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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 pdficon_small.

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.

Alabama Delaware Louisiana Nebraska Oklahoma Utah
Alaska
Hawaii Maryland New Mexico South Carolina Virginia
Arkansas Idaho Minnesota North Carolina South Dakota West Virginia
Colorado Indiana Mississippi North Dakota Tennessee Wisconsin
District of Columbia Iowa Montana Ohio Texas Wyoming

If you are involved in an accident or injury for which another party is responsible, please also complete an Accident/Injury form.

Overseas claims
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 pdficon_small. 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®.

Hawaii