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4.1

Overall Score

Author: Kaitlyn Short

LAST UPDATED: August 8th, 2024
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Attention: GEHA insurance is only available to federal employees and retirees.

GEHA health insurance coverage a great option if you're a current or retired federal employee. If you're not, you'll need to consider another health insurance company.

GEHA provides excellent medical plans for federal employees and retirees. It offers three plan options that come with great discounts and perks. GEHA also offers Medicare supplemental insurance. GEHA health insurance plans include medical coverage abroad.

GEHA is a not-for-profit health insurance provider with many years of experience in providing affordable and quality health insurance. It has built a network with millions of in-network provider locations and thousands of hospitals.

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The Good

  • Plan Options
  • Rate Transparency
  • Plan Perks Available

Plan Options

GEHA offers three main health insurance plans and Medicare supplement insurance.

Its High Deductible Health Plan (HDHP) is combined with a Health Savings Account (HSA) or Health Reimbursement Account (HRA). People who choose this plan option can set aside money to use to pay medical bills and other medical services approved by the IRS.

The HDHP Plan

  • out-of-pocket max: $5,000 or $10,000
  • deductible: $1,500 or $3,000
  • GEHA HSA/HRA contribution: $900 or $1,800

GEHA’s Standard Option Plan

  • higher premiums and lower copays than the HDHP
  • out-of-pocket max: $6500 or $13,000
  • deductible: $350 or $700

The High Option

  • best coverage for brand name prescription drugs
  • out-of-pocket max: $5000 or $10,000
  • deductible: $350 or $700

GEHA also provides Medigap insurance that helps cover expenses not covered by Original Medicare.

Premium Rate Transparency

Monthly premium rates for each GEHA health plan are available on its website on each plan's respective page. These rates can be adjusted by location, job-type, and number of people on the plan.

This transparency makes it easy to understand how much you'd be paying for each health plan wherever you live and whether you want an individual or family plan. Make sure the monthly premium fits into your budget because paying premiums consistently is how you keep your plan in force.

GEHA Plan Perks Available

Each of GEHA’s health plans come with the following discount opportunities:

  • Eyewear discounts
  • 30 percent to 60 percent hearing-aid discount through TruHearing
  • 20 percent off of home teeth whitening
  • Up to $250 in incentives for completing health screenings for qualified out-of-pocket expenses or health-related items at WellDeserved
  • $25 per month (plus taxes) for fitness center membership
  • Discounts on Life Alert medical alert services
  • Out-patient lab work is 100 percent covered
  • Discounted ultrasonic cariPRO electric toothbrush for $27.99 (plus shipping and handling)

With GEHA’s maternity program, expecting mothers can find educational resources about pregnancy and health and receive one of the specified Homelink breast pumps and two supplemental supply kits for free.

GEHA also offers weight loss support through an online Virtual Lifestyle Management (VLM) program. This program was created by medical professionals. Through this program, GEHA members are coached on nutrition and exercise. Only GEHA members with chronic conditions are eligible for participation.

GEHA offers another program Better Choices, Better Health (BCBH) to eligible members that provides support for managing chronic conditions.

Many insurers offer similar programs and benefits with their health plans, so GEHA is competitive for the industry with these perks.

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The Bad

  • Insufficient Customer Reviews
  • Limited Availability

Insufficient Customer Reviews

Best Company has not received many GEHA reviews, so conclusions about the customer experience are unavailable. Without more reviews, it's difficult to know what GEHA members like and what they dislike.

Limited Availability

GEHA health insurance plans are only available to current and retired federal employees and their spouses and dependents. Other people will need to find another health insurance provider.

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The Bottom Line

GEHA is a great choice for current and retired federal employees. The insurance carrier's focus on affordability and quality make its health insurance plans competitive. It offers three health plan options and Medicare supplement insurance.

GEHA is very forthcoming about rates and coverage on its website. This transparency makes it easy to compare monthly premium payments and out-of-pocket medical expenses across GEHA's insurance policies.

Rates are also personalizable by job-type, location, and number of people on the plan from its website. The ease for receiving customized pricing makes GEHA's website a great tool for people shopping for an individual or family plan.

GEHA’s insurance policies also have excellent perks, like discounts on hearing aids, electric toothbrushes, gym membership, and more.

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Star Rating

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1.4

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58 Reviews

Review Breakdown

5 grade

5%

4 grade

0%

3 grade

3%

2 grade

9%

1 grade

83%

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Kim Decker Indianapolis, IN

I have been with GEHA for about 18 years and have always had good coverage. But I found out that in order to get my prescriptions filled I will have no choice but to get them filled at CVS. I have one prescription that has always cost $150. Per month to fill , my pharmacy would use a $125. Coupon so my actual pit of pocket cost was $25. Per month. When I tried to pick the same prescription up a week ago it was going to cost me $290 . After a prescription is filled 3 times in 2023 I now have to pay 50% out of pocket. I will also have to fill my prescription through CVS pick up or use their mail order and fill 3 months at a time. This will be an outrageous cost for me. This will be with every prescription that my husband and I have. If I had known this change was coming I definitely would have switched to a different insurance. I don't understand how an insurance company has the right to tell you where you have to fill your prescriptions. This is just unbelievable.

2 years ago

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Gary Tennant Rehoboth Beach, DE

I have been with GEHA for more than two decades. I noticed about half-way through covid (2020ish) that they must have outsourced or changed their customer service organization. Service clearly became secondary to saving money. I watched as certain prescriptions became unfunded and lots of questions about medical care (not prevalent the prior 20 years) started surfacing. (Maybe a tactic to run old people off?). Multiple instances of this. Example: I have a documented long-standing hearing loss and use hearing aids. I realized when it was time to renew my hearing aids (5 yrs old), GEHA doesn’t service my area (TruHearing) so I had multiple calls with them (all recorded and documented?) to get instructions on best approach. Followed all instructions, including paying full at POS and then doing required vouchers…only for them to deny the claim multiple times (even though I now have the best hearing aids ever at a cost almost 80% cheaper than TruHearing). To make matters worse, they’ve iterated multiple written letters back to me with issues that were obvious to them day 1; i.e. “we need a code” then “we need date of birth” then “we need diagnosis code”. They could have instructed me ONE time to handle. Clearly a wear down tactic. Worst yet; THEY REMOVE MY REQUEST FROM EOB LIST ON THE WEBSITE SO IT LOOKS LIKE I NEVER FILED CLAIM AND THEY NEVER DENIED IT (Twice). I can’t help but think it’s a numbers game now. I love the GEHA doctors and 90% of the service, but the back end has taken a change that simply is NOT sustainable. Here we come open season.

2 years ago

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margie kinney Waco, TX

I have had GEHA for many years. Everything was good. Customer service was informed and friendly. Not anymore. They say they didn't increase premiums but they sure jacked around with benefits. Also now everytime a provider submits a bill they end up having to call me because it is not recognized by system. Never use to happen. Be cautious. Now when you ask if a provider is in network--be sure you verify they are in network for United Health Care and GEHA. Then verify with GEHA. What a hassle. After many years I will be changing next open season even if it cost a little more.

3 years ago

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Jean Wolf Silver Spring, MD

My biggest problem with GEHA is finding in Netwerk providers. They used to have a book but now they have information online. You can also call and try to get local doctors . However, the information is always incorrect. You can end up calling a dozen doctors who no longer participate, or no longer accept new patients, You're going to have to go out of network.

3 years ago

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DS

Coverage for miscarriages is nonexistent. They treat it like an abortive procedure which is zero coverage. Insult to injury and just doesn’t make sense.

1 year ago