GEHA Anmeldelser 157

Edited 6/15/2023

Received check in mail this date for reimbursement of Invisalign which was denied 3 times and had gone thru all appeals which was declined Called and was told they re-evaluated claim and determined to pay for claim. Not sure why they retracted, but will change from 1 star to 2 stars. Although I am still a bit bitter for the hassle and strife they put me thru. Perhaps if they gave me interest it could have been 3 star.

Original post.
Claims for Invisalign not paid although it was supposed to be covered for malocclusion. Had problems with clenching of jaw daily night and day due to malocclusion. Lost a crown due to pressure. Went thru a year of Invisalign and no longer having problem. Yet they refuse to pay their share. They have not covered retainers either. I fought the issue with them and no longer can refute the issue with them. I pay for the higher price monthly for the better plan, I did not do it for cosmetic issue, it was all functional reasons. I will be changing companies unless they see the light!
Also may I add that I even attempted to get a pre auth but they told my dental provider it wasn’t needed, and to just submit claim.

I have been trying for months to join a GEHA approved fitness center. There is a Y in my area and I was
told before picking GEHA that it would be in the plan. Now no one can tell me how to get the benefit. I have bee calling 10-15 times, told twice I would get a call back from a manager, never have I received the call. I have already lost out on 3 months of the GEHA payment for a fitness center, I am paying it myself. The fitness centers should not be mentioned as a benefit because it is impossible to get signed up.

Customer Service rep was awful, she refused to tell me about plans during open enrollment except for one I'm already enrolled in. THAT'S WHY I'M CALLING! TO SWITCH.

The insurance company abdicated medication decisions to CVS who profits from them. Constantly tell you that your doctor needs to change your prescription to something else. Because they know better than an actual doctor who had actually seen me. Constantly denying claims. Require reauthorization of medication every 6 months including resenting the exact same forms with the exact same info. Patient in pain, who cares let them suffer through the 30 day appeal process to them be denied.

Mixed feelings, their criteria for reviewing claims is inconsistent and can take forever for them to process one (I am overseas).

Idea: They should have a portal to submit the claims directly that alouds you to track your claims by number, with timeline of the process and a more friendly interface in case you need to dispute.

If you are overseas: it doesn't cover the yearly preventive tests for women: like a mammography or worst if you don't have a uterus, in which case you need an ultrasound, they just don't cover it... they just cover the pap smear.
I even call to ask why? since it is a yearly preventive test, they should encourage any test, but they just disagree.
I had a 75$ MasterCard reward card for being a good healthy gurl, it was denied at the CVS Pharmacy when trying to pay for a prescription, so again... I don't understand them. My advice... think it twice.