GEHA Avis 146

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.

I've had this insurance for close to 20 years if not longer. Since it's consolidation with UnitedHealthcare I can only say that the services have reduced drastically. I have never had a prescription require more verification especially since I've been taking it for 2 or 3 years. Communication is difficult, the web pages are extremely complicated now and go around in circles.

I have tried to resolve a claim involving an in network provider for the last 6 months. GEHA says I owe $204.57 because it was billed out of network by mistake. I should owe $3. GEHA acknowledges the error but has no idea how to fix it. I have been on the phone for over 2 hours with an "advocate", mostly on hold. I was promised but no callback.

I've had this insurance for quite a few years, over 10. It seems it has been overhauled several times, and now, if you are wanting to have a baby, you are in luck!! Everything is covered! No charge. But, if you are retired, they are trying to get you to go with this new Medicare RX, Silver Script. It's been a nightmare to get it straightened out. We didn't go with Medicare, and I don't want Medicare. Our insurance rates are so high now, as a retiree, it's scary that we may not be able to afford medical in the future.

My Jardiance went from $75 to $400. I am sure the rest of my drugs will do the same. They no longer include the Dentist I have been with for over 20 as a preferred provider. Trying to use the computer system and Caremark Prescription is a frustrating. I have been with GEHA for 30 excellent years and now they have went horrible. I will change at first chance.

I have close to 20 claims that I have had to resubmit because the EOB shows a check was written, but I never received it. When I used the "chat" function, the rep told me to resubmit all 20 claims because the checks either were never mailed, got lost, etc. I think it was simple fraud. For 30+ years, I had no trouble receiving checks from GEHA. My husband and I thought GEHA was great. Then UHC took over. Now I think they are part of a mafia scheme. They take the insurance payment from me and stiff me on the claims. Clearly, I am not the only person who is going through this. I wonder if the RICO statute would apply if a class action suit were filed. GEHA's obvious exposure could be a boon for an aggressive attorney looking for a "hot" class action suit. I guess there's always a silver lining to a problem.

Cannot wait to switch during open season..THE WORST WEBSITE AND CUSTOMER SERVICE EVER

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.