GEHA Insurance Review & Complaints: Health Insurance

Our GEHA insurance review & complaints: health insurance will go into all of the details you need to know. GEHA dental insurance has two available plans alongside a selection of policies for GEHA health insurance and a GEHA medicare supplement for government employees. Bi-weekly GEHA insurance rates for the Standard Plan are $44.71 for postal employees and $53.86 for other employees.

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

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Leslie Kasperowicz holds a BA in Social Sciences from the University of Winnipeg. She spent several years as a Farmers Insurance CSR, gaining a solid understanding of insurance products including home, life, auto, and commercial and working directly with insurance customers to understand their needs. She has since used that knowledge in her more than ten years as a writer, largely in the insuranc...

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Reviewed by Leslie Kasperowicz
Farmers CSR for 4 Years

UPDATED: May 4, 2021

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GEHA

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The Government Employees Health Association, or GEHA, does what the name implies – provides 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 GEHA insurance review, type your ZIP code into our free and helpful tool above to find reasonable dental and health insurance quotes in your area.

What is GEHA?

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.

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What Products Does GEHA Offer?

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 our article 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
Hospital Inpatient Deductible and CoinsuranceEstimated Medicare Part A Deductible and Coinsurance Rates
Days 1-60: Coinsurance
for each benefit period
$0
Days 61-90: Coinsurance
per day of each benefit period
$352
Days 91 and Beyond: Coinsurance per
"lifetime reserve day"*
$704
Deductible
for each benefit period
$1,408
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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 an 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.

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Are GEHA Rates Affordable?

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. 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 are Claims Processed?

Most claims for medical care will be handled directly through the provider, but with dental, vision, and hearing insurance there are sometimes out-of-pocket expenses that must be submitted for reimbursement.

Claim forms can be found on the GEHA website in the Forms and Document section and downloaded for printing and submission.

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Are Ratings and Consumer Reviews for the Company Positive?

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.

What’s the Bottom Line?

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. Its rates are low and their coverage seems to be comprehensive.

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

Feel free to type your ZIP code into our helpful tool below to find GEHA insurance quotes in your area.

Frequently Asked Questions: GEHA Insurance Review & Complaints: Health Insurance

Check out some common questions below if you want to know more before you buy GEHA insurance.

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#1– Is GEHA good insurance?

They are fairly well-reviewed and have a low amount of customer complaints.

#2– Is GEHA dental or government insurance good?

The dental portion is well-reviewed by the BBB. There’s not a lot of information on the merits of GEHA government insurance.

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