GEHA Anmeldelser 157

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.

I switched to GEHA's high deductible plan last year. They initially processed some claims, but since May have stopped entirely. They won't deny them - they just refuse to process them at all, despite acknowledging that they have received them. At this point, they haven't processed almost $10,000 in claims, including for the birth of our child. I've called and used the chat to try to get them to act for months with no result. I'm going to have to hire a lawyer to see if I can get a judgement forcing them to simply process my claims. It is crazy - it isn't even that they are denying valid claims (they also do that) - they just won't act on them at all. I'm switching back to my old provider this open season. Avoid GEHA at all costs.

They have taken over four months to process a dental claim (overseas). They do not have an overseas department you can talk to. I have requested a supervisor call back several times and none have ever called me back. There is never one available when I call in. I will be switching during Open Season. This company is very unprofessional

I have had GEHA insurance for almost 25 years and have only recently retired with a major health problem. Claims for my wife and I date back to December of 2024. Each time we call customer service, they apologize for the errors and promise to resubmit but say it will take 60 days to reprocess. We wait two months and the cycle repeats. Meanwhile, we dig money out of our Social Security check to avoid collect agencies (on top of the expensive premiums). The claims are covered under the policy, but GEHA says they are waiting for Medicare to pay since we are over 65. Medicare is not a requirement for the plan and we do not have Medicare. Horrible experience with this company

This company should be investigated for fraud. Their customer service is nonexistent, and that’s after you stay on hold forever, and calls getting terminated. One would be nuts to even consider them for insurance. Clearly the worst insurance provider (and I use that term loosely) I’ve ever experienced. Terrible, and I mean the very worst, in customer service, along with employees who may it perfectly clear that they have zero interest in their jobs and would prefer to be anywhere other work. Horrible, horrible, and more horrible!

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!!