GEHA Avis 

Claim payments now take up to 7-8 months. No live representatives are available to answer any questions. We will have to get out of network to keep our sanity. I also advise our patients against getting covered by GEHA if there is a choice. They are USELESS!!!

If i could give zero or negative i would, wasting my time and never do what they say, i think they are trained to say they will take care of it and nothing happens, 10 times now over 18 months, i'm going to file a court case if this last time gets no results and why would it?

GEHA is not processing claims. I have three submissions for my claims (twice through the App and once online), three different confirmation numbers, but none of them have been processed two months later. GEHA should be banned from doing business with the government or any other agency.

I have had GEHA Dental Overseas for over 20 years. Since they made the switch in their processing of claims, my claims have not been processed in a timely. I had 2 claims for services in late 2024 and submitted my clams in early 2025, after receiving the bills. The claims ended up being loaded in their system twice, approx. a month apart. After monitoring the claim status online I started making chat inquires and was told by a representative that it takes up to 75 business days to process a claim. Even caught them laying about when the claims initially arrived, they were using the 2 time they were loaded, not the first time as date of arrival, but I had evidence to the contrary and proved it to them. After about 5 different chats, they finely processed the claims 101 business after they were initially received by GEHA Dental. I have another claim pending right now and it already at 60 business days since it arrived and is still pending. I have a FEHB plan for overseas care that pays my health clams in less than 30 calendar days and they are far more complex that the dental claims. Will switch plans during OPM's next open season.

Failure to file appropriate paperwork for silverscript changeover with Medicare. I am on third inhaler as they keep changing which one is authorized

Total Failure o every level. Customer service is HORRIBLE, THEY CANT & WONT FIX WHATS BROKEN. THEY REFUSE TO GIVE EARNED BENEFITS!!

Recently inquired that the hospital in my city is no longer covered by United Health Care. a contract was not signed by either party. Now in order to be a 4patient in a local hospital, I have to drive about 45 minutes to Chattanooga, Tenn. No provision was made. I was toldGEHA that they cannot force them to sign a contract. But what about patients????

I've had GEHA health insurance for almost 40 YEARS so I know what I'm talking about when I say they have become totally incompetent at EVERYTHING! They also contract with CVS, another company that sucks, to manage prescriptions. My oncologist prescribed some pain meds for me and CVS overruled my doctor and wanted me to pay FULL price. I refused and ended up in the ER. So these dumb@$$es were on the hook for an ER visit because they refused to fill a $10 prescription! You think I won't be doing this more often?! 😂

Is zero a possible score?

No one knows what they are talking about. Get a different answer when you call or when you use CHAT online. Horrible horrible horrible since January 1, 2025!! What happened?? Cannot wait to dump them. Choose ANY other insurance company. Our claims are not even complicated and still it's an nightmare. You have to double check ALL claims and follow up. They will kick back most of them. Hoping you won't appeal. Only choose them if you like running in cirlces and want to be on the phone for 1 - 2 hours to be given misinformation and the run around.

When GEHA changed contractors for 2025, the entire system became terrible.
1. It took about five months for the new contractor to catch up on claims processing.
2. FEDVIP dental, the premier dental coverage, pays pennies on the dollar. It's about the same as standard, yet you pay more for the coverage.
3. Contacting them is laughable. If you phone outside of business hours--which they don't define--you go through the motions of entering your ID and birthdate, and then you are told they are closed. The new contractor never thought of saying they are closed right at first. Trying to message them: I live in Australia. I must select the Australian flag to enter my phone number, but guess what, it asks for a 10-digit number BUT ONLY ALLOWS NINE! Thus, I cannot message them, because this field is mandatory!
I don't know why they ditched the previous contractor, but it was immeasurably better than this incompetent crew.

Horrible insurance company! I called TWICE before scheduling a "missed miscarriage" procedure to make sure it was covered. When I called in tears, to double check, I was told it was by both reps, anything maternity related, 100% coverage, well turns out it wasn't! I received a bill in the mail less than a month after my miscarriage for $8000!! The DNC procedure was the safest and fastest, as the baby needed to be removed as soon as possible for my own safety.
While I am grieving and trying to heal from this traumatic event, I continue to receive invoices over the last year. It is beyond triggering. Thus, I called countless times, spoke with management, sent emails, and filed two levels of appeals. GEHA even made an oversight with filing, and I had to start over. I ended up having to send over 100 pages certified to OPM, including my entire medical record and chart notes from the procedure for review. After a year of battling, I received a one page generic letter from OPM, stating that its my responsibility to know the details of my plan; what is covered or not, and being verbally told something doesn't matter. Thus, the bill is valid and I am responsible for the amount. Its not like I can take back the procedure I had so I don't have the bill. I was misinformed TWICE, and I paid a lot of money monthly to be told the correct information. I gave my hard earned money to this company for accurate information not to be lied too and billed later. I trusted this company. There is no accountability on their end. A lost child for $8000, its beyond stressful and heartbreaking. GEHA is not longer my insurance company and never will be.

I had an Ortho pre-approved service completed back in September 2024. I've been calling on this bill since April 2025. As I write this, I'm on hold while someone is escalating my claim up for the 5th time. I want to speak to someone on the Ortho side. I will be cancelling my policy and going with someone else during open season. This is beyond ridiculous. I am going to file a Congressional and file a complaint with the Better Business Bureau next.

I started suffering blinding headaches last weekend. Three Board Certified Doctors (internist, ophthalmologist, ENT surgeon) all recommended and ordered an immediate CT scan of my sinuses and head.

GEHA has refused to act on the CT orders. This has left me taking double doses of Torodol, and 10-12 ibuprofen per day, to manage the pain. GEHA will not explain any of their failures to act on this. They did say a nurse (likely an LPN) would try to look at the CT orders.

If you had a zero that’s what I’d give GEHA. I have experienced a 8 month delay in processing my claim. During that times they have claimed to have lost it twice(despite fact I have signed receipts that they received it) claimed that because they changed PO Box in same small tow three weeks AFTER I mailed it and still do not have an accurate claim being processed. Unfortunately Trump fired all the inspector generals who normally would be protecting us from this fraud. I am contacting a lawyer. I see by the reviews there should be interest in a class action suit.

I have 3 claims that I have been trying to get paid since January, this year. I call customer service I get the same answer its in processing. Then they process it out of network, so I call again an she says I will send it back because its defiantly in network. After another week I call still in processing. Every time its sent back they say it takes 30-90 day to reprocess.

GEHA is by far the worst Dental coverage any Fed employee or retired could possibly purchase. The customer service people lie every chance they get confirm claims that are incorrect. They are running a Ponzi scheme and Arthur Nizzar is just like Bernie Madoff. The really sad part is OPM is OK with Gov employees getting screwed Dennis Hodges is #1 attached to GEHA. GEHA and BENEFEDS need to be investigated for corruption and should save the taxpayers more money. GEHA employees should all be fired immediately. Every claim this year resulted in them not reviewing my claim from overseas however there automated reply stated they had received them. The past has resulted in 90-95% or claims being resubmitted 2-3 times I now have to send all claims to a certain individual named Heather to get them processed which is UNSAT. There in no part of GEHA Dental that is any good save your money take the organization down they are affiliated with United Healthcare which is under investigation

As with other complaints, something has changed and GEHA went from decent to TERRIBLE. The customer service people know nothing -- they can't do anything more than you can do yourself on the website/portal. But, as others are saying, it's the claims processing that is the biggest joke. I have the same appointment every week and it's processed at different rates! In addition the dr is in network but processed as out of network. I send every claim back for reprocessing and nothing changes or (as happened with one) they reduce what they'll cover! You just beat your head against a wall with this company and they don't care. You have to pay your doctor's office in the end or go to collections.

I know it's stereotypical to say "I'd give 0 stars if I could," but genuinely, if I could take stars away from them for the headaches and mental breaks they have given me, I would. Working with them has been an absolute nightmare. I had coverage under my mother, and when I turned 26, I had thirty days as a grace period. I needed an appointment during that grace period for some health issues and making sure those were resolved, so I went, assuming I would be covered for the appointment and bloodwork I needed for my health issue. I find out by policy, I have to submit a claim. No problem. I do so. It gets rejected because my coverage ended. I reach out to them, informing them of the grace period. They resubmit the claim. Denied again. I find out the bloodwork was the claim they were referring to and not the appointment. I submit a claim for the appointment. I call many times to ensure both are in the system and am told yes. However, I just found out the claim I submitted myself for the appointment was lost (despite asking about it less than a month ago and being told it was found and filed), and the lab was rejected AGAIN. These bills total to $1,000. I don't have this kind of money lying around. The policy I was on SAYS I would be covered. Their claims team even TOLD ME upon review of my policy. I have been fighting this crap for half a year about. The incompetency is astounding. I don't know how any organization can be so cruel in how stupid they are. I have been having breakdowns, calling my doctor humiliated over being unable to get this claim processed, calling on a near weekly basis babysitting this garbage, being told they are doing everything they can. Are you really? And if you truly are, do you not feel even a bit of shame if this is your best? Stay away from GEHA. They truly highlight how corrupt and garbage our healthcare system really is in this country, and for anyone on it, I am so very sorry that this is what they offer government employees. You deserve better.

I am writing to formally express my frustration regarding the excessive delays in the processing of my claim, which was submitted seven months ago and has yet to be reviewed or resolved. Despite multiple follow-ups and assurances that my paperwork was received and in good order, I continue to face unnecessary obstacles and delays.
Initially, I was informed that system updates caused a three-month delay. Following that, an additional month passed before my claim was assigned to a reviewer, only for it to be mistakenly canceled due to an error on your end. I have since attempted to escalate the issue multiple times, receiving conflicting information from different representatives regarding the status of my claim. I was also promised a supervisor call within 48 to 72 hours, which never occurred. As of today, I have been advised that my claim will take another 30 to 45 days for processing, pushing it into its eighth month of delay. This level of inefficiency is unacceptable, and I am now formally requesting immediate action to rectify the situation.
I ask that my claim be expedited for review and processing without further delay. Additionally, I would like a direct point of contact who can provide accurate updates and ensure that my case is handled promptly. If this issue is not resolved, I will be forced to escalate further, including filing a formal complaint with regulatory authorities and sharing my experience with consumer advocacy groups. Please someone from GEHA provide an update on the immediate steps being taken to resolve my claim. I expect a response no later than 6/11/2025.

Thank you for your attention to this matter. I look forward to your prompt response.

I'm a retired GOV employee with 30 years experience and GEHA is by far the WORST insurance company. AVOID it all costs. Months to process claims, 0 communication, denials. They sent me a check on a claim that never got for 3K. I found out after I filed a complaint to OPM. 2 months later and they still haven't re-issued my check, saying it takes 30 business days!!! STAY AWAY!!! Can I give -0 stars?