Catastrophic Medical

For catastrophic medical expenses after your G.H.I. basic refund, the DEA requires an out-of-pocket deductible of $4,000 per family per calendar year. When G.H.I. original Explanation of Benefit (EOB) statements are submitted to the DEA reflecting the deductible, we will refund $3,000 of the $4,000 deductible. All covered expenses i.e., those claims in which GHI has made some level of payment, after the deductible will be processed at a 100% reimbursement level not to exceed $250,000 lifetime per family. This catastrophic medical benefit applies only to members enrolled in the GHI-CBP program offered through the City of New York Health Benefits office.

There is an additional benefit under the DEA Catastrophic Benefit Program for Retired Members who do not qualify for the Catastrophic benefit  described above.

For members who have out of pocket expenses ranging between $2,000 and $4,000 in a calendar year, the DEA Health Benefits Fund will reimburse you the amount between $2,000 and $4,000.  GHI Explanation of Benefits (EOB) statements will be required for submission to the DEA in order to obtain reimbursement.  Please telephone the DEA Health Benefits Office at 212-587-9120 for an Annual GHI/DEA Refund Form.