How to File a Claim
In-network medical claims
When you use a health care provider that is in GEHA's network, you will not have to fill out any claim forms in most cases. GEHA's in-network providers and facilities file claims for you as indicated on your ID card.
Out-of-network medical claims
If you use an out-of-network provider, the claim may be submitted by either you or by the provider. Federal regulations require that a claim submitted by a provider must be filed on a CMS-1500 form.
If you need to submit an out-of-network medical claim yourself, please complete a Medical Claim Form .
If you live in one of the states listed below and are filing an out-of-network claim yourself, please click How to File an Out-of-Network Claim with UnitedHealthcare.
|District of Columbia
If you are involved in an accident or injury for which another party is responsible, please also complete an Accident/Injury form.
If you have claims for medical care while living or traveling abroad, see Outside the United States.
Appealing a medical claim
If you would like GEHA to reconsider our initial decision on your benefit claim, please complete a Medical Appeal Form . You must write to us within six months of the date of our decision. For more information about appeals, click on the disputed claims process.
Other GEHA plans
For claims/appeals information for GEHA's FEDVIP dental plan, click GEHA Connection Dental Federal®.
For claims/appeals information for GEHA's supplemental dental plan, click Connection Dental Plus®.