GEHA Anmeldelser 146

As with other complaints, something has changed and GEHA went from decent to TERRIBLE. The customer service people know nothing -- they can't do anything more than you can do yourself on the website/portal. But, as others are saying, it's the claims processing that is the biggest joke. I have the same appointment every week and it's processed at different rates! In addition the dr is in network but processed as out of network. I send every claim back for reprocessing and nothing changes or (as happened with one) they reduce what they'll cover! You just beat your head against a wall with this company and they don't care. You have to pay your doctor's office in the end or go to collections.

I know it's stereotypical to say "I'd give 0 stars if I could," but genuinely, if I could take stars away from them for the headaches and mental breaks they have given me, I would. Working with them has been an absolute nightmare. I had coverage under my mother, and when I turned 26, I had thirty days as a grace period. I needed an appointment during that grace period for some health issues and making sure those were resolved, so I went, assuming I would be covered for the appointment and bloodwork I needed for my health issue. I find out by policy, I have to submit a claim. No problem. I do so. It gets rejected because my coverage ended. I reach out to them, informing them of the grace period. They resubmit the claim. Denied again. I find out the bloodwork was the claim they were referring to and not the appointment. I submit a claim for the appointment. I call many times to ensure both are in the system and am told yes. However, I just found out the claim I submitted myself for the appointment was lost (despite asking about it less than a month ago and being told it was found and filed), and the lab was rejected AGAIN. These bills total to $1,000. I don't have this kind of money lying around. The policy I was on SAYS I would be covered. Their claims team even TOLD ME upon review of my policy. I have been fighting this crap for half a year about. The incompetency is astounding. I don't know how any organization can be so cruel in how stupid they are. I have been having breakdowns, calling my doctor humiliated over being unable to get this claim processed, calling on a near weekly basis babysitting this garbage, being told they are doing everything they can. Are you really? And if you truly are, do you not feel even a bit of shame if this is your best? Stay away from GEHA. They truly highlight how corrupt and garbage our healthcare system really is in this country, and for anyone on it, I am so very sorry that this is what they offer government employees. You deserve better.

I am writing to formally express my frustration regarding the excessive delays in the processing of my claim, which was submitted seven months ago and has yet to be reviewed or resolved. Despite multiple follow-ups and assurances that my paperwork was received and in good order, I continue to face unnecessary obstacles and delays.
Initially, I was informed that system updates caused a three-month delay. Following that, an additional month passed before my claim was assigned to a reviewer, only for it to be mistakenly canceled due to an error on your end. I have since attempted to escalate the issue multiple times, receiving conflicting information from different representatives regarding the status of my claim. I was also promised a supervisor call within 48 to 72 hours, which never occurred. As of today, I have been advised that my claim will take another 30 to 45 days for processing, pushing it into its eighth month of delay. This level of inefficiency is unacceptable, and I am now formally requesting immediate action to rectify the situation.
I ask that my claim be expedited for review and processing without further delay. Additionally, I would like a direct point of contact who can provide accurate updates and ensure that my case is handled promptly. If this issue is not resolved, I will be forced to escalate further, including filing a formal complaint with regulatory authorities and sharing my experience with consumer advocacy groups. Please someone from GEHA provide an update on the immediate steps being taken to resolve my claim. I expect a response no later than 6/11/2025.

Thank you for your attention to this matter. I look forward to your prompt response.

I'm a retired GOV employee with 30 years experience and GEHA is by far the WORST insurance company. AVOID it all costs. Months to process claims, 0 communication, denials. They sent me a check on a claim that never got for 3K. I found out after I filed a complaint to OPM. 2 months later and they still haven't re-issued my check, saying it takes 30 business days!!! STAY AWAY!!! Can I give -0 stars?

Despite months of calls and escalations, GEHA Refuses!
Despite months of calls and escalations, GEHA has refused to pay my $105 dental claim from Oct 2024. Their customer service failed to follow up or resolve a basic issue. Avoid if you expect accountability or timely reimbursement.

Avoid these guys like the plague. We submitted out claim ten weeks ago. No one can give me a timeframe for when that claim will be processed. I can't get a straight answer from anyone. I paid $2622 out of pocket.

Had a claim from last November that they incorrectly processed as out of network when it was in network. Repeated calls got nowhere. I finally filed an official appeal and they agreed with me. However over two months later after that, they still have not reprocessed the claim. Calls and emails get the same canned response of promising to expedite it. Never happens. There is also no way to talk directly to anyone in the processing dept. 6 months to process a claim is ridiculous.

With as many known issues and problems by United Healthcare, prior to GEHA using them to process claims, WHY-WHY would they make such a HORRIBLE decision, unless their customers are no longer their priority. I am SO DISAPPOINTED in their service.
You cannot tell me, no one within GEHA, did not do any research in negative reviews for United Healthcare, for at least 5 years prior, that is taught in business 101 courses.
Have called several times, for updates, first 3 times "claim did not show in system" so resubmitted 3 more times. finally it showed up in their system the 4th time I called. Representative stated it would take 45 BUSINESS days (not calendar days as previously notified) to process.
(05/20/25) Got off of the phone with another representative... the processing has still not started. Representative said she was going to escalate the claim, since it's over 90 days... we'll see, I'll probably be calling in another 2 weeks and be told the same thing.

Been waiting since 8/22/'24 for settlement of a dental claim - almost 9 months! The level of incompetence is shocking. They have made four request of me for duplicate information and more than a dozen request from my dentist for reports, x-rays, documentation, etc.

Very very slow in processing my most recent dental claim. Nobody will provide a straight answer. Nobody knows where we are in the process (that's called the mushroom treatment). On line chat is useless. Live body, when you can get one, never has an answer. Won't get back to me even after promising they would. Then, when GEHA finally processes the claim, the provider says GEHA processed an in-network provider as out-of-network. Intentional or incompetence?

Our kids have not seen a doctor in 4 years and they denied a well child visit because we combined it with a sports physical. The hoops they make you jump through are ridiculous and they are terrible to deal with when you are overseas.

Have had GEHA dental for over 20 years. Neve4 had any complaints until this year. They are obviously stalling on all pre approvals and maximizing profits quick for new ownership by not providing services. My daughter’s dentist submitted for pre approval 8 weeks ago. I called them last week and they w3nt to their go to move of saying the DDS did not submit. However, my DrS did submit and had the email to prove it. GEHA then said they would expedite and my daughter is still waiting. I suggest everyone leave GEHA as soon a# possible. America being made great again!

On 5-06-2025, I called the customer service about my recent dental claim status. They told me basically it's not in their system. According to the USPS tracking, it was indeed delivered to their location on 3-10-2025. Very incompetent unprofessional people working there. How can you lose people's documents like that. Not to mention the security risks involved when that happens. Obviously there's some serious issues with GEHA, including their personnels and their disorganized systems. The open season can't come fast enough.

I would give no stars if I could. Their service is horrible. I have two claims from 2024 that are now 6 months with no payment and all I get when I talk to them is “they are processing” with no indication on if they will pay or when they will finish their “processing”… 2024 started rough with geha and just went downhill from there. DO NOT USE THEM!! I’m not having to pay out of pocket for expenses that should be covered…

I have had GEHA for 16 years. Since GEHA made the switch at the end of 2024 to UnitedHealth Care for processing claims, I have not been able to get multiple claims processed despite repeated calls and resubmittals. They can never find the claims that have been submitted online. I have been told by a representative that it takes up to 60 business days (3 months) to process a claim. Promised call backs from supervisor never happen. At this point, I am planning to drop GEHA at the next open season.

The only reason they get two stars instead of one is because they do have options that many other dental plans don’t. The reason they should get one or zero stars is that it takes forever for claims to be processed and paid. Right now, May 20 25, it takes them one to two months to upload claims into their system. Then it takes 30 to 45 days to pay. And that’s if you’re lucky. If I knew that, it was going to take four months to be reimbursed for dental, I would’ve gone with someone else. I still might just change at the next open enrollment

GEHA system changed as of 1/1/25. Never had problems for years before that. Now, they only know how to spout the company line - not try to solve the problem. The lady I spoke to today was rude, a bit belligerent, and then transferred me to terminal hold. When I told her that my providers are getting incorrect information about my co-pays, she told me that my Drs. offices are billing incorrectly! All six of the providers are getting wrong information - but GEHA wants me to believe that they are the problem. Can't wait till I can switch to something else. Shame on them.

DO NOT USE GEHA!!! I've had them for years and now that I need an expensive dental procedure they're using every tactic to delay. They keep asking my dentist for more information, but my dentist states it's the SAME requests. I call GEHA constantly and today I'm given a number for my dentist to call to resolve the matter. They did not give my dentist the number, I had to reach out otherwise this would have gone on indefinitely. Beyond shady. Stay away from this expensive USELESS dental insurance.

Never in my 74 years of life have I dealt with a company as bad as GEHA. Since changing my health insurance from Federal Blue Cross Blue Shield to this company I have had nothing but problems. Now I am going to have to pay a penalty because I didn't sign up for SilverScript in January 2025. I had never heard the name SilverScript until I received a letter in the mail two days ago informing me that I am required to sign up for this program and pay a penalty for not signing up in January of this year. If you have other choices, please don't even think about enrolling in this company.