GEHAReviews of geha.com

I like this insurance for the most part but please give us a better gym membership, We are only offer Fit and Active which only accepts ONE gym for $30 a month

I have a medical need to have my braces re-done due to some damage caused by a permanent retainer. The retainer is causing a recession in the front bottom tooth and could cause me to lose that tooth if not fixed. They received my claim on June 21, 2024, and they have been holding off till yesterday, Sept 3, 2024, to deny it. It has been well documented that I need to have this fixed and they are being horrible. I will be changing my dental ins as soon as the open enrollment window is there. They are so terrible to work with when you call as well. Even my kids orthodontist office said GEHA is horrible to work with.

I have been happy with GEHA dental insurance for several years, but in 2024 that all went out the window. They are denying claims saying there is other primary insurance for my wife but there isn't. My EOB's are not available and they blame a "third party". I think it might be time for a class action suit! I am now going to file a final appeal with OPM because GEHA is so awful.

I have had both GEHA standard and High option dental for several years. I have never had them deny a claim. Not everything is covered but that is normal for any insurance company. It is true you can't currently get EOBs online but that is due to the Change health care cyber attack and they have a banner on their website saying that. That is all insurance not just GEHA. I do wish they had expanded customer service call hours. Their hours are pretty much when I work.

GEHA and their in network pharmacy, CVS/Caremark, have been requiring pre-authorizations for basic services and prescriptions. They seem to deny everything by default or total neglect of understanding. I subscribed to the high option, wanting to have the best, but GEHA is now the worst. My doctor prescribed a medication that worked well for me and they denied it. He appealed, saying that the medication was my best option and had worked well previously for me. GEHA denied the authorization again, saying my doctor told them the medication HAD NOT been successful (why would he have prescribed it then?). Now we are dealing with a longer appeal while I risk my health with a cheaper and less successful and less safe option. My doctor also sent me for an MRI after a previous test showed what looked like a tumor. GEHA denied the preauthorization because they said I needed an MRI of a different body part instead, or possibly just a different code from my doctor. They didn’t have a firm answer for me, but were happy to keep me waiting for weeks to find out if I might be dying while taking hours of my doctor’s time on appeals. I have also been told to use CVS to get the in-network price for meds, but CVS pharmacies are as common as unicorns where I live, and the only one doesn’t have a drive through. It’s in a superstore. That CVS tends to be out of my more expensive meds even when other local pharmacies have them, which seems like another excellent scam to save GEHA money. Isn’t that a conflict of interest for GEHA? Their own customer service people even seem frustrated with the company. Like many others, I was also denied dental coverage for adult braces due to TMJ, misalignment, and other issues. My teeth looked straight, so it wasn’t cosmetic. I paid $3,000 out of pocket and GEHA covered $0. That was a few years ago before things got so much worse with coverage of tests and prescriptions. Also, they are supposed to notify us before preauthorizations expire, but I have never gotten a notice, just had previously covered meds no longer covered within the same plan year. I can’t wait for open enrollment! OPM should drop them from our available plans.

I have tried to get reimbursed for a claim submitted months ago. First GEHA miscoded and denied it. I have made three long phone calls, made an additional trip to my dentist for documentation, emailed them multiple times, and still the claim is "in process." I can't see any details of the claim and the rep on the phone could not tell me how long it would take to process, just that I had to continue calling back every couple of weeks. THIS IS THE WORST DENTAL INSURANCE I HAVE EVER HAD IN MY LIFE.

GEHA is terrible about paying claims. I’ve now had at least 3 different providers/procedures where GEHA did not pay per the estimated given to the provider ahead of the procedure. This has become a trend. Every office I speak to tells me that they hate dealing with GEHA, because they never want to pay.

Worst customer service and horrible processing of claims.