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You must write to us within 6 months of the date of our decision. Please explain why you believe our initial decision was wrong, based on specific benefit provisions in your plan brochure: Attach additional sheets, if needed.
GEHA, like other federal medical plans, requires providers to obtain authorization before some services and procedures are performed. Youll find more information on authorizations in the GEHA plan brochure. For quick reference, see the GEHA members ID card.
GEHA (Government Employees Health Association) is a self-insured, not-for-profit association providing medical and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits (FEHB) program and the Federal Employees Dental and Vision Insurance Program (FEDVIP).
If you would like GEHA to reconsider its initial decision on your dental benefit claim, please complete this appeal form. You must write to us within 6 months of the date of our decision.
Plans are offered by GEHA and insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract. Enrollment in the plan depends on the plans contract renewal with Medicare. Benefits, features and/or devices vary by plan/area.
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