Atlantis Health Plan Complaint - Breach Of Contract
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 highatail 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!!!
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