GEHA Avis 146

I had nothing but trouble with GEHA, they constantly denied legitimate dental claims and delayed the payments they did honor. With their high premiums and refusal to pay claims I would have been better off just paying out of pocket. I switched to BCBS dental and now my claims are paid quickly. I hope GEHA goes out of business!

I have a chronic disease … I get infusions.. I’ve been off my medication for 2months!!!!! I’m waiting for insurance to approve the medication that I’ve already been on the last year that’s been working… they denied it and said I need to try a cheaper option (biosimilar) I’ve been talking between the doctors, infusion clinic, insurance, cvs,& cvs Caremark. Someone points the fingers to someone else… this is the worst insurance I’ve ever had!!!!!! When I call they say it’s approved.. when I call to fill the order they say insurance needs to approve it.. wait another 2weeks!!!!!!

Long-time Federal Employee GEHA user and I've seen GEHA decline from a good company that provided good basic service to members to a company that is now completely terrible and does to support it's core customers. Dental claims go un-processed and it is next to impossible to get any resolution for even basic dental claims.

My psychology provider was denied payment with no explanation and I spent almost 2 hrs trying to get answer. Ridiculous with hang up calls and some explanation that my provider had agreed to provide services with no compensation. Horrible service

Horrible and they deal with CVS Caremark which is even worse. Open season cannot come soon enough so that I can stop paying these crooks.

Well at least I know I am not alone in my assessment of incompetence that goes beyond any reasonable human capabilities. It is obviously a government run operation. No one else could mess things up so badly and still be in business. I have tried for two solid months to get a person with the ability to fix their screw up. Each time I am told it is fixed, but then I get either an email or letter, sometimes both, telling me I am on yet a different plan. My favorite is the fact that I am not old enough for Medicare, but they put me on a Medicare supplement policy! I am. Counting the days until I can dump this horribly incompetent company!

I recommend Trust Pilot add a 'Zero Star' because even one star too generous for GEHA Dental.

I've had the same problems as others with GEHA Dental. Whenever I checked on my claim status the answer was always that my claims were 'being processed'.

I submitted two dental claims in the spring of 2024 while I was temporarily overseas. When I returned stateside in September, the claim checks weren't in my mailbox. The GEHA claims Rep stated they would cancel the checks and reissue new ones.

Since 2024 I have called repeatedly monthly on their status and the answer was always the same -the claims were 'being processed'. In DEC 2025, after getting the same answer, I finally realized GEHA Dental was doing nothing.

In JAN 2026, I sent a certified letter to GEHA Dental, explaining my case and threatened legal action. To my surprise, GEHA responded. Instead of reissuing the original checks, they reprocessed the claims (very quickly) using New GEHA Dental Math. I got less than half of my claim money. This was just spite. Unlike some, at least I got something.

Something happened to GEHA Dental in 2024. It seems they changed contractors. GEHA Dental clients are left to suffer from incompetence.

I implore Gov't employees and retirees to please alert friends and colleagues to AVOID at all costs GEHA Dental.

The new GEHA obviously hires customer care employees who know nothing about the medical field. I used to be able to speak with knowledgeable personnel, but now across the board they have no working knowledge. They answer questions knowing they're committing errors and only if I press for more information, they will place me on hold over and over to get the answers I need. Asking for a supervisor seems to be the only sane thing to do--that is--if you can get to talk with a person who follows through and competently. Providing medical codes with the claims is like playing a game show. Even if the doctor writes the full diagnosis and treatment, if the "right code" isn't given, you lose! No guidance is given to find the right code. You simply lose the game! I found all the codes I needed in abundant supply by doing a search on the Internet and then chasing after my doctor to resubmit the claim with the right codes. Then I had to locate the supervisor again who said the claim would be covered and processed right away. It sat for another month and I could not get a call back from the supervisor. Finally, customer care placed me on hold multiple times and the claim was magically processed while I was on the phone. I was given the wrong amount that would be reimbursed (10% payment of the claim amount!), so she put me on hold again and came back and said I would be getting 3 checks instead of the one she first quoted. However, all three checks only add up to less than 50% reimbursement even though the every climbing out of network deductible had been met. It still remains to be seen if I will receive payment. I can't understand why there are 3 checks when all the office visits were bundled into one member submitted claim. The amount of hours I put into this has been staggering.

The provider delta county memorial hospital refunded charges to my HRA. GEHA cashed the check but will not refund the amount to my HRA

In December 2025, I purchased two OTC items from CVS Pharmacy. When I attempted to use both my and my wife's U-cards to pay with our quarterly benefits, CVS stated the items (vitamin supplements) did not qualify, and we paid for them out of pocket. Later, GEHA/United deducted our benefit balances as though we received them at CVS. This was reported immediately and I was told it would be investigated. After hearing nothing, I called in February 2026 and was told there was no "ticket" issued and since it was over 30 days, tough luck. This has happened twice!

I've been appealing a claim for 2 crowns, now for 6 months. I just received a denial of my final appeal dated 1/13/26, which was supposed to go to an independent reviewer.
I wouldn't be surprised if they are handling all their initial claims and appeals using AI. They don't even read the letters you send them. I just wrote a final letter of complaint to them but could not find the name of any executive to send it to, directly. I had to send it to their general post-service appeals address, which means no one will read it. I can't wait until Open Enrollment Season comes around ago, so I can cancel them from my life.

GEHA dental insurance's website/portal is an absolute nightmare for families. I have three separate logins for myself and family members (as required for individual access), but I can never log in reliably. No matter how carefully I enter the username and password—I'm 100% sure they're correct—I get the same error: 'The username and password combination entered does not match our records.'

I've called GEHA tech support multiple times. They can sometimes get me logged in after 20–30 minutes of troubleshooting on the phone (resetting, verifying, etc.), but the very next time I try independently? Same error, same lockout. It's infuriating and wastes hours. This isn't a one-off glitch—it's persistent across multiple accounts and browsers. Fix your login system, GEHA—this is basic functionality!"

GEHA medical has always been great insurance for us. Can't say the same about their dental insurance. What we can't believe is how much the High Option increased... over $300 a month for self plus one (retired annuitant). For the first time ever in all these years (40), my husband's bring home pay is less, even with the COLA raise.

I've had GEHA as my dental insurance for a few years now. Overall they had been doing fine until this past year when multiple concerning issues have arisen.

First, the more minor one - took 3 of my kids to a dentist in July 2025 that we have used in the past with GEHA insurance without any issues. It was for a routine cleaning. GEHA sent EOBs to me showing I owed $0 on the services, as expected. However, I kept receiving bills from the provider for 2 of the 3 kids. Turns out, even though they had received IDENTICAL services, they had only paid in full for one of my kids and only paid half for the other two. Had to call the dentist and GEHA several times and to get this resolved. Concerning and inconvenient, but not ultimately a dealbreaker worthy of a 1 star review.

Which brings me to my next and more concerning issue. Our plans states that GEHA covers 70% of orthodontic services, up to $3500 total lifetime maximum payment per person, for in AND out of network providers. On my last assignment overseas (but still US territory), we had orthodontic services provided for my son. The provider unfortunately did not have a process to submit claims, so I had to do a member-submitted claim. The initial services were done 4/15/25 and 5/8/25. The entire payment was made up front by me out of pocket for $5607. I received the needed paperwork from the provider on 5/15/25 and submitted the claim on GEHA's website through my member portal on 5/19/25 exactly according to the instructions as laid out by GEHA. After a month went by I reached out to them to confirm it had been received and they said it had. After another few months I called again to check the status and was told it would be "escalated." I called several more times, including 11/20/25, 12/4/25, and 12/11/25. During one of the calls the rep told me that it looked like additional documentation might be needed (even though it wasn't being processed yet, she was trying to supposedly preemptively assist me), so I reached out to the provider and got the additional documentation together to meet that requirement (despite it not being listed on GEHA's member-submitted claim instructions). The rep had told me I could call back once I had the documentation and it could be added directly to the existing claim without having to resubmit or negatively impacting the timeline for processing; she also allegedly "escalated" the claim for processing again. However, when I called back, the new rep I dealt with told me that it was not possible to do what the original rep had said; finally, after much back and forth, she directed me to submit it via email following specific instructions. I did so on 12/11/2025 and also asked again for an update on the status and when the claim might be processed; I never received a response either answering my question or even acknowledging receipt of the additional documentation.

As of 1/30/2026 the claim still just shows in the system as "submitted." I am sick and tired of waiting for this claim to be processed. There is no reason it should be denied, but even if it were, at least at that point I would have recourse to file and appeal and eventually take it up with OPM if still denied. But right now the status is just indefinitely in limbo and I have no idea what I'm supposed to do to force them to process a claim I submitted nearly 9 months ago. The customer service at this company is absolutely horrendous and their processing times are ludicrous. It should not take this long to reach a decision. It is surprising that in this day and age, with review sites like this and BBB, as well as social media, that companies still try to pull this kind of crap on customers. I mean, just look at their 1.4 star rating. Who would ever choose to do business with them going forward? I for one will be changing companies at the next open season and will not look back.

Missed so many prescriptions and delayed. So many procedures in an effort, to deny valid insurance and physicians' recommendations. Manage by united healthcare. I am saddened by the killing of the ceo. That poor man lost much of his life and now has to spend eternity in hell.

GEHA has a new way to delay and not pay on claims. They now refer you to ClearHealth at 888-550-8910 for processing out of network pharmacy claims. I contacted ClearHealth, who informed me they cannot help with this claim.

GEHA does not process legitimate claims, nothing but excuses with this company. I just switched to BCBS for my dental. I urge the federal government to drop GEHA as a provider as the do not actually provide anything. They are tenacious at denying legitimate claims though.

I give them a 0 review. Awful! They dont know what a routine wellness is for an adult, they keep raising our out of pocket.

I recently attempted two appeals after being denied for a service connected to my VA disability. I offered to provide VA documentation. I followed appeal steps as specified the GEHA call center and sent my appeals to the published email address & received confirmation emails. After nearly seven months and many requests for status by both phone and email, I have yet to hear anything back whatsoever. GEHA holds use beneficiaries to their timelines, yet feels no compunction to abide by the timelines required by the DHA. GEHA is also required to have a Grievance procedure, yet none seems to exist. They can ignore their members with impunity.

GEHA refused payment of a ROUTINE Claim with my HUMANA Medcare USAA Dental Advantage plan. My insurance and Dentist has not changed in 3 years!! I spent 2 hours with a GEHIA Rep who took all my information and said they had not been paid. I called my Dentist and they (as always) billed HUMANA and sent claim to GEHA, who LOST intentionally did or didnot pay?? MY GUESS is that GEHIA may not be in business long. They are incompetent. Anther hour on the phone again today. They do not care. BENEFIDS must investigate and DROP.