GEHAReviews of geha.com

Beware! Dental is a scam. I paid the high option for two years and had some dental work. But now will only pay less than 1/3. Though the claim submitted in late Jan, they claimed it was never received; so I sent it again on March. Now, they say that the check was mailed over a month ago, but ‘the check is on the mail,’ that never came. First mail lost ever. Other insurance companies do direct deposit but not them. I think OPM should have a hard look into GEHA. They should be dropped as insurers.

Worse Dental especially for Invisalign. This is still an ongoing issue. I have been receiving rendered service regarding invisalign. The provider is in network and have submitted claims multiple time. One claim has been received since 05/28/2024 yet it's still in process. When I questioned how long will it take to process because I am paying out of pocket right, I was told basically told it will get process in due time. They are slow and you cannot access your EOBs! As a Federal Employee I will definitely be changing because this is not it. Even prior I asked if a pre Auth is needed and was told no!. Their policy claim to cover 70% with $3500 lifetime maximum. Since February and they cannot respond to the provider with their coverage amount.

I will not be renewing next open enrollment. I was on a medication for my diabetes for a year. My A1C had never been lower and I lost 60 pounds. Put in for a refill and pharmacy said insurance won't cover. I called the insurance company and they said I need to try 5 other medicines first before they consider approving the meds. I tried one and it really didn't work well. I tried it for about 5 months. My doctor prescribed another one. I was on it for three months before they stopped approving it saying it needs pre authorization and statement from my doctor. I've been off of meds for 2 months while my doctor has been fighting for me. Geha is wrong. Doctor sent stuff over and they keep saying they never receive anything. Now I have gained 40 pounds back in the last year and my A1C is up. Wouldn't they want me to be on the best medicine that works for me?

GEHA is terrible. All of my claims that I verified on the website in network went to out of network deductible. Additionally, some expenses I paid to in network deductible reflected for about a week before they were removed again. My prescription was denied because they would rather have me use older and cheaper medicine rather than more advanced treatment. What’s the point of paying for insurance if they don’t process your claims properly and cover you for newer safer treatment recommended by your doctor. I’ve have to delay seeking care for another month because of GEHA to find a company who can actually help me. GEHA is awful.

I went on o a GEHA approved lab for covered standard lab tests 02/22/24. GEHA processes the claim with $0 to the provider, saying services were not covered (They are!). On 07/02/22 I had an emergency room claim that by contract should have been covered. GEHA put that claim in an “In Process” status and NEVER PAID! I was stuck with a $15,000 bill from the hospital. GEHA must be sued and not allowed to do business for breach of contract

I have been unable to get a dental claim processed for over 100 days. It’s ridiculous. There is no access to EOB’s. Do not use this company for dental. They used to process claims, but not anymore. It’s horrible.

For almost two months now, GEHA has not been able to provide EOBs. They keep showing this error on their website: "GEHA members may be unable to access certain self-service documents, including EOBs, due to an ongoing service outage at one of our vendors. GEHA Customer Care team members are also unable to view EOBs at this time. We are monitoring the situation with our vendor, and we appreciate your patience. We will update this message as more information becomes available." What a joke.

A significantly reduced and new staff lacks appropriate knowledge and training before being placed on customer service calls to its members. Then comes the lack of access to records. It's been over 90 days, and they still haven't fixed the issue of where you can access all your claims. GEHA used to be good, but leadership decisions have degraded this once-fine company. Even their website is stripped of what it once was. Disappointed member of 19 years - moving to another provider this coming open season.