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GEHA was founded in 1937 as the Railway Mail Hospital Association in Kansas City, MO. They 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 dental plans to 1.8 million people. Coverage 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 offers a selection of choices for health insurance, as well as Medicare and dental plans.
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.
The High Option 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 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 services are not covered until the deductible is met. After the deductible, there is a 5% coinsurance on primary care and specialist visits.
Prescription drugs are covered starting at a 25% coinsurance after the 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.
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 benefits are available to those enrolled in any of the GEHA health plans or enrolled in the Connection Dental program. These benefits do not appear to require an extra premium.
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 employee sponsored plans anywhere else as they are specific to government employees.
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.
Claims forms can be found on the GEHA website in the Forms and Document section and downloaded for printing and submission.
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.
The Bottom Line
As one of the choices offered to federal employees, GEHA has something of a niche market and a large share of that market. Their 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.
For a list of companies that we recommend, visit our Best Insurance Companies page.