ComplaintsforHealth First Health Plans

• Initial Complaint

  01/05/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Hello, I have a HealthFirst health insurance plan through HealthCare.gov. I just wanted to say that I am just filing this complaint as I have found that the executive team of any company only helps you solve your issue when a BBB complaint is filed. Otherwise, you will get the runaround for sure. My HealthFirst member number is ***********. So on December 5th, 2023, I made a credit card payment of $340.18 to HealthFirst to pay for my January **** policy payment and the reference number is 05777Z. I used the link through HealthCare.gov to pay HealthFirst (pay.instamed.com). I have used this link to make payments in the past as HealthFirst always seems to have issues when you login to your HealthFirst account to make a payment (such as application error, etc, etc). So I noticed that my HealthFirst online account was not showing any active policy so I called HealthFirst and their customer service representative said there was no record of the $340.18 payment. This is completely wrong as someone there made a mistake and did not put my payment towards my policy. The representative also said they are showing a last payment of $296.22 made on December, 3, 2023. This is COMPLETELY wrong also as I made the $296.22 payment on November 7, 2023 (authorization #******), not December 3, 2023. My health insurance premium went from $296.22 in 2023 to $340.18 in ****. I have enclosed the email payment receipts for both of these payments. It's pretty obvious that HealthFirst has totally messed up my account payments so I need someone there to fix the issues. They need to show my January **** payment of $340.18 paid and apply correctly this time to my policy. Again, HeathFirst representative-I just have no recourse to get any help so hoping someone there can fix your billing mistakes on my account. I hope HealthFirst can fix their errors so I don't have to file a complaint with ******* **** of Health and a credit card dispute. Thank you.

  Customer response

  01/19/2024

  Hi, the issue has been resolved as HealthFirst was able to find my missing payments (shortly after filing the dispute).  I e-mailed the BBB to try to cancel the complaint, but found out I cannot since HealthFirst received the complaint. So hopefully I can close the dispute out as resolved satisfactorly if HealthFirst does respond.  Thank you again to the BBB for all your help.

  Customer response

  01/22/2024

  Hi, the issue has been resolved as HealthFirst was able to find my missing payments (shortly after filing the dispute).  I e-mailed the BBB to try to cancel the complaint, but found out I cannot since HealthFirst received the complaint. So hopefully I can close the dispute out as resolved satisfactorly if HealthFirst does respond.  Thank you again to the BBB for all your help.

• Initial Complaint

  01/02/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  Arrived for my six month dental cleaning to be informed my dental coverage was not activated. No information in Heath ******************** documentation listing the dental insurer company's name, contact information or member ID. Contacted ******************************************* who was unable to resolve problem, no access to other insures data base. After waiting on hold for 20 minutes while health first called the other insurer I was informed it would take two days to have my account activated. The health ******************** representative suggested I pay for the service and fill out a form to be reimbursed, or use my $250 annual allowance for routine dental procedures. Two issues, Health ******************** documentation stated a debit card would be issued for $500, not the $250 stated by the representative, however the card was never received. Second issue, I didn't want to wait months to be reimbursed for their error. On my second call to inquire about debt card and follow up on dental issue I was informed no new debit card would be issued, the $500 would appear on my OTC card - not what their documentation states. Also, I could call, or go online to follow up with Liberty Dental (the other insurance company) directly. Well, without a Liberty Dental member ID, which I wasn't issued, both attempts failed. I requested to speak to a supervisor only to be informed they were all busy, however, someone would call back - still waiting. Summary: the dental provider lost income, I had to reschedule my procedure, wasted the good part of my morning due to the incompetence of Health ******************** and indifference of their management team not to respond. Not an isolated problem, my wife checked and her dental coverage was also not activated and the dental office staff informed me I was the third person in two hours with the same issue!!

• Initial Complaint

  12/28/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  I received a bill from Health First on September 15, 2023 for a date of ******* of **** 19, 2023. I contacted Health First on 9/25/23 to inquire about the bill and was told that they did not have any health insurance listed for me. I provided my health insurance information at that time and was told they would bill my insurance. I have called 9 other times from 9/25/23 to 12/13/23 and each time was told they would file a claim to my insurance. My last call was on 12/13/23 to which I spoke to a supervisor who assured me the claim had been filed and I just needed to give it more time to reflect with BCBS and to not worry about the warning letters I was receiving about being sent to collections. They have not yet filed a claim and they have now turned me over to a collection agency.

• Initial Complaint

  03/06/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I pay for insurance for my underage daughter through this company. I began calling in December, 2022, for insurance cards because the cards she had no longer worked. I have called approximately five times throughout January and February, 2023. Wait times have exceeded over one hour in some instances, and the phone call is often disconnected before anyone answers. On each call, I explain to the agent that I have not yet received cards, and they tell me they are sending more out. My last call was on February 6th. The operator I spoke to said it did not look like the previous request had been submitted, but assured me he was submitting a request that day. I verified they had the correct mailing address. I have also attempted to contact them by email through their website, but have received no reply. As of March 5, 2023, we still have not received insurance cards. I am paying close to $150 dollars a month for insurance we cannot use, and they never fail to take the money from my account (that's the only service I am receiving from this company).

  Business response

  05/05/2023

  Dear Customer, Thank you for bringing this matter to our attention, and we apologize for any inconvenience you have experienced.  We see that we received one phone call on 2/6/2023 requesting ID cards.  Unfortunately, our system listed an incorrect address for the customer's mailing address.  We have termed the incorrect address we have on file and new ID cards were ordered and sent to the correct address on May 2, 2023.   On May 3, 2023, we were able to confirm in our tracking system that the cards had been mailed. It will take 7-10 business days for the cards to arrive.  Unfortunately, we do not have a record of any email correspondence, but we apologize for the lack of response.  If you have any further questions or concerns, please do not hesitate to contact us.

• Initial Complaint

  02/07/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I received a call concerning health insurance in late July or early Aug. 2022. Having been unemployed, no insurance, no income, no money, I listened especially when "Free insurance" was mentioned and I had been hospitalized numerous times. I gave my address and date of birth and was told I would be receiving insurance cards and more information in the mail. I was having second thoughts about this offer as I know nothing is free. Ten days later I received mail with a 2022 Marketplace Eligibility Notice in it. It showed $19,000/year as estimated 2022 income used to determine eligibility for financial help.. My income had ben Zero for almost 4 years. The "Action: Next steps" listed By Oct. 7, 2022, Choose a Marketplace plan. By Nov 11, 2022, submit documents to confirm citizenship and by Nov. 6, 2022, submit documents to confirm household income. It also said "Marketplace coverage start date generally depends on when you select a plan. I decided I would not pursue this insurance as the $19,000 income was misinformation. There were no insurance membership cards in this mailing. I surmised that since I was not choosing a membership plan or submitting documents to confirm citizenship or household income, Marketplace would be unable to determine eligibility, therefore would not continue to pursue my eligibility for membership. I continued to receive mail giving me deadlines, which I ignored. I have been getting medical assistance through the Indian River County Hospital District and when I recently completed an updated application with them, I was told I no longer qualified as I now had insurance through Health Insurance Marketplace. I also received a 1095-A Statement that I am required to file with the IRS. How can I be responsible if I never even completed the eligibility process. Clearly someone else completed is responsible for entering misinformation. My name is **** ******* Let me know what else I need to submit.

  Business response

  02/27/2023

  We received the BBB Complaint submitted by former Health First Health Plan (HFHP) member, **** ******.   In order to investigate the allegations in the Complaint, Health First Special Investigations Unit was contacted to review.   After thoroughly reviewing the allegation, Health First Special Investigations Unit found no evidence of potential fraud.  This review included a phone interview with the former member on February 24, 2023, at 12:38 P.M.  The review also included medical/pharmacy claim validation and enrollment confirmation.  At this time, no potential fraud was found to be associated with Mr. ******'s enrollment in Health First Health Plans.

• Initial Complaint

  08/05/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  Member ID OSC ******** Service Ticket ******* I have a max out of pocket of $6,900, I met that in January of 2022 and from that date Health First paid what they were supposed to. On July 18, 2022, they erased from their system the $6,900 that I paid to providers and started me over on what I needed to pay. I provided proof of what I paid through receipts from pharmacies and copies of my credit card transactions. The person I was dealing with Kelli (supervisor for Oscar) (Oscar processes the transactions for Health First) agreed that I met my max out of pocket. She said it was**** Caremark that maid the error and they were the one who had to fix it. **** Caremark backed me up acknowledging that I had made those payments, so there was nothing wrong on****'s side. At this point no one can go into the computer and fix anything. To this date I am responsible for $8,630.01, $1,730.01 over what I should be responsible, and I need to spend $5,228.10 more before insurance will start to pay.

  Business response

  09/16/2022

  Business Response /* (1000, 10, 2022/09/07) */ ***Document Attached*** Consumer Response /* (2000, 12, 2022/09/09) */ (The consumer indicated he/she ACCEPTED the response from the business.) They have refunded the money due to me. It took a long time for them to fix such an easy problem.

• Initial Complaint

  11/23/2021

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Hello, I purchased a health insurance plan through HealthCare.gov, effective 7-1-2021. The health insurance plan is a Health First Health Plan and also through AdventHealth. The plan name is AH Gym Catastrophic *** **** **** XXXXXFLXXXXXXX. My member ID is XXXXXXXXXXX. The member login portal is located at https://ahap.healthtrioconnect.com/. When you login, a message appears on the welcome screen where it shows "Click here to start earning rewards, including a $25 gift card for completing your Health Risk Assessment." So I after I clicked on the CafeWell button to take the assessment, it took me to CafeWell.com. This site has HealthFirst Health Plans at the top so its obviously through Health First. So I completed the Health Risk Assessment on November 16, 2021. It shows that Iearned the $25. So when I select a gift card of any amount $25 or under, it says I have zero points and won't let me redeem anything. So I have tried calling Health First (855-443-4735 and XXX-XXX-XXXX) X times from November 22 to November XX XXXX, but what happens is-you wait a long time and then no one ever answers and it offers you the survey then it disconnects you. It is so frustrating to say the least. I did speak with Health First phone rep Nicole on November 23 around 8:15 am and she had no idea how to help me. She referred me to call HealthCare.gov and of course their phone reps said they have nothing to do with me getting the gift card that Health First says you will get by completing the assessment. I also emailed customer support at CafeWell, but they never respond. So I just would like to request the BBB's help to get me my $25 gift card. I would prefer an Amazon $25 gift card to be mailed to me or sent digitally. This whole deal is so upsetting because this just shows if I had a health claim through Health First then I am sure I would have a hard time getting my rightful compensation with their awful service so I cancelled my 2022 renewal policy with them.

  Business response

  12/02/2021

  Consumer Response /* (2000, 6, 2021/11/23) */ Hello, I have decided not to pursue this case as I want to keep my health insurance through Health First next year. Hopefully, they will send me my $25 gift card. BBB, please close the case and thank you for your help.

*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. ↩