare prescription drug coverage. This is great news because it means you likely won't need to enroll in a separate, open-market Medicare Part D plan and pay extra for prescription coverage. You can maintain your GEHA coverage without penalty if you decide to enroll in Medicare Part D later. However, it's crucial to understand the implications of dropping your PSHB coverage. If you go 63 days or longer without prescription drug coverage that's at least as good as Medicare's, your Medicare Part D premium could increase by at least 1% per month for every month you were without that coverage. This higher premium can be a permanent adjustment.
For those with limited income and resources, there's assistance available for Medicare prescription drug plans through the Social Security Administration (SSA). You can find information on their website (www.socialsecurity.gov) or by calling them at 800-772-1213.
On the flip side, some individuals with higher incomes might face an additional premium for Medicare prescription drug coverage, known as the Income-Related Monthly Adjustment Amount (IRMAA). This is an amount you pay in addition to your PSHB premium and is based on your reported income. You don't pay this to your PSHB plan directly. More details on this can be found on the Medicare website.
If you ever need to reach out for assistance or have questions about your GEHA plan, their customer service number is 800-821-6136. It's always good to have that number handy.
