I obtained Insurance through Cinergy Health Short Term Medical Insurance on Feb. 12. The policy was a six-month policy and the agent told me that I would have a $500 deductible. After satisfying this deductible, my policy would then go into a co-insurance period. During this time my insurance company was supposed to pay 80% until I reached $1,000 out of pocket. After this, all eligible expenses were to be covered at 100%. I renewed my policy on August 12 and was assured that it was the same policy and coverage.
I had an emergency appendectomy on Sept 17. I started receiving bills for thousands of dollars. When I called Cinergy I was given the run around. I spoke to various people who wouldn't take responsibility for the error. I was told various times that someone would be calling me back and no one ever returned my calls. Eventually, after numerous attempts on my part I got a hold of someone who told me that the reason I was receiving these bills was that during my co-insurance period I was actually responsible for $5,000 out of pocket. This was $4,000 more than they told me I would be responsible for when they sold me the policy!
At this point I argued with the company and was assured that my problems would be forwarded onto a supervisor who would review my case, including the recording of the original phone call when I bought the policy. They have never gotten back to me. It is currently March - I started the process of calling them in November. Eventually I reported them to the Ohio Board of Insurance and they called to let me know that they are requesting payment from Cinergy because they got a hold of the recorded conversation and they believe that I am correct.
Since all of this they have also denied two different claims saying that my coverage had been terminated on the dates of service - which it definitely had not been. One of these was for my son's well child check up, the other was the surgeon's bill for my appendectomy - both medically necessary claims. I called them out on these claims and they are supposedly reprocessing them. Then yesterday I open yet another bill for my surgery for another $1,914.
This company has not provided me with the coverage that they sold me and has denied one claim after another. When I call their customer service department, I cannot get a straight answer out of anyone and they keep me on they phone forever transferring me from person to person. They have never returned my calls in a timely fashion. This is the worst experience with insurance I have ever had. I highly recommend that NO ONE out there purchase insurance through Cinergy.
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