Claims

For GEHA medical members


When providers send claims to GEHA with billing information regarding your medical service, GEHA processes it and covers the cost based on your medical benefit plan. Depending if you visit an in-network or out-of-network provider can determine if you need to file a claim yourself instead of your provider. For the proper steps for filing a claim with GEHA, review the information below.

Filing an in-network medical claim

When you visit 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.

Filing an out-of-network medical claim

If you visit 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 find the claim needs to be submitted and mailed to GEHA by you, please complete a Medical Claim Form.

 

download medical claim form

 

When you’re ready to mail your out-of-network medical claim to GEHA, send it to the following address:

PO Box 21542
Eagan, MN 55121

If you live in one of the states listed below and are filing an out-of-network claim yourself, please visit filing an out-of-network medical claim with UnitedHealthcare.

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

Let GEHA know if you have claims for medical care while living or traveling out of the United States.
WANT TO FILE AN APPEAL?

Let GEHA know if you'd like us to reconsider a claims decision.
Accident or injury?

Let GEHA know if you are involved in an accident or injury for which another party is responsible.