GEHA Anmeldelser 157

I used GEHA since 1988. For several decades they were an effective company. Then they were bought out a few years ago. Quality and service plummeted, and they began the delay, deny, defend game. My wife had outpatient surgery at the biggest hospital in our state. I confirmed that they were in network both with the GEHA website and with the hospital and was assured that they were. When GEHA finally issued an EOB, they claimed that the hospital was out of network on the day of surgery, despite being in network before and after that date. CSR told me I could not rely on any information on their website. Conveniently for them, all of their records were off-line due to data breaches, and they refused to discuss or correct their mistakes.

I dropped them at open season, just in time to avoid the forced conversion to SilverScript. I'll never use GEHA again. Stay away from this new bunch pretending to be the former reliable GEHA.

First, I need to give credit to JACKIE, who should be in charge of GEHA and their useless computer answering system. That would not get anything right or even tell me what I was doing wrong or get me to a human. After Jackie took over, everything got fixed. My email that started this "fiasco" was telling me to change my password. What it should have said was: "WE HAVE CHANGED EVERYTHING THIS YEAR AND NOW YOU HAVE A NEW MEMEBER ID, ETC." That would certainly have saved me over an hour on the computer.

Incompetent customer service. Like other reviewers, I have tried for 2 days to update my HealthSafe ID. On day two, someone figured out that they had to change my phone # on record. Sat on hold for an hour only to find out I was sent to the wrong person. Cannot log into my account, no one knows what is going on, and I am extremely upset.

Long hold rude customer service. Do not buy just go thru united. Geha sucks!

Horrible stressful and very useless. I can't even update my address. I've spent 3 hours on the phone and transferred multiple times to change my address which was changed according to several different people. I keep getting transferred around I was told to contact the HR department ( haha) my husband is a veteran and OPM has nothing to do with the medical as far as EOB's etc. This is horrible and you ought to be ashamed of yourselves giving such horrible customer service and for the premiums we pay. If I could give a zero I would.

They claim to be non-profit. I think they have their head up their @$$. Went to Mexico for dental work. I, personally, saved thousands of dollars. Tried (and that is the operative) to submit claims. What a FU mess that was. We need this document. Now we want that document. On and on. Finally I told them, after all the emails and sent docs thatthey didn't accept, "Look, we can argue about how much your going to pay, and until we agree, YOU WON'T PAY A DAMN THING! JUST PAY ME" They did. About my annual premium. I'm better off not using GEHA.
THEY'RE DISCUSTING as far as I'm concerned.

I got my new card Tried to go through the automated system to register it with no luck. I can only imagine what would happen if I needed to get a claim corrected. This is the worst plan you could ever get. Wish I had canned it during the open season. Don’t be fooled by this company. No one takes this with in 40 miles from me.

My dental claim started on 10/10/2024; my dentist incorrectly billed. On 10/17/2024 I called GEHA to make sure they didn't pay; they paid; a corrected claim was submitted by my dentist; GEHA incorrectly processed it as a duplicate claim; I called again on 11/8 to no avail; I called again on 11/13/2024 to no avail. I called again on 11/22/2024 and was told the CSR would send the claim back through as an "expedited correction." She didn't. I called on 12/17/2024 and was told there was a backlog of expedited claims and that mine goes to the back of the pile even further back than original claims! Seems there are 2 separate processing teams and the expedited claims aren't really expedited. What lousy management. It's worse than the government! If I had known it was this bad, I would have chosen another insurance company during Open Season.

Do NOT go with this insurance company, especially if you are on daily meds that you need as they do NOT know how to count calendar days (when I say 'they' i'm speaking in reference to their general first line CSR's, Senior Reps, Case Coordinators, and then Supervisors-and plan to spend hours on the phone with all these multiple people to see the day of light. Over 2 days I spoke with several people (Nathan, Kathy, Michelle, Joanne, Alan-all in the depts I stated above...The ones that do see the day of light DO NOT NOTATE the account NOR fix the INCORRECT dates, which will leave you out of medicine for days close to a week. Do to their lax about the situation will put you in a screaming mood and give you high blood pressure (I'll be lucky if i don't end up in the hospital tonight for high blood pressure due to dealing with these incompetent workers. FYI-over the years, this is what you go through anytime there is an error on their side, this is NOT a one time deal....This is the year I will switch to BCBS where there aren't problems with incompetency and the lack of urgency to fix their errors or notate them.

Our family moved overseas to an impoverished country with extremely limited Dental services. There is really no use for Dental insurance. I figured a move was a QLE and waited until just before we moved to request cancellation. (Despite the fact that my dentist office told me that their cash discount for full payment was about the same as GEHA’s copays). I was told I could not cancel outside of open season because we could submit claims ourself in a country with no authorized providers. I now find we should have been allowed to cancel and the time limit has elapsed. We were not aware of this open season until the last minute and connectivity issues here did not allow us internet access to the site in time. Not happy to have already paid 9 months of service we cant use and now be told we have to pay yet another year! Don't let this poor coverage trap you.

Your review of GEHA is FALSE! My husband and I have had GEHA for decades and not ONE COMPLAINT from us about their company

I have had GEHA since 2009 and haven't had any issues. Maybe I'm just lucky...don't know. Not to fond of the outsourcing and the layoffs. Need to also make sure my physicians are still participating.

GEHA and my medical provider have parted ways. I received no word from GEHA that I should be looking a new provider. The provider sent a letter telling me that GEHA will no linger be paying my treatments and they will be out of pocket billed to me. For my wife that is $16,000 per Oncology treatment. Now I am scrambling to find a new doctor in-plan to continue the treatments.

I would rate this 0 stars if I were able to. I have had nothing but problems with this company from day one. I have had to go through about 5 different diabetic shots. First 3 months would be 25.00, then after that jump up to 300 - 600.00 a month. GEHA/CVS wanted to say it was the pharmacy giving me a discount, and the pharmacy was adamant that they hadn't. This happened EVERY TIME. At one point I had to go without my shots all together which pushed my A1C to over 11. I did some research online about Generic GPL-1's, as CVS stated that a generic form is much cheaper. I found Liraglutide. I talked to my Doctor, he prescribed it. They declined. When I called, they said it was a name brand, Victoza. I said no, the VICTOZA WAS NAME BRAND, Liraglutide was the generic form. It was denied. During this time I was on Xultophy, it did AMAZING with my A1C and it dropped from 11 to 7. But guess what?? It again went up to over 300.00 a month. I was then put on Novolin N, I take over 35 units twice and day and my numbers don't go below 220. So I do more research, cause God forbid, CVS try to help someone figure this out. Again, I looked up Liraglutide in the CVS med search for costs and it gave me the cheaper price. WHAT?!?!?!?! So now, I finally got it approved, so taking 30u of Novolin N 2x a day and .06 of Liraglutide once a day and still can hardly stay under 200. Sure is sad, that someone pays HUNDREDS of dollars a month for insurance and can't take what actually helped them (the Xultophy). NOW, lets jump into the mail order B.S. I live in Alaska, we don't have a CVS. So I would have to do mail order for any 90 day supplies. I finally decided to do that with all the insulin I now have to take. About 10 phone calls to them AND MY DOCTOR, (which Im sure my Doctor's office loved) 10 emails and 4 different deliveries, they have their $#!+ together. Not that I would ever do it, but now I truly understand why people commit suicide because of medication/pharmacy issues. This last 2 years has been rediculous!!! DO NOT USE THIS INSURANCE/COMPANY. YOU WILL REGRET IT!!!

Have had this insurance for several years. They have since switched to using UnitedHealthCare which will not be accepted by WellSpan after October 31, 2024. Called their support to find a new Dr. who will take this insurance. ABSOLUTELY NO HELP! They won't help to find anyone and their list is out of date. They just don't care. Always having issues with Explanation of Benefits and payment to medical facilities. Unacceptable so I will move on. Open enrollment right around the corner. Tired of poor customer service.

We will be opting out this year as the service is terrible and the value, if they ever pay, is not worth the payments we male.

I'm pending a reimbursement check since May 2024. Process date of Check #24067910, process date May 13, 2024.
Reasons and dates:
1. 5/21/24 - pending process, not mailed out
2. 6/27/24 - check not mailed out due to backlog.
3. 7/13/24 - check mailed out on 5/13/24, lost in the
mail.
4. 7/31/24 - stop payment issued and new check.
5. 8/08/24 - pending reissuing.
6. 8/22/24 - stop payment and reissuing was done
incorrectly. Was corrected and
resubmitted for payment.
7. 9/09/24 - Per Supervisor, paperwork is pending
process. Due to back log no reissuing
date can be provided.
To anyone reading my compliant might think it's insignificant, but it's the principle of the matter. Monies are taken from my check each month promptly. Quality of service sucks with everyone working from home. It's the wait and see attitude and it's not acceptable. I'm counting the days to Open Seasons.

I like this insurance for the most part but please give us a better gym membership,
We are only offer Fit and Active which only accepts ONE gym for $30 a month

I have a medical need to have my braces re-done due to some damage caused by a permanent retainer. The retainer is causing a recession in the front bottom tooth and could cause me to lose that tooth if not fixed. They received my claim on June 21, 2024, and they have been holding off till yesterday, Sept 3, 2024, to deny it. It has been well documented that I need to have this fixed and they are being horrible. I will be changing my dental ins as soon as the open enrollment window is there. They are so terrible to work with when you call as well. Even my kids orthodontist office said GEHA is horrible to work with.

I have been happy with GEHA dental insurance for several years, but in 2024 that all went out the window. They are denying claims saying there is other primary insurance for my wife but there isn't. My EOB's are not available and they blame a "third party". I think it might be time for a class action suit! I am now going to file a final appeal with OPM because GEHA is so awful.