I joined this supposed insurance plan for self-employed people because my husband is a minister and his denomination does not offer an insurance plan. I am no longer working and consequently am not able to provide us with an employer's insurance plan. I was told that I could make changes to my plan at anytime with NO PROBLEM. I decided to do so almost immediately; adding 2 visits per quarter to my plan instead of one. I called and was told they would make the change.
A few months later I checked before I made appointment at doctors office. The change had not been added, however it was recorded that I had talked about it with someone on the phone. I was told that I would recieve papers in the mail to make this change. When no papers came I called back and called my agent, who assured me that I was able to change the plan. Then I was told over the phone that the only time a change could be made to the amount of doctor visits was in the first month of plan or on the anniversary of the plan. I would have to wait a year. But I had asked someone, they just did'nt make it.
I was ready to drop the plan and expressed my desire to leave, then someone offered a NEW plan that would insure me doctor visits each month as long they were not over 125.00 per month. Out of my 300.00 plus dollars a month they would credit me with 125.00 into an account for doctors visits. That way as long as my 125.00 was not spent I could go to the doctors office more often. Since I had not been yet to see a doctor, this sounded like a good plan to me. When the new plan kicked in I called about a particular doctor to see if he was in the network. He was and I was told I had 375.00 dollars credit in my doctors visit account.
I then made 2 appointments, one to an eye doctor for medical concern and one for an allergy shot. I had 375.00 and I would finally be able to see a doctor. Then the second claim was denied saying I only had 125.00 in there. I fought this and they backed down, promising to send me papers to sign, return and they would resubmit and pay. It was recorded that a woman had told me I had 375.00 in my account. To date I have had no papers sent. The doctors bill is unpaid, and they want their money.
I went in June to see the doctor for a related followup visit to the tune of 65.00 and since it was a new month I knew it would be covered.
Well the bill came back to me this week and they paid 12.00!! Now I owe this doctor 100.00!! What happened to this alleged 125.00 per month per doctors visit. I have had nothing but TROUBLE with this company since the beginning. It's a cloak and dagger kind of operation, that I have paid over 3000 dollars to and had nothing but TROUBLE from. That is why I am going to dismiss them as BIG MISTAKE before I am out anymore money.
0 comments