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Business Profile

Health Insurance

Rocky Mountain Health Plans

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for Rocky Mountain Health Plans's headquarters and its corporate-owned locations. To view all corporate locations, see

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Rocky Mountain Health Plans has 3 locations, listed below.

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    Customer Complaints Summary

    • 1 complaint in the last 3 years.
    • 0 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:01/19/2023

      Type:Billing Issues
      Status:
      Resolved
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      Although the business has failed to explicitly accept liability for the $5.00 Zaleplon charge, and further they have failed to promise any changes for their refusal to address these issues internally in the future, I take their written comments to apply they are accepting responsibility for the $5.00 Zaleplon charge I ought not have been charged, and are acknowledging their failure to appropriately resolve this issue initially, and are promising to make necessary changes to treat their customers better.

      If and only if this is explicitly understood, then I accept their response.

      $351 co-pay. I would not have purchased this medication if it was not approved.

      I filed a written complaint, which they have not repsonded to. I called three times. The first time they refused to tell me which medications were covered, then placed me on hold "to get a supervisor". After one hour the call disconnected. The third time I spoke to a supervisor. She gave conflicting information. When I asked how I can know what medications were covered, she placed me on mute and 20 minutes of silence later she hung up the phone.

      This is clearly intentional, illegal, fraudulent behavior. I have audio recordings to support these events, if required.

      Business Response

      Date: 02/21/2023

      RMHP responded to a DOI complaint the member filed on January 19, 2023. I've attached a copy of the letter that was sent to the member.  Here is a summary of the resolution.

      RMHP reached out to ******* pharmacy and spoke with **** on January 24, 2023. He verified that there was a claim processed for Zaleplon in which you paid $5.00 on January 17, 2023, a claim for Zileutin was also processed. The cost for that medication was $351.00, you did not purchase this medication. Both claims were processed under a *** pharmacy plan. You verified with the pharmacy that plan was incorrect, you are on a ******** ******* plan. The pharmacy voided the *** plan on your profile. RMHP shows that the prescription for Zaleplon ran January 23, 2023, the cost you paid was $9.67 for a 30-day supply. The pharmacy ran the prescription for Zyflo January 31, 2023, and you paid $40.00 for a 30-day supply. The prior authorization for Zyflo is approved for a year and will end January 31, 2024, as long as you are eligible for the ******** ******* plan.

      Please let us know if you have any other questions on the complaint. 

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