So, my story is I graduated, and couldn't find a permanent job. I work for the state as a temp but we are not offered health care (at least not until the Fed. Gov. took our state to court... Now it's strongly recommended you don't select it and by all temp companies in the area sort of a requirement of employment if you will). So... I scurried over to the Market Place and applied. I picked out Coventry (I was looking at a BCBS policy but as soon as I did my application it disappeared! Was nowhere to be found).
I go to my old doctor (they tell me they are in-network tier 1). I get a bill, they took off %40 and charged me the rest. I call to inquire, they say they are not in-network. Finally several calls later they said they are tier-2 now? A woman says "oops they made a mistake. We owe you money!" *disconnect* (I'm standing still it's not my reception. I forgot to mention most of those calls I got hung up on by them putting me on hold and randomly disconnecting me. I never yelled, but they are always horribly rude). Sometimes they leave you on hold for near an hour to the point where you hang up.
Anyway, back to the story. I call back excited "The woman I just spoke with told me they owed me money they didn't process the claim properly". The woman says no record of call, no clue what I'm talking about. I ask for a supervisor, she gives me hell to get to one says "it will make no difference". Finally (hour later, the first time they said one was available and hung up) I get to the... supervisor - "we did make a mistake! You were suppose to be charged in full! Tier 2 has a $5000 deducible it's only tier 1 that doesn't." *mouth drops open* "What, what! Stop working on my claim I can't afford more!" *Drops call.
I get a message the claim is back in process again, it will take up to three months - I will be charged the full bill. I get a medicine monthly so I need to see a doctor each month (it took me months and hours on the phone, crying, frustrated to find one in-network); after a few visits I start getting the claims back, they charge $550 per apt and they only paid out $70! Yet I need this doctor, I can't do anything about it!
Now my savings is gone, I'm on payments plans to multiple different health companies before I'm even in my late 20's (Not to mention another giant bill and corporate giant being the student loan holders. My monthly Is over $500 with only $60 hitting the principle the rest is monthly interest). I call back to find a new doctor who is in network... I need to get my annual “stuff” done (I'm a female); they email me a site (fyi this is how I found my first doc was on it then called in to confirm to later find once I received the bill it was a lie).
I've been searching for a month, no doctors in-network will accept our insurance yet they tell me on the phone they must (no you don't get it, they don't accept my insurance because they never pay out claims). I spoke with a representative to get the real deal and she said even if I get my annual, my pap and blood work will all be charged to me (about $500, I cannot afford on top of it all). This is ridiculous! This is preventative care and my annual, I've never heard this before and I've had it done for years.
I can't believe this company… The market place has no other options so I have to stay with them but I'm suffering, I can't even get my annual… They said it was preventative but Coventry doesn't and they've backed me into a corner where I'm scared to even get my annual because they already said on the phone it won't be covered. They give horrible customer service, they yell at you on the phone. If you speak up they punish you!
I have $5 in my bank account for gas for the work week after paying all my bills and I need to give another call to a medical company today to beg them to give me a few more days to make my monthly payment to them. I'm a healthy person, just for an annual and a monthly medicine I've given my savings, every hour I work, and months of stress to. I can't take much more… and yet I don't know what can be done.
There is no one out there to help any of us suffering. We grew up before our time and now we are entering our 50s while still in our 20s in debt, in stress. I work a full-time and a part-time to pay my bills and yet I need another job. I get yelled at if I call Coventry. I don't expect sympathy just a human… would be nice… I don't know what more I can do, or if anything can be done, or if I can take anymore.
ATLANTA, GEORGIA -- "We've cleared the path for you to control your own healthcare" boasts the banner, on Coventry's website. They're also busy clearing the path for you to pay for and PROVIDE your own health care. Eventually, they'll send you a "DIY Surgery Kit" -- you'll do the cutting and suturing - but you'll have to pay THEM, because "hidden costs".
It has always been a painful struggle to get any response via email. They don't cover anything, and phone encounters have been a nauseating 3-ring circus of non-communicative exchanges with incompetent "customer service" representatives.
I signed with Coventry for a child's health care. "Oh, yes - children are our priority" began the mantra. They started early, giving me the one step forward, two steps back treatment. That should have been a red flag. We won't cover A, but if you go to B, they'll refer you to us to cover C, and then you can file for A. But we don't cover A, so file for A and see what happens, 'cause we love paperwork.
The list of "covered" providers. On a list of 20, 17 were no longer accepting Coventry as a carrier. (Golly, wonder why?) Of course Coventry reps wanted to argue with me on this, even after I'd gotten the info directly from the provider. And mysteriously, providers who did accept Coventry coverage -- Coventry didn't have listed. Right hand, left hand - who's minding the store?
Last straw. I called to transfer coverage for my move to another state. "You'll get a call back to confirm that within 2-3 days." Of course I had no call from them. After a week, I called back. No one had any record of that conversation. I was put on a 20 minute hold. I called back. This representative insisted I'd have to wait for paper mail - no one could email me any information - it just wasn't done. They email me junk 3 times a week, but this question couldn't possibly be confirmed via email. I asked to speak with a supervisor and was suddenly, magically disconnected. What a shock.
Coventry provides no response, no straight answers, returned phone calls or any kind of information - EVER. It's been a nightmare trying to find out what, if anything, they cover - and when claims will be processed. The answers: "nothing" and "wait and see". Good riddance to bad rubbish. Coventry is a bad joke. I'll be changing providers as soon as humanly possible.
HENDERSONVILLE, NORTH CAROLINA -- I am enduring my second year with this den of thieves. I had no choice but to enroll with them because this is the only insurance my company offered. The prescriptions they cover are minimal at best. It's almost like you have no prescription coverage at all. Most prescriptions my family has had, was paid out of pocket.
For most of 2014, most doctor visits were denied due to “pre-existing conditions”. The VERY RUDE customer service reps had my wife running in circles trying to get our claims paid. I do not know how many hours my wife spent on the phone but it was substantial.
After speaking with the agency that suckered us into this D-rated company (BBB), I told my wife that we needed to gather up all our medical records for the past 3 years and submit this to Coventry to thwart the pre-existing claim. After running all over town, compiling proof of prior coverage and writing a lengthy cover letter, we submitted the information to Coventry. Sorry… claim(s) denied. I then filed a complaint with the NC Insurance commissioner (2 filed so far). Coventry said that because it was past 120 days from the date of service, they refuse to pay. I was then told to reference page 67 of the (non-coverage) handbook.
In short, this is their M.O. Deny most claims up front. Do not tell the insured what they have to do to get their claims paid and string everything along past the 120-day cutoff. Many people will simply pay to avoid damaging their credit like I had to do and the rest is history. I have paid over $2000+ out of pocket and $9600 (my part) in premiums in the last year.
Coventry apparently feels they have the right to steal my money and so far they have been successful. If my employer offers Coventry as our only choice this year, I will tender my resignation as others in my company have done.
ATLANTA, GA -- BEWARE!!! The worse health insurance company ever to be established on earth!!! Very unprofessional, unorganized, and disrespectful. They will over-charge for monthly service and take months for a refund. Every time I would call to inquire about my account, they had no recollection of who I was or even what occurred on my account in the past. It took them days to even get my coverage start date correct. They will give you the runaround and eventually hang up on you!
I have never experienced this level of unprofessionalism. Some of the representatives speak as if they have a third grade education. One supervisor claimed he would "expedite my refund and send my money through an electronic wire". I called back the next day, another representative said that process simply doesn't exit! DO NOT SIGN UP WITH COVENTRY ONE! BEWARE!!!
OVERLAND PARK, KANSAS -- First they said they sent me a letter October of 2014, saying that family policy was going to change. I never got a letter. Without my permission, they took out twice the amount from my bank account and told me it was my problem that I did not respond to the letter, that I NEVER GOT! They automatically renewed me to a NEW policy that costs almost double what I had been paying. They would not credit me but went on to further screw me.
After hours on the phone they put me on the plan and into the Marketplace, but my 18-year-old son had to go on a separate policy. They put me on automatic payments for my son's insurance. I paid my first payment and then I had to keep calling for them to straighten it out.
On March 10, I spoke with an agent who told me not to worry about it and I asked him several times if I needed to make a payment because they were behind a month. HE said no, several times! After my payment was not taken out in April, I called back. THEY CANCELED THE INSURANCE ON FEB 28th! The supposed Supervisor told me that I had to back pay the whole month of March, even when he had no insurance, or they were going to cancel the whole policy and I would have to wait to enroll him! They are horrid and I have read other stories like mine on other sites. Why isn't someone holding them legally accountable for this?
I recently transferred over to Coventry as of Jan 2015 from Blue Cross because I was getting a similar policy for about 89$ less a month. Boy, I am sorry I did that. First, I cannot register online with them because the website is constantly telling me I am not an active member, Second, they have denied the two general Doctor visits my husband had to make in 4 months and third, I received a bill from them that was due on the last day of the month (which was a Friday ). I tried to pay it the following Monday and I was told my policy had been cancelled.
The lady I was speaking to on the customer service line 1-877-849-9690 stated she had no idea why it was cancelled and that there is usually a 90 day grace period and all my other payments were on time. She told me she would ask her supervisor what was going on and then she literally told me to call back in 3-5 days to figure out what was going on then because her system would not allow her to do anything. Two thumbs down guys. So wish I would have stayed with Blue Cross right about now!!! SAVE YOURSELF THE HASSLE AND DON'T GO WITH THESE GUYS!
FLORIDA -- After my first visit to my primary care doctor who ordered blood tests, they told me that I had to pay $193 for having the blood drawn and for the lab tests. If I had Medicare alone they would have covered 80%. Their people are useless, just mouth the "company line" and their website is completely defective. I registered and it never allowed me to log in again (said my birth date was wrong, my email wrong and even my ID number "invalid"). I believe based on my experience that they are cheats and that it is a very bad company!
BROWARD, FLORIDA -- I made appt with family doc and when I arrived, he would not see me. I had to have appt with a nurse. But they billed insurance for a doctor, when I told Coventry they ignored my email. I made appt with ophthalmologist and when I arrived, he would not see me. I was forced to see an optometrist. But I still had to pay as a specialist which she was not. When I told Coventry nothing was done. My GP dropped all Coventry patients, but Coventry never told me. I found out when I attempted to make an urgent appt. Then I had to wait a few weeks to get a new doc.
URBANDALE, IOWA -- January of 2009, my employer changed from Wellmark Blue Cross Blue Shield to Coventry because "The savings was unbelievable". One Month later I found that I had testicular cancer. I went to a specialist and they recommend a procedure to remove the cancer and still be able to possible have more children with my wife.
Coventry got an authorization from the Dr. just one day before the surgery and then called me to tell me that they denied the procedure because it was considered experimental. They said that they had evidence from other specialists across the country that the procedure my first Dr had recommended often times did not effectively treat the cancer and it came back twice as often as it would with other treatments.
I was taken aback at first because "How could a Dr ever recommend something that wasn't the best for me?" Coventry said they would pay for me to have a second or even third opinion but they wanted me to have the best outcome for my health. I then went to the MAYO Clinic for the second opinion and they recommended another procedure because of the same reason that Coventry had told me they denied the first one. I was astonished. Six months later I saw an article in the paper that my first doctor was being sued for malpractice. Almost two years later I am in complete remission and Coventry saved my life by caring enough to deny a procedure that was not in my best interest.
SAGINAW, MICHIGAN -- 3 Month old fever of 99 with a bit of a cry. Found low sugar of around 40ish. Multiply attempts at an IV in arm all fail, IV inserted in temporal vein. This was done to raise sugar. After being a bit of a hard head with the doctor I called the child's main physician. After the office called emergency to get details I got back in contact with them and was told "it is common practice to move from arm to head for IV in young patients". Then was told (mind you they called the hospital for the numbers so to speak) "the steps taken were not necessary they could have placed the child on his back(!!!) Or gIVen a oral dosage of ___?___." Does this sound like professionals to you?