GEHA Insurance Review & Complaints: Health Insurance (2024)

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Our GEHA insurance review found that the Government Employees Health Association, or GEHA, does what the name implies – provides affordable health insurance to government employees. A not-for-profit organization, GEHA offers both health and dental plans. Let’s begin our GEHA health and dental insurance review.

But diving into this review of GEHA insurance, type your ZIP code into our free and helpful tool above to find the best health insurance quotes in your area.

GEHA Explained

GEHA insurance company was founded in 1937 as the Railway Mail Hospital Association in Kansas City, MO. It initially provided medical assistance to railway postal workers, but a few decades later expanded to provide coverage to all government employees.

In 1959, they began offering coverage under the Federal Employees Health Benefits Act and followed up with a 1964 name change to the Government Employees Hospital Association. The replacement of Hospital and Health in the name took place in 2007.

Today GEHA provides medical and GEHA dental plans to 1.8 million people. Coverage with this insurance carrier is available to federal employees, their families, and retirees as well. Qualified applicants can enroll directly either online or over the phone, depending on where they work.

GEHA Insurance Products

GEHA offers a selection of products for health insurance coverage, as well as Medicare and dental plans. If you’d like to learn a bit more about Medicare costs, read on to find out what is the maximum out-of-pocket expense with Medicare.

Before we continue, let’s take a look at a table to get a gist of the cost of Medicare part A.

Medicare Part A Hospital Inpatient Deductible and Coinsurance Rates

As you can see, part A can run you quite a bit. Let’s now take a look at GEHA’s various options.

Standard Option

GEHA’s Standard health insurance option is one of the lower premium plans, with a $15 co-pay for primary care visits. The self-only plan has a $350 deductible, while the family plan has a $700 deductible. The plan offers both in-network and out-of-network coverage options. Prescription drugs start at a $10 co-pay for generic drugs.

The Standard plan also includes vision, hearing, and dental coverage.

High Option

The High Option policy has a slightly higher monthly premium than the Standard Plan. There is a $350 individual plan deductible, and a $700 family plan deductible, just like the standard plan. Primary care visits have a $20 co-pay, as do specialist visits.

Like the Standard plan, there is coverage for medical services both in and out of network, and prescriptions start at $10. Prescription coverage has no deductible, and coverage under this plan is more comprehensive with lower co-pays on higher tiers.

This option also includes some vision, dental and hearing coverage.

Health Savings Advantage

This plan has higher deductibles but utilizes a Health Savings Account (HSA) to help save pre-tax dollars for medical expenses. Deductibles are $1,500 on the self-only plan and $3,000 for families.

While preventative care is covered with no deductible, other health care costs are not covered until the deductible is met. After the deductible, there is a 5 percent coinsurance on primary care and specialist visits.

Prescription drugs are covered starting at a 25 percent coinsurance after the annual deductible is met.

Medicare and GEHA

GEHA offers a Medicare supplement plan that covers out-of-pocket costs including deductibles and co-pays for eligible members who are enrolled in Medicare. The plans include savings on hearing and vision care, as well as access to the GEHA network of providers.

Dental Coverage

GEHA has two dental plans available. The GEHA Connection Dental Federal is part of the Federal Employees Dental and Vision Insurance Program (FEDVIP). The Connection Dental Plus plan is not part of that program, and thus allows year-round enrollment for qualified members.

Vision Program

Vision benefits are available to those enrolled in any of the GEHA health plans or enrolled in the Connection Dental program. Vision coverage insurance benefits do not appear to require an extra premium.

GEHA Insurance Rates

GEHA’s insurance rates are set based on whether you are a postal employee, work for another branch, or are a retiree.

The Standard option, for self-only, starts at bi-weekly premiums of $44.71 for postal employees and $53.86 for other employees. The High option starts at $89.15 bi-weekly for postal employees and $101.46 for other employees.

Rates are more than doubled for Self Plus One plans but do not increase as much for self and family plans.

It is not surprising that these rates are very low, resulting in affordable prices for customers. Since the federal government backs these plans, employees get a greatly reduced rate. These rates cannot be compared to any marketplace or employer-sponsored plans anywhere else as they are specific to government employees.

How Geha Insurance Manages Claims

Ease of Filing a Claim

GEHA Insurance offers government employees and retirees a range of health and dental insurance plans. To file a claim with GEHA Insurance, policyholders may need to follow different procedures depending on the type of insurance and the nature of the claim. Claim forms can be found on the GEHA website in the Forms and Document section and downloaded for printing and submission.

Typically, medical claims may be handled directly through healthcare providers, while GEHA Dental Connection Plus, dental, vision, and hearing claims may require submission and reimbursement. Policyholders are encouraged to visit the official GEHA website or contact GEHA directly for comprehensive guidance on how to file claims, including any available online or mobile app features.

Average Claim Processing Time

Timely claim processing can significantly impact a policyholder’s experience and satisfaction with an insurance provider. Policyholders interested in GEHA Insurance may want to inquire about the typical claim processing times when discussing policy options with the company or their licensed insurance agents.

Understanding how quickly claims are resolved can help policyholders plan for potential healthcare expenses.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback is a valuable resource for assessing the reliability and effectiveness of an insurance provider’s claims handling. Prospective policyholders and current policyholders seeking insights into GEHA’s claim resolutions and payout experiences may consider exploring online reviews and gathering feedback from individuals who have interacted with the company’s claims process.

Real-world experiences can provide valuable information when making insurance decisions.

GEHA Insurance: Navigating Reviews and Feedback

Digital and Technological Features of GEHA Insurance

Mobile App Features and Functionality

Mobile apps in the insurance industry often serve as a convenient tool for policyholders, offering features such as policy management, claims reporting, digital ID cards, and access to provider networks.

Individuals interested in utilizing the GEHA Insurance mobile app should consider visiting the company’s official website or contacting GEHA directly for comprehensive information on the app’s features and functionality.

Online Account Management Capabilities

GEHA Insurance online account management typically includes features like policy viewing, bill payment, document access, and claims tracking. Prospective policyholders interested in understanding the capabilities of GEHA online account management system are advised to explore the company’s official website or contact their customer support for comprehensive information.

Digital Tools and Resources

Insurance providers often offer a range of digital resources to assist policyholders in their insurance journey. Digital tools may include insurance calculators, educational materials, coverage guides, and frequently asked questions (FAQs). These resources can help policyholders make informed decisions about their insurance coverage and better understand their policies.

Prospective policyholders interested in accessing digital tools and resources should visit GEHA Insurance’s official website or reach out to the company directly to explore the available digital assets.

GEHA Ratings and Consumer Reviews

The only Better Business Bureau (BBB) page we were able to find for GEHA references their Dental Connection plan specifically, and not the company as a whole. The BBB gives an A- rating, with six customer complaints on file in the past three years.

There are many more reviews for GEHA on Yelp, a total of 50 with some positive and the majority negative. Many complaints center on poor customer service experiences and claims that are not being paid. Billing appears to be a common problem, with several similar issues noted.

The number of complaints here is not especially high for a company serving 1.8 million members, but there are some repeated comments that do bear noting. You can find more reviews for insurance companies on our insurance reviews directory.

Exploring GEHA Insurance: Coverage Options and Provider Accessibility

Final Word on GEHA Insurance

As one of the medical plan options offered to federal employees, GEHA has something of a niche market and a large share of that market. Our GEHA insurance review found that its rates are low compared to the average health insurance cost in the U.S., and their levels of coverage seem to be comprehensive for the plan types provided.

With a complaint volume that is low for its size, GEHA appears to be worth considering for federal employees needing an affordable plan in health or supplemental coverage.

Feel free to type your ZIP code into our helpful tool below to find GEHA insurance quotes in your area. There are plenty of options and policy types available. Start your search for a health insurance plan and providers now.