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Business Profile

Health Insurance

Simply Healthcare Plans, Inc.

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Health Insurance.

Complaints

Customer Complaints Summary

  • 21 total complaints in the last 3 years.
  • 8 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:04/23/2024

    Type:Order Issues
    Status:
    Answered
    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.
    my kid is unable to see his dr and the insurance company assigned to him refuses to help my 13 yr old seeing his primary care

    Business Response

    Date: 05/02/2024

    Good Evening,

    Due to federal laws pertaining to the Health Insurance Portability and Accountability Act (HIPAA) and the Protected Health Information (PHI) portion of it that went into effect April 14, 2003 we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to the consumer. This consumer complaint was forwarded to our Grievance and ************* so that an analyst can speak with the consumer about his concerns.

  • Initial Complaint

    Date:03/26/2024

    Type:Product Issues
    Status:
    Answered
    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.
    All you **** interconnect healthcare ******* need to get this through your ******* heads! "*********************" DOES NOT F****** EXIST AT ********************************** ************, ** *****!!!! If you don't stop this f****** harassing amount of mail sent to this address IMMEDIATELY I'll be forced to pursue legal action against you!

    Business Response

    Date: 04/03/2024

    Good Morning,

    The phone provided is not a valid number and the email is not as well.  We cannot confirm this consumer is a plan member with the information that was provided and therefore are unable to place this consumer on 'do not mail'.

  • Initial Complaint

    Date:03/14/2024

    Type:Billing Issues
    Status:
    Answered
    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.
    Simply Healthcare needs to pay for root canal performed on 9/11/2023. I went to Sage Dental on 9/8/23 in excruciating pain and had to wait three days before the root canal could be done. Simply paid $111.00 on total bill leaving a balance for me to pay $595.00 for the service after they approved the procedures. I had HMODSNP which covers all expenses incurred for services on 9/11/23. I have contacted Simply Healthcare numerous times over the last five months and submitted an appeal for the denial for payment to no avail. My last contact wirh them was February 23, 2024.

    Business Response

    Date: 03/18/2024

    March 18, 2024

    BBB
    Attention: **************
    **************************************
    VIA: Portal


    Member: *****************************

    ********** Claim
    BBB File No.: 21436026

    Dear BBB:

    This is in response to your correspondence dated March 14, 2024, regarding the above referenced member.

    Due to federal laws pertaining to the Health Insurance Portability and Accountability Act (HIPAA)and the Protected Health Information (PHI) portion of it that went into effect April 14, 2003, we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to *****************************.

    I trust that the information provided will aid in resolving your concerns and want to thank you for the opportunity to assist you.  Should you have any additional inquiries, please do not hesitate to contact me at ********************************************************************.         

    Thank you for your concern.

    *********************************
    Grievance Analyst I
    Medicare Complaints, Appeals & Grievances

    Customer Answer

    Date: 03/18/2024

     
    Complaint: 21436026

    I am rejecting this response because: HIPAA has nothing to do with payment information and this bill needs to be paid immediately. 

    Sincerely,

    *****************************

    Business Response

    Date: 03/25/2024

    March 25, 2024

    BBB
    Attention: **************
    **************************************
    VIA: Portal


    Member: *****************************

    ********** Claim
    BBB File No.: 21436026

    Dear BBB:

    This is in response to your correspondence dated March 14, 2024, regarding the above referenced member.

    Due to federal laws pertaining to the Health Insurance Portability and Accountability Act (HIPAA)and the Protected Health Information (PHI) portion of it that went into effect April 14, 2003, we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to *****************************. 

    Customer Answer

    Date: 03/26/2024

     
    Complaint: 21436026

    I am rejecting this response because: as I stated HIPAA does not apply to billing and payments. Please pay this bill and resolve this matter. Thank you for your assistance and cooperation so the provider can receive payment. 

    Sincerely,

    *****************************

    Customer Answer

    Date: 03/27/2024

    Attached Preapproval from Simply/Dentaquest for services rendered 9/11/2023.

    Please reopen complaint. Thank you.

     

    Customer Answer

    Date: 03/27/2024

    Attached Preapproval from Simply/Dentaquest for services rendered 9/11/2023.

    Please reopen complaint. Thank you.

     

  • Initial Complaint

    Date:01/19/2024

    Type:Service or Repair Issues
    Status:
    Answered
    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.
    Last year I had a dental implant done. I need to finish the abutment etc. that they had okayed the previous year. I called insurance company to make sure they had the same coverage for dental for ****; and that I would be able to complete with no extra charges. They said yes; for this zip code there were no changes. So, I continued with the insurance.My dentist said Simply changed everything and that I would have to pay $1600 plus dollars.Now I have implants in my mouth and cannot complete the work done.

    Business Response

    Date: 01/29/2024

    Good Afternoon,

    We have been attempting to contact the consumer to confirm member eligibility with the plan. The consumer has not responded. In order to provide additional assistance, the consumer needs to respond to the plan.

  • Initial Complaint

    Date:12/11/2023

    Type:Order Issues
    Status:
    Answered
    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.
    it is my desire to be removed from your mailing list. Any information can be sent via email - but please do not send it via the ***************

    Business Response

    Date: 12/21/2023

    The plan made several attempts to contact ******************** and voice messages were left. As of today, we have yet to receive a response. In order to further assist ******************** we need additional information from him.

    Customer Answer

    Date: 12/21/2023

     
    Complaint: 20993048

    I am rejecting this response because:

     

    The attached screenshot shows my voicemails - none have been received from Simple Healthcare. Your response leaves doubt as a direct number is not provided - to call the general line would be a sign of poor taste. If you truly are committed to ethics and professionalism, an email address would be inline. At this point I must consider you to be unethical.

    Sincerely,

    *************************

    Business Response

    Date: 01/01/2024

    An e-mail was sent to the consumer and as of last Friday we have yet to receive a response from him. 

  • Initial Complaint

    Date:11/21/2023

    Type:Product Issues
    Status:
    Answered
    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.
    I am writing to bring to your attention a matter of concern regarding my enrollment in the Simply Level Platinum (HMO C-**** plan.During the enrollment process, I was informed that I would receive a $164.90 reduction in my ******** Part B plan. However, I received conflicting information via text, initially stating that this reduction would not be applicable. Subsequently, I received confirmation multiple times that I would indeed receive the rebate, although the process remains unclear.I kindly request that someone from your team urgently contacts me to provide clarification on the status of this rebate and the process through which it will be applied. It is crucial for me to understand the details and ensure that all aspects of my plan are accurately represented.Please see photos showing this promised feature. Member ID: *********

    Business Response

    Date: 11/27/2023

    November 27, 2023


    BBB Serving Southeast Florida and *************
    Attention: ****************
    4411 *************
    ***************, Florida  33407
    VIA Portal

    Member Name: *****************************

    Re: Refund or Exchange Issues
    BBB File No.: 20903328


    Dear BBB:

    This is in response to your correspondence dated November 22, 2023, regarding the above referenced member.

    Due to federal laws pertaining to the Health Insurance Portability and Accountability Act (HIPAA)and the Protected Health Information (PHI) portion of it that went into effect April 14, ****, we cannot relinquish information without proper authorization.  Therefore, we will be addressing the concerns in question and responding directly to *****************************.

    I trust that the information provided will aid in resolving your concerns and want to thank you for the opportunity to assist you.  Should you have any additional inquiries, please do not hesitate to contact me by email at ***********************************************

    Thank you for your concern.

    *********************
    Grievance Analyst I
    Medicare Complaints, Appeals & Grievances

    Customer Answer

    Date: 11/28/2023

     
    Complaint: 20903328

    I am rejecting this response because: we have contacted the email provided and no reply given


    Sincerely,

    *****************************

    Business Response

    Date: 11/30/2023

    November 30, 2023

     

    BBB Serving Southeast Florida and *************
    Attention: ****************
    *******************************
    ***************, Florida 33407
    VIA Portal

     

    Member Name: *****************************
    Re: Refund or Exchange Issues
    BBB File No.: 20903328
    Dear BBB:

    This is in response to your correspondence dated November 28, 2023, regarding the above referenced member.

     

    Due to federal laws pertaining to the Health Insurance Portability and Accountability Act (HIPAA) and the Protected Health Information (PHI) portion of it that went into effect April 14, ****, we cannot relinquish information without proper authorization. Therefore, we will be addressing the concerns in
    question and responding directly to ******************************

     

    I trust that the information provided will aid in resolving your concerns and want to thank you for the opportunity to assist you. Should you have any additional inquiries, please do not hesitate to contact me by email at ********************************************************.

     

    Thank you for your concern.

     

    *********************
    Grievance Analyst I
    Medicare Complaints, Appeals & Grievances

  • Initial Complaint

    Date:11/07/2023

    Type:Service or Repair Issues
    Status:
    Answered
    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.
    This company will NOT STOP CALLING ME!!! They call 3/4 times A DAY. I have asked over 10 times for them to take me off their list and they still call. They even know I dont want to be called because when I wait for a live person, they say, I know, dont call you. But then they call me the very next day. This has been going on for months and frankly, I dont even answer my phone at all anymore. I understand that everyone has a job to do, but when people are asked to be put on the do not call list and you continue to call, something needs to happen. To top it all off, they are calling my business line, not my personal line. Im not even old enough for *********

    Business Response

    Date: 11/20/2023

    The consumer was contacted and informed us that she was receiving calls from the Health Plan offering ********* As of now we have not been able to confirm that the calls she is receiving are coming from the health plan.

  • Initial Complaint

    Date:06/20/2023

    Type:Service or Repair Issues
    Status:
    Answered
    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.
    Ive been trying to make appointments with the pcp that simply has put on my cards themselves to make appointments for my various health issues. Half of the providers didnt even accept the simply insurance and the other half would cancel my appointments or schedule the appointments for months away. Now come to find out simply sent me a letter stating they were dropping me from the insurance for an unknown reason. Im not going to assume its because of my income because Im legitimately poor and young. So now Im here stuck with severe medical issues and in pain. I cant go to a hospital because I wont be able to eat or pay my bills which I already struggle with, if I face a hospital bill I will physically not be able to live. The emotional distress on top of all of the health issues Ive been unable to tend to because of this business is immense. I cannot tell you how much my health has deteriorated month by month because of these people. Ive called several times now for help and they have been generally unhelpful and just send me a new card by mail with their recommended pcps that do not accept me. I genuinely do not know what to do anymore.

    Business Response

    Date: 06/30/2023

    The health plan has made several attempts to contact the complainant in order to address the member's concerns and provide resolution and have left voice messages However, the complainant is unresponsive. If the complainant responds, then we can work with the complainant and provide a resolution that is satisfactory for her.

  • Initial Complaint

    Date:02/21/2023

    Type:Service or Repair Issues
    Status:
    Answered
    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.
    Came here too see doctor after being referred by chiropractor after a hit and run accident... And got here at 8:58am for a 920am appointment... Get inside the office and was told our appointment was switched to 10:00am and was told to wait... while two other patients walked in after us and was seen before us... Terrible customer service... I can't believe that we were told to wait when we were early and our paperwork was already filled out and ready to be

    Business Response

    Date: 02/23/2023

    Good Evening,

    The health plan's member services ***** spoke with the customer today and she confirmed she was from ******* and was not affiliated with this health plan or any of it's sister companies of Elevance or within Florida. Simply Healthcare Plans, Inc. does not operate in *******. As such, this complaint was sent to this health plan in error. When asked, the customer indicated she was all set with no issues and that we could close this case on our end.

     

  • Initial Complaint

    Date:01/04/2023

    Type:Order Issues
    Status:
    Answered
    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.
    THEY HAVE NOT TAKEN CARE OF ANY OF MEDICAL NEEDS AND THE DENIST PART IS IMOSSIBLE TO GET ANYTHING DOEN FOR A YEAR OF PAIN IN MY MOUTH THEY HAVE RIPED ME OFF THE 50 DOLLAR CARD THEY GIVE US EACH MONTH DOES OT WORK ANYWHERE THEY LIE THEY DO NOT HAVE MANY THAT SPEAK ENGLISH THEY ARE DESTROYING MY HEALTH AND I AM PAYING FOR IT

    Business Response

    Date: 01/18/2023

    Good Morning,

    The plan has contacted the member to discuss and address her concerns.

Simply Healthcare Plans, Inc. is NOT a BBB Accredited Business.

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