I changed my health care from Oxford to Atlantis only because Oxford was getting way too expensive. Since I have been taking pain medication for over 10 years to deal with chronic pain, I only switched after I was assured by the representative that there would be no problem with filling my medication every month. Then when I got a copy of my contract it specifically stated that any ongoing treatment would be covered while under review. NOT TRUE!! They cut me off and had me go to one of their Dr. s (who I still go to). I paid for all my medication for the first 3 months and never got reimbursed.
I have been with Atlantis now for almost 2 years and have never gone to get my medication without a problem. Every time I'm told "Atlantis are refusing to cover it". When I get on the phone with Atlantis, they say they never got a request from my Dr. I call my Dr. and he tells me he did send request. A couple of times I conference my Dr. and Atlantis. All of a sudden the story changes. Then Atlantis finds the request and tell me I have to wait 72 hours for approval!! Over the past two I have counted the days that I have been left without my pain medication and it amounts to 3 1/2 months!!
I had the nursing supervisor hang up the phone during one of our conversations, saying "I don't have to deal with this". They haven't paid my Dr. in 6 months and I am embarrassed every time I go to see him. I have told Atlantis that I am going to sue them for breach of contract and false advertisement. During one of my problems, they told me the Dr. was looking into my claim. The Dr. was in India and had been for some time!
Also, I spent 10 days in hospital with chest pains. Atlantis would only pay for 2 days, saying the rest of the time was medically unnecessary. On the 6th day of hospitalization they found that I had a hightail hernia, 4 days after Atlantis said it was medically unnecessary! In conclusion, if you can afford another plan, stay away from Atlantis. They lie, they cheat and they're incredibly rude. When you get someone on the phone, they act like they're doing you a favor!! On a scale of 1 to 5 apples, I give Atlantis Health Plan a worm from one of those apples!!!
I was thrilled to find a health insurance plan that appeared to be reasonably priced. The co-pays seemed in line with other carriers and my doctor participates in their program. They also boast about their "no referral required" policy. What I did not realize was that every breath you take has to be pre-authorized through the company. I have a chronic condition which requires daily medication for the rest of my life. If I skip a day of medication my body begins to build up immunity to the medication which could eventually cause my death. I was informed that the pre-authorization would only take 72 hours.
Unfortunately, it took Atlantis six weeks to pre-authorize the medication - which left me without medication for three days. While this is a lifetime med, the company requires pre-authorization every 90 days - which I just cannot understand as this is a waste of time and money for the doctors as well as the insurance carrier - not to mention the insured! They also require that you use their mail-order pharmacy out of Ohio but will not authorize the release of the medication until you have completely finished the current month's prescription - once again leaving you without medication for a number of days.
Every insurance carrier I have previously had, allowed a 90-day supply of long term medication if shipped from their mail-order pharmacy. Atlantis will only authorize a 30-day supply. I highly recommend that you read all the small print if you proceed with Atlantis but I strongly suggest that you stay as far away as possible. It may seem like a good deal but that couldn't be any farther from the truth.
NEW YORK, NEW YORK -- This insurance will take you for a ride. It seems cheap compared to the others until you need something done. They claim that they have all these doctors in their network however if you call those doctors, they don't accept Atlantis anymore. Since they pay doctors so little, the doctors that do accept them, will see you for 2 minutes and kick you out. Every little thing you want to do will require "PRE-AUTHORIZATION" and they will usually deny it as being MEDICALLY NOT NECESSARY!
Save yourself the Time and headache. Don't get this insurance. If you already do have this insurance and are having problems, don't hesitate to contact the NY State Attorney General office at **. Also, you can contact the NYS Dept of Insurance at **