GEHA Avis 

Despite months of calls and escalations, GEHA Refuses!
Despite months of calls and escalations, GEHA has refused to pay my $105 dental claim from Oct 2024. Their customer service failed to follow up or resolve a basic issue. Avoid if you expect accountability or timely reimbursement.

Avoid these guys like the plague. We submitted out claim ten weeks ago. No one can give me a timeframe for when that claim will be processed. I can't get a straight answer from anyone. I paid $2622 out of pocket.

Had a claim from last November that they incorrectly processed as out of network when it was in network. Repeated calls got nowhere. I finally filed an official appeal and they agreed with me. However over two months later after that, they still have not reprocessed the claim. Calls and emails get the same canned response of promising to expedite it. Never happens. There is also no way to talk directly to anyone in the processing dept. 6 months to process a claim is ridiculous.

With as many known issues and problems by United Healthcare, prior to GEHA using them to process claims, WHY-WHY would they make such a HORRIBLE decision, unless their customers are no longer their priority. I am SO DISAPPOINTED in their service.
You cannot tell me, no one within GEHA, did not do any research in negative reviews for United Healthcare, for at least 5 years prior, that is taught in business 101 courses.
Have called several times, for updates, first 3 times "claim did not show in system" so resubmitted 3 more times. finally it showed up in their system the 4th time I called. Representative stated it would take 45 BUSINESS days (not calendar days as previously notified) to process.
(05/20/25) Got off of the phone with another representative... the processing has still not started. Representative said she was going to escalate the claim, since it's over 90 days... we'll see, I'll probably be calling in another 2 weeks and be told the same thing.

Been waiting since 8/22/'24 for settlement of a dental claim - almost 9 months! The level of incompetence is shocking. They have made four request of me for duplicate information and more than a dozen request from my dentist for reports, x-rays, documentation, etc.

Very very slow in processing my most recent dental claim. Nobody will provide a straight answer. Nobody knows where we are in the process (that's called the mushroom treatment). On line chat is useless. Live body, when you can get one, never has an answer. Won't get back to me even after promising they would. Then, when GEHA finally processes the claim, the provider says GEHA processed an in-network provider as out-of-network. Intentional or incompetence?

Our kids have not seen a doctor in 4 years and they denied a well child visit because we combined it with a sports physical. The hoops they make you jump through are ridiculous and they are terrible to deal with when you are overseas.

Have had GEHA dental for over 20 years. Neve4 had any complaints until this year. They are obviously stalling on all pre approvals and maximizing profits quick for new ownership by not providing services. My daughter’s dentist submitted for pre approval 8 weeks ago. I called them last week and they w3nt to their go to move of saying the DDS did not submit. However, my DrS did submit and had the email to prove it. GEHA then said they would expedite and my daughter is still waiting. I suggest everyone leave GEHA as soon a# possible. America being made great again!

On 5-06-2025, I called the customer service about my recent dental claim status. They told me basically it's not in their system. According to the USPS tracking, it was indeed delivered to their location on 3-10-2025. Very incompetent unprofessional people working there. How can you lose people's documents like that. Not to mention the security risks involved when that happens. Obviously there's some serious issues with GEHA, including their personnels and their disorganized systems. The open season can't come fast enough.

I would give no stars if I could. Their service is horrible. I have two claims from 2024 that are now 6 months with no payment and all I get when I talk to them is “they are processing” with no indication on if they will pay or when they will finish their “processing”… 2024 started rough with geha and just went downhill from there. DO NOT USE THEM!! I’m not having to pay out of pocket for expenses that should be covered…

I have had GEHA for 16 years. Since GEHA made the switch at the end of 2024 to UnitedHealth Care for processing claims, I have not been able to get multiple claims processed despite repeated calls and resubmittals. They can never find the claims that have been submitted online. I have been told by a representative that it takes up to 60 business days (3 months) to process a claim. Promised call backs from supervisor never happen. At this point, I am planning to drop GEHA at the next open season.

The only reason they get two stars instead of one is because they do have options that many other dental plans don’t. The reason they should get one or zero stars is that it takes forever for claims to be processed and paid. Right now, May 20 25, it takes them one to two months to upload claims into their system. Then it takes 30 to 45 days to pay. And that’s if you’re lucky. If I knew that, it was going to take four months to be reimbursed for dental, I would’ve gone with someone else. I still might just change at the next open enrollment

GEHA system changed as of 1/1/25. Never had problems for years before that. Now, they only know how to spout the company line - not try to solve the problem. The lady I spoke to today was rude, a bit belligerent, and then transferred me to terminal hold. When I told her that my providers are getting incorrect information about my co-pays, she told me that my Drs. offices are billing incorrectly! All six of the providers are getting wrong information - but GEHA wants me to believe that they are the problem. Can't wait till I can switch to something else. Shame on them.

DO NOT USE GEHA!!! I've had them for years and now that I need an expensive dental procedure they're using every tactic to delay. They keep asking my dentist for more information, but my dentist states it's the SAME requests. I call GEHA constantly and today I'm given a number for my dentist to call to resolve the matter. They did not give my dentist the number, I had to reach out otherwise this would have gone on indefinitely. Beyond shady. Stay away from this expensive USELESS dental insurance.

Never in my 74 years of life have I dealt with a company as bad as GEHA. Since changing my health insurance from Federal Blue Cross Blue Shield to this company I have had nothing but problems. Now I am going to have to pay a penalty because I didn't sign up for SilverScript in January 2025. I had never heard the name SilverScript until I received a letter in the mail two days ago informing me that I am required to sign up for this program and pay a penalty for not signing up in January of this year. If you have other choices, please don't even think about enrolling in this company.

Every claim submitted in 2025, and there have been about 22 since my husband has multiple myeloma, has been denied for the reason: Claim status description:
Medicare Eob Needed
We have been with GEHA for over 10 years, neither one of us has ever had Medicare and currently do not have Medicare, I have emailed them and talked on the phone and all they say is the claims will be re-processed, well this morning 3 claims from Quest Diagnostics were re-processed and still denied: Claim status description:
Medicare Eob Needed, what has happened to this organization? We for 10 years thought we had the best insurance company out there, I thought having SilverScript jammed down my throat this year was going to be a problem, now this is making our medical coverage non-existent, anyone else suddenly getting denials due to lack of Medicare EOB's when you are not on Medicare?

I’ll be switching at open season. I had a baby last year and they didn’t pay a claim for baby from the day he was born! He was healthy, the hospital was in network, I called months ago and was told they made a mistake and were reprocessing the claim but, nothing has happened. I just got a collection bill in the mail.

I feel like I never know the cost on my end before I go to a doctor anymore. I went to an in network dentist and they were never able to get ahold of GEHA for coverage so, I had to pay for my annual exam out of pocket.

Haven’t been able to use MDLive after the ID number switch either. It’s supposed to be free for members.

I’ve had GEHA for 9 years and have never had these issues. I’m tired of getting surprise big bills, I’m ready to switch,

I have been with GEHA 20 years and using the High Deductible plan. At 65 I was switched to an HRA instead of a HSA. It worked for many years. This year it is has been impossible to get reimbursements for my out of pocket costs. I have numerous phone calls and using their new chat system and the representatives are clueless. I have been apologized to numerous times and told my issue has been escalated, but three months later still no payments are made. They are turning into the worst option for health insurance and I cannot wait for open season.

Have had GEHA for 8 years and have loved the service, had multiple children and they covered a ton for us. We didn’t have a single negative experience. Until they started going downhill with their merger with United it seems.

According to the GEHA reps we have spoken to concerning the insane bills we have had to pay lately: They changed their policies…AFTER OPEN ENROLLMENT…as of 2025. We have had multiple sick kids and our bills keep coming back with GEHA covering a $1.18! $1.18! We have ALWAYS had money in our HSA until this year when GEHA nearly doubled our out of pocket. All of a sudden the 3k in our HSA was drained for needing to put tubes in our kids ears.
We asked multiple doctors if we could pay cash, out of pocket for a lower rate, but they said they legally have to send it to insurance since we have it. So our last two exams for our boys came back with an insurance adjustment of $1.18. What’s the point?!

We will sadly be changing providers next open enrollment.