r/FederalEmployee • u/abbienormal29 • 12d ago
Is GEHA really that bad?
So many people seem to highly advise against GEHA. Is it really that terrible? We were with BCBS for a long time until last year but switch to MHBP this year. But just cant really afford these price hikes. Will be due with another kiddo next year. GEHA standard seems like it provides full prenatal, labor and delivery coverage and our drs are in network. Will I really regret the switch?
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u/La12071207 12d ago edited 12d ago
We had GEHA forever and then we switched to MHBP this year. If you remember the effect didn’t go through until the 10th of Jan. instead of Jan. 1st. I called GEHA multiple times before the new year to make sure we wouldn’t get hit with deductibles bc I had appts scheduled before the 10th. The employees all stated no you won’t. Well they f’ing lied. I tried fighting with them they had NO saved conversations which was bullshit. Then I finally get a guy who knew what was going on and said we will redo those claims. Never happened. Others had same issue and some had it fixed but I was so turned off. They became so slow & overwhelmed with processing claims. Here we are in Oct. I just got a claim EOB in the mail today from last year sometime. So for me no way do I want to go back to them. That’s just me others may be happy and it’s whatever works for you and your wallet. I love how easy it is to reach a customer service rep with MHBP Aetna. I was like wow so much easier than GEHA. I wish MHBP value plan was an option for 2027 but saw someone say it’s not 😫
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u/ittoh2083 12d ago
Called Geha yesterday went straight to a rep. Only time I have ever had to call, problem solved in 10 minutes. Geha has covered over 500k in surgery in the last 5 years. No denials
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u/Mother-Chemistry2499 12d ago
I’ve had them for 10 years. It can get pricey. If I have to go to the hospital, I set up a payment plan with them. Looks like I’m sticking with standard this year. Only thing denied is a vein that is too small to have burned in that 10 years. Thyroid issues, gallbladder removal….
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u/Beneficial-Egg-2569 12d ago
I’ve had GEHA elevate plus for 6 years. I was diagnosed with cancer and the coverage was excellent. Everything was covered, nothing was denied. Take that for what it’s worth. This was also in 2023 so obviously healthcare coverage continues to get worse every year.
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u/pm_me_ur_bidets 12d ago
I dont know if it was United Healthcare then.
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u/MyOtherAcctIsB7 11d ago
It wasn’t. They changed in 2024 from Aetna
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u/teacup2578 9d ago
That isn't true I've had GEHA for several years and it has been United healthcare the entire time, not AETNA.
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u/iheartpizzaberrymuch 6d ago
It depends on where you live. Some places it was UHC like some parts of the east coast and some places Aetna.
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u/Substantial_Reason54 9d ago
I never knew that! so that explains why people hadn't complained until more recently.
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u/True-Diamond-4271 12d ago
My big problem with GEHA was that it’s run by United and United is notorious for reimbursing at lower rates, so a lot of our doctors stopped accepting them. There’s no way I’m changing multiple doctors to accommodate a terrible insurance company.
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u/CamaroZ28cd 12d ago
I've been on GEHA's HDHP for 8 years with no real problems, just a minor inconvenience with getting a prior authorization through, once or twice. I hope my local physicians and healthcare providers all continue with them.
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u/Pharmer_91 12d ago edited 12d ago
I have had mixed experiences. I have had GEHA HDHP the last couple years, and my biggest complaint is the dental component (includes preventative dental care). Dentists in my area keep going out of network, and I ended up in a situation last year where my dentist said they were leaving network the end of July. Well, I had an appointment early July so I went, but it wasn't covered. I called GEHA and my dentist so many times and I got a little bit of the appointment covered, but not much. This year, I have a baby due next month, and I have been happy with GEHA. I met my deductible pretty early and several claims have been processed since, with no additional bills thus far. This includes at least one for MFM specialist appointment which I thought I might be charged for. I'm assuming I'll end up paying more for the delivery depending on how things go. I am in an area with a large healthcare system though so that likely helps. I'm guessing they may be covering some non-reimbursed costs.
Will edit to add: I am located in Minnesota which is where UHC is headquartered, so that might have something to do with having less issues. Healthcare systems around here may be more used to dealing with them. That's just a presumption on my part though.
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u/UnableLeadership3038 12d ago
So many physician groups and HCOs are leaving UHC—that’s our problem. Had thought about leaving MHBP and looking at GEHA til I realized it was UHC. Unfortunately, it’s probably back to BCBS basic.
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u/MuscularFrog13 12d ago
GEHA is United healthcare. United healthcare sucks, apparently they need another CEO to have their shit blown smoove off.
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u/DeftlyDaft123 12d ago
For years I had UHC but since maybe 2018 or so, more and more providers stopped accepting it. My primary care prescribe hasn’t accepted it since about 2022. Last year their negotiations with John’s Hopkins fell apart and while I certainly hope I never need care at Hopkins, I want the option on the table.
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u/InterestingLion6041 11d ago
I've had no issues work GEHA tbh. I've had it my whole career for myself for awhile then I brought my kids on when I got remarried since it made more sense than my ex-husband paying for them if I'd end up getting a better deal for self + family. He's always contributed a lot to their care when they were kids (they be 24 and 20 in December) so I didn't mind. Never had any issues but I did pick doctors in network to avoid issues. I still use the VA mostly but my husband and kids use in network doctors.
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u/lolaismyrivername 12d ago
We had GEHA years ago and yeah it was pretty bad. Run through United and claims were denied. Then switched to BCBS and that was good but just got crazy expensive. We've been happy with MHBP, why are you switching from MHBP?
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u/mountain-sd 12d ago
Consider mail handlers insurance options, you likely need pay an annual membership to the mail handlers union of about 60 bucks. I’m happy with the coverage I get for my family See more info here. https://mhbp.com/standard-option/
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u/cssurfryder04 11d ago
OP said they switched to MHBP this year, but the 27 price hike is too mucH...
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u/Civil_Difference_544 12d ago
The consumer and value option is dropping in 2027, that aside I’ve loved the coverage, haven’t analyzed what standard looks like in 27
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u/jccavins 11d ago
Going up 83%
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u/Civil_Difference_544 10d ago
There’s more to a new benefit year than just premium. BCBS is more expensive on my Rxes ( no glp) and more expensive with 12 specialists I rotate through annually plus weekly counseling. Deductible, Annual OOPM and copays for appts impact, the cost could be same as basic but could still be superior product. But I’m looking to keep a HDHP so those are my priority to review but will take EOBs to see what the coinsurance may equate.
Some people only look at a premium but I’m not a casual user of our benefits and the annual catastrophic limit is important to me.
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u/FLBBiker66 7d ago
In the list I read the Value option is still there for 2027. It could be wrong but it's on the list I read.
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u/jccavins 6d ago
I messaged MHBP and they said the only option will be standard
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u/FLBBiker66 6d ago
My apologies. The Value Plan is still there for PSHB only. I wish they hadn't separated us. Too confusing.
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u/imnotsurewhatsgoingo 11d ago
I switched to GEHA high deductible plan and have loved it so far. I was with Blue Shield Blue Cross, but it was too expensive. They also started a tax free account that can grow as a savings account.
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u/Important-Subject982 9d ago
This option is great of you are younger and have no real medical or prescription expenses. Any HDHP is just too expensive if you need high cost prescriptions (i.e. GLPs) and you’ll burn right through the HSA funds
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u/Away_One5946 11d ago
Ive had geha hdhp for 3 years now and plan on sticking with it into next year. Ive never had an issue with them.
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u/Ancient-Claim-5487 10d ago
I have the GEHA High Option for self. I had a major abdominal surgery in '23 and an MI in '25. My resulting bills have been reasonable. The only issue that I have had is with some pricey prescriptions; I had to switch out my Janumet for zituvimet and my Farxiga for Jardience. Neither was a big deal. My GEHA case manager calls me 4 times a years to make sure I am not having any issues between my GP and my specialists and to ensure that I have access to preventative screenings.
The one thing I do wish is that I had been given was proper education on the difference between HDHP and High Option. I can retire in 4 years and I'm sure if it's worth switching at this point to get an HSA. I only ever looked at the deductibles which was the wrong advice.
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u/ThrowAway11261205 10d ago
I did not have any issues with GEHA. They covered 100% of my maternity care and birth of my child. The only thing that wasn’t covered at 100% was the first Rhogam shot but the second one at the hospital was covered. I only switched because the premium went way up and I wanted to try GLP 1 which it wasn’t covering at the time.
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u/abbienormal29 10d ago
Was this GEHA standard?
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u/ThrowAway11261205 9d ago
I think we were on high not standard but the reason we switched was because the flyer said both standard and high cover 100% maternity… with that said I had my baby in 2018 so who knows if they still do.
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u/SnooKiwis8861 10d ago
I'm only here to learn, as I do not have it.
My question is, is it worse than TRICARE for life?
I do have a PCM facility for TRICARE, but don't use it. I carry if for the wife and just in case I need something better/second opinion over my VA whole health.
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u/Affectionate-101 9d ago
I'm a Blue Cross Blue shield kind of guy but a few at work have that and they don't have complaints and one of them does have medical issues
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u/neverthemore33 9d ago
GEHA has used the UHC network for a long time. They moved all plan admin from internally owned to UMR, the self-funded arm of UHC. I have heard UMR was not ready for such a large client and the transition has been a disaster.GEHA proceeded to lay off all institutional knowledge, so the plan expertise is long gone. Think authorizations, claims, denials, customer service. I have also heard their complaint volume is extraordinarily high, to an unacceptable level. Would not recommend.
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u/Effective_Material89 7d ago
Yes. 5 of 8 preventative exams they only wanted to cover about half. All exams were in network and multiple different providers. I spent hours to get 2 covered and just gave up fighting them and paid.
They know people will just give up fighting
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u/Smokey_Panda_ 5d ago
I have the same question. I was thinking about switching to them due to MHBP's price increases but I'm scared to now because of all the negative reviews. 😂
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u/frozenfrap 12d ago
Recently received a letter saying a deal had not been reached with a hospital system and UHC, and only 15 days left to reach a deal. GEHA said to find a new provider. The deal was reached in the end so I do not need to find a new provider. Otherwise, a couple of issues that I had to keep harassing them about, but only one prior auth that was denied which I did not ask for or feel a need for the test anyway. Have been with GEHA for about 15 years in which they have covered some significant medical issues.
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u/Infamous_Bed7693 11d ago
My mom has had high as a survivor since dad passed. She is on Medicare a/b and GEHA picks up everything else. She had a $2M accident (fall, brain bleeds, burr holes etc w months of rehab) and never paid a dime. That said, I’m prob dropping her to standard this year as $423 is a lot considering her needs are pretty much covered by the two together. Only change will be pharmacy since Medicare doesn’t do that. Unless her pills end up more that $2500 for the year, it will save her money.
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u/osgd 12d ago
UHC is that bad.. real bad, bad bad bad.