GEHA Indemnity Benefit Plan, Elevate Option: 2027 FEHB premiums and benefits
| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code 254 | $77.92 gov $233.77 | $168.83 | $168.83 | +$0.00 biweekly | $2,026 |
| Self Plus One code 256 | $187.99 gov $563.96 | $407.31 | $407.31 | +$0.00 biweekly | $4,888 |
| Self and Family code 255 | $228.85 gov $686.57 | $495.85 | $495.85 | +$0.00 biweekly | $5,950 |
Traditional, PPO network. Offered nationwide: anyone eligible for FEHB can enroll, in any state. The government share is the lesser of 72% of the program-wide average premium or 75% of this plan's premium (5 U.S.C. 8906).
Educational information only; StandWatch is not acting for OPM, and the brochure and your agency's benefits office are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $750 out of network $2,000 | $1,500 out of network $4,000 | $1,500 out of network $4,000 |
| Out-of-pocket maximum | $10,600 out of network $17,000 | $21,200 out of network $34,000 | $21,200 out of network $34,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Primary care visit | $10 Copayment | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Specialist visit | $30 Copayment | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Urgent care | $50 Copayment | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Emergency room | 35% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 35% Coinsurance (Deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Labs and X-rays | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| CT, MRI, PET | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Hospital stay, per admission | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Hospital room | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Surgeon, inpatient | $250 Copayment (25% of the Plan allowance, for surgical procedures performed in all other settings. Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Outpatient surgery | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Mental health, office | $10 Copayment | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Mental health, inpatient | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Physical therapy | $30 Copayment (Up to 30 visits combined, per calendar year) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Chiropractic | $10 Copayment (Up to 12 visits, per calendar year) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Acupuncture | $10 Copayment (Up to 20 visits, per calendar year) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Maternity care | Member Pays Nothing | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Maternity hospital stay | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Infertility diagnosis and treatment | $30 Copayment (Surgical and Prescription cost share may apply depending upon services delivered) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Not Covered | Not Covered |
| Durable medical equipment | 25% Coinsurance (Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Home health | 25% Coinsurance (For up to 50 visits, per calendar year. Deductible applies, Self $750, Self Plus One/Self & Family $1,500) | 50% Coinsurance (Of the Plan allowance and any difference between our allowance and the billed amount, deductible applies, Self $2,000, Self Plus One/Self & Family $4,000) |
| Adult dental exams | Not Covered | Not Covered |
| Children's dental exams | Not Covered | Not Covered |
| Routine eye exam | Not Covered (Discounted vision services are available in-lieu of covered benefits) | Not Covered (Discounted vision services are available in-lieu of covered benefits) |
| Eyeglasses | Not Covered (Discounted vision services are available in-lieu of covered benefits) | Not Covered (Discounted vision services are available in-lieu of covered benefits) |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $10 Copayment | 100% Coinsurance |
| Tier 2 | 50% Coinsurance | 100% Coinsurance |
| Tier 3 | 50% Coinsurance | 100% Coinsurance |
| Mail order | No | No |
| Prescription out-of-pocket maximum, Self | $10,600 | Not listed |
| Prescription out-of-pocket maximum, family | $21,200 | Not listed |
| WITH MEDICARE | ||
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
GEHA Indemnity Benefit Plan plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 71-018 · (800) 821-6136
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the Office of Personnel Management or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM FEHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM premium charts for the change from 2026.
