GEHA Avis 

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.

With the recent open season, I moved from Aetna Dental to GEHA Dental, as I wanted to try something different. My main objection with Aetna was they still used the antiquated payment method of paper checks vs electronic payment. This I found odd, as the Aetna medical (processed claims for FSBP) did do electronic payments.

Unlike GEHA, Aetna at least processed claims and offered customer service.

GEHA has had a message on its website for over a month that states "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."

I have had a dental claim that has not be processed for over a month.

I have written to GEHA three times (2x via the web form, 1x via email address) and still no response after over 2 weeks from my initial contact.

I would give GEHA zero stars, if it were an option, and I am so thankful I did not also switch my medical plan to GEHA.

Go elsewhere next open season!
Very expensive mistake.
If I could get out of this mess, I would. 4 premium payments and no service of any kind. You stuck for a year. Good luck with an appeal which they have a form.
Sad part is they take your premiums and have no obligations to actually provide paid service. They have 3 venders who are sub-contractors that actually pay your dental charges. So, you are just getting another layer of management to complicate the whole process. Go direct for your insurance and most dentists have their own. I always wondered why my dentist was slow to show GEHA payments all these years. Now I know.

Very dissatisfied. I enrolled in the Federal High Dental knowing my kid would eventually need braces. When I eventually put in my claim for $4,926.87 they cover a mere $1306 and when I asked how in the world they came to that number they sent me this from deep in the fine print:
On the initial claims processing, we processed the total billed charges as 3,950 Great Britian
Pound (GBP) with a conversion band date of May 18, 2023. Charges were based on the
total case fee of $4,926.87 U.S. dollars with a maximum allowed amount of $273.71 divided
by nine months of treatment. We paid 70% of the Connection Dental negotiated amount,
$163.33 monthly and applied 30% of the contracted fee schedule towards your monthly
coinsurance amount of $ 70.00. The monthly disallow amount of $40.38 is the difference
between the billed charges and the Plan allowance and is applied towards the patient
liability since in-network providers do not extend outside of the United States. Your total
patient liability amount includes a coinsurance amount of $630.00 plus the disallow amount
of $363.42, which equals to $993.42.

I cannot express my massive hatred towards GEHA. When I contacted GEHA about my claim that was sent out SIX WEEKS AGO, they stated "we do not see anything about your claim". Actual BS. My orthodontist gave us proof they sent out the claim. Why should I wait any longer for a simple response? Why can't anyone here do their job properly? On your website, it states "give us 30 business days to respond to your claim". LIES. ALL LIES. IT HAS BEEN WAY OVER 30 DAYS!!!!!

I can NOT wait another minute. Every time I check the mail, having some faith GEHA will pull through, nothing. This insurance disappoints me. They do not deserve any of their customers. Honestly, I do not understand why they have customers in the first place.

I do not understand why it takes so long to give a simple response. This company is worth $1.9 BILLION dollars. They earn so much money, yet gives bad customer service. Yes, I understand they have many claims they need to solve, but why should it take so long? I can do a better job than some of these employees.

Furthermore, it's baffling that a company worth $1.9 billion can't manage to provide customer service. With such immense financial resources, one would expect GEHA to invest in efficient claim processing and responsive customer support. Instead, they seem to leave their customers hanging for weeks on end, with no regard for the inconvenience and stress caused by their incompetence. They billion dollar companies only care about themselves, especially the higher-ups.

Moreover, the lack of transparency is alarming. How can they claim to have not received a pre-authorization that my orthodontist has proof of sending? It's either a blatant lie or an indication of their disorganization. Either way, it's completely unacceptable.

I might just need to escalate the issue to the higher-ups at GEHA or seek legal experts, because I believe this is not right. It's unfortunate it has come to this, but I need to make sure my rights are respected and that someone is held responsible for what's happening.

I truly despise GEHA. They deserve absolutely nothing. Insurance is supposed to provide peace of mind, but with GEHA, it's nothing but a source of frustration and anger. The whole system feels like a scam – paying extreme premiums each month for coverage that may never come through when needed.

Just thinking about this awful insurance company makes me upset. Only if I could give them a negative star review, I would. GEHA needs to step up and take responsibility for their failures. They owe their customers better service and accountability. Until then, my disdain for this company will only continue to grow.

The worst--overseas customer--they provide no support lose claims, dont have a standard process to submit claims, and reject things that are covered services. Thier employees all have different answers to the same question or no answers at all and never have accurate timelines on benefit approval. Claims paid out via check 10 weeks after submission, at about 20% of service cost, due to a variety of deductions that are not codified in claim letter. This appears to be a scam and will change next open season. Pretty shocked they are still a federal employee plan provider...

They were disappointing to have as a health insurance provider. It was clear they are not interested in providing good service for their customers or the medical service providers. There are multiple different routing addresses for claims, and often the claim would default to the wrong address. GEHA would send a letter to the medical service provider to resubmit to the correct address rather than rerouting it to the proper department internally. I found them difficult to work with and the medical coverage was minimal. Claims took significantly longer the complete, so we would often be left paying the higher rate and then reimbursed after the claim finally was sent to the MSP. It is also frustrating that they are not the health insurance provider, but an intermediary for a different Health Insurance company that would change on an annual basis. Why not go directly with the Health Insurance company instead of working through an additional layer of management. In all, I was disappointed in GEHA and could not get a new insurance fast enough

We have Geha high option. I broke two teeth. One required a root canal. Both needed crowns. Geha dental refused to pay any toward either required work. Never did I expected they would pay $0. I called and they would not review. This is worthless dental insurance.

My GEHA STANDARD is secondary to aarp UHC advantage plan. The biggest gripe is the GEHA ID CARD does not have the proper group and bin number for secondary payer; consequently, it is a nightmare every time I go to Walgreens pharmacy. They do not run the secondary (GEHA) so there is always a high cost. I have to have them re-run the insurances through again. I had to choose a date when these events took place for this review; however, it happens each time I go to the pharmacy.
Also, the rewards do not apply to me. This is really discrimination. For instance, my doctor advised me to get a Mammogram. She suggested as a woman ages, her chances of breast cancer increases. But it appears I am too old to be rewarded for having a mammogram.

True rating is ZERO. Will drop them asap.

We are extremely dissatisfied with GEHA Dental. We signed up for this plan thru Benefeds three yours ago. So far, we had four minor claims. Out of the four, GEHA managed to lose three claims, requiring extensive follow-up on our part. Our latest claim was submitted in October 2023 and GEHA has yet to pay or process the claim. When you write or call them to ask for the status, you never get details… just canned responses. I’ve asked for a management call-back each time, but never received a response. This will be our final year with this insurance company… worst experience ever!

Good morning GEHA Connection Dental Federal. I just wanted to ask you how are even able to sleep at night when you denied claims of this poor soul(ME) who tried her best to contact you, explain to you and begged to communicate with you to connect with her provider and all you paid was $500+ after her treatment due to her bleeding gums, loose teeth and pain and yet you GEHA CONNECTION DENTAL FEDERAL REFUSED TO BELIEVED MY PROVIDER AND REFUSED TO PAY THEM? I WAS A CLIENT/ COSTUMER PAYING $50 SOMETHING EVERY 2 WEEKS FOR A COUPLE OF YEARS UNDER HIGH FAMILY OPTION AND YET YOU DECIDED NOT TO RE IMBURSED MY DENTAL PROVIDER BECAUSE YOU DIDN'T BELIEVED MY DENTAL PROBLEMS ARE REAL? NOW I HAVE TO PAY $4600+ OUT OF POCKEY MONEY ON THE TOP OF ALREADY PAYING $2500 FOR MY DENTAL PROCEDURE IM DECEMBER 2022.!! I HOPE THAT NONE OF YOU WILL EVER EXPERIENCE WHAT I HAVE EXPERIENCED.. EVERY TIME MY PROVIDER WOULD CALL YOU AND GIVE YOU ANYTHING YOU NEED YOU ARE CONSTANTLY ASKING THINGS ONE AFTER ANOTHER! U WANT KETCHUP, MUSTARD, TOMATOES, ONIONS ETCETERA! SO FREAKING RIDICULOUS! BEEN HERE IN THIS COUNTRY FOR OVER 20 PLUS YEARS NEVER HAVE I BEEN TREATED THIS WAY AND DENIED DENTAL RE IMBURSEMENT FOR HIGH OPTION LIKE THIS! ONLY RIGHT IM NO LONGER YOUR COSTUMER BEGINNING THIS YEAR!

VERY UNSATISFIED AND VERY UNHAPPY COSTUMER,
MYSARAH ANDREWS
919 886 2078

I have had GEHA High Option Dental for Years and generally they have been good, but in 2023 they included what I call a "scam" benefit. It is a third cleaning. Sounds good right? NOT! No dentist will do a third cleaning without a third medical exam, and GEHA will not pay for that third medical exam. Not knowing all this, we scheduled our second cleaning early (expecting the third cleaning later in the year), then were shocked when our dentist (and no other dentist) would honor it, without our paying hundreds of dollars for a medical exam without coverage! I spent HOURS searching for a dentist to do the third cleaning--a complete waste of my time. I am FURIOUS and this makes me question the credibility of this dental plan now and I will start looking at other options.

Worst dental insurance to have, don't matter if it is high or low option. This is an example like many others dental insurances. Their only objective is revenues, integrity is non-existent.
I need a big dental work to restore and protect my already deteriorate teeth from years of grinding. But no they won't covered and I'm on the high option side. Even a plastic mouth guard they will only cover 50%. Time to search for a better dental insurance.
By the way I have experienced them hanging up the phone on previous call. Today was one of those day, they did it 3 times.

Have had geha for 15 years and have had very few problems. Today i had a problem with my Doctors billing service and representative Gina from geha talked to the billing service for me and did an outstanding job correcting this problem. She is the best representative from Geha i ever talked with. 👍👍👍👍 Thanks Gina at elevate plan.

The insurance company support the con artist rip off activities of providers with no recourse for members. Select GEHA if you enjoy wasting your money, time and resources. Pitiful. Unhelpful and low quality providers.

That should be ZERO stars because they aren’t much helpful to find PCP doctors. Never updated on lists of doctor. I m planning to go back to BCBS. Nothing honestly for those GEHA employees doing their jobs. Very disappointing.

If I could give them a negative score vs. 1 star I would.. Never and I repeat Never take their word that they will reimburse you on a claim when you have to pay an establishment up front for rental of medical equipment. I had to pay $150 out of pocket for a turning knee walker. Given the run around about missing codes and comments on how do we know you didn't get this for a family member : /
How about the surgery you paid for me to have!!! Every time you call another rep says something different and they claim no notes are there from previous calls.