Complaints
Customer Complaints Summary
- 18 total complaints in the last 3 years.
- 6 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe 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.
Initial Complaint
Date:07/10/2025
Type:Status:AnsweredMore info
Complaint statuses
- 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 claim to allow 4 periodontal cleanings and 2 dental cleanings per year. They then downgrade your periodontal cleanings (use the same code) to dental cleanings having you exhaust your dental cleaning bene fits'. This is a first for me after 19 years of dental insurance coverage. I was told by at least 3 claim supervisors that they did not understand why this claim was being denied. I was also told I could not alternate perio and dental visits, and I did not time my visits properly. This has been a deny at every turn claim even after I was told it would be paid.
Business Response
Date: 07/18/2025
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint is being investigated, and outreach to the appropriate parties will be made once the resolution is finalized. To prevent the release of protected health information (PHI),the Plan is unable to disclose the details of the investigation or communications with the member.Customer Answer
Date: 07/21/2025
I had 2 periodontist cleanings that were both covered. I had 1 dental cleaning that was covered and 1 that was denied. The plan offered 2 dental cleanings and 4 periodontal cleanings. Both providers assure me that neither of them did any services that are not within their customary scope. No other claims were submitted for 2024. They both feel periodontal codes were changed and made into dental codes so that the dental benefits were exhausted. Periodontal cleanings (done by the periodontist) and dental cleanings (done by the dentist) have different codes and are different procedures, No one would believe that if you are allowed 4 periodontal cleanings and 2 dental cleanings and only see the periodontist twice and the dentist once that your second dental cleaning claim would be denied because your claims were exhausted.Business Response
Date: 07/23/2025
The complaint has been investigated and outreach attempts to the appropriate party have been made. We will pursue additional attempts with the party. To prevent the release of protected health information (PHI), we are unable to disclose the details of the investigation or communications with the party. The outcome and resolution will be communicated directly with the appropriate party.Customer Answer
Date: 07/23/2025
What does that response mean? I am the party and there have been. no attempts to reach me. I do not understand the response.Business Response
Date: 07/28/2025
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint has been investigated and outreach to the party has been made. To prevent the release of protected health information (PHI), the Plan is unable to disclose the details of the investigation or communications with the member. The outcome and resolution has been communicated with the party.Customer Answer
Date: 07/28/2025
Complaint: 23580924
I have reviewed the business' response and am rejecting it because:
I was notified today by essencehealthcare that they will pay the claim. I am very happy with that news.But I will wait until my ******** provider receives this payment before signing off. Thank you.For all of your help in this matter
Sincerely,
******* ******Initial Complaint
Date:06/05/2025
Type:Status:ResolvedMore info
Complaint statuses
- 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.
April ******* I was out of town visiting relatives missed a step and fell forward body hitting ground hard. Started having sharp pain chest hurting when I breath. I was taken to Patient First an *********** by In ************* it was closet in area. So I gave my Essence insurance card to copy for billing. So I got a bill from Patient first in May I called essence spoke with *** to see was this claim being processed but no it wasnt so the Essence *** called Patient First and said we will have to request her records before it is paid. And asked can this be put on hold tilled it is sorted out so as not to go to collections on patient they gave a 60 day hold. After 60 days got another letter saying they want payment called essence the 2nd time. Essence said they need records they gave me a 30 day hold. So this would be the 3rd time i called Essence after I got a bill again Essence said we never got records so they gave me another 30 day hold. After 30 days i got another bill from them called Essence again they asked for records. So June 2 2025 I got another bill from Patient First say this bill is due by June *******. So this has been a whole year going back and fourth with ******** about this bill. On June 2, there was a claim put in for this bill so by June 17 this bill is going to collections I dont have $906 laying around Iam on SSI and money is being taking out monthly to pay the claims. Called on June 4th spoke with ****** requesting to find out if the claims was working the bill since I have lest that 14 days to get it paid. She said she saw only 1 claim filled on June 2 and they werent working on it yet told her ***** had placed this June 2 with a level of urgency. Since I have been calling to get this claim paid she only sees 1 claim filed. But this is way they are demanding I pay this bill because Essence keeps stalling say they are waiting on records 1 claim was filed I was told have been calling since May 2024. Very frustrated with Essence.Business Response
Date: 06/11/2025
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint is under active investigation and outreach to the appropriate parties will continue through resolution of the issue. To prevent the release of protected health information (PHI), the Plan is unable to disclose the details of the investigation or communications with the member.Initial Complaint
Date:05/19/2025
Type:Status:AnsweredMore info
Complaint statuses
- 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 Fall the Wife needed new dentures Oct 16, 2024. The dentures was approved for payment to the dentist. Now, the insurance company isn&#**;t covering the expense for the dentures. My wife had to get some hip replacement and other medical procedure done before she can get the dentures. The policy number-Members-********* and the group number#M0000001. and the insurance is still effective. I want my wife dentures to be pay for as this procedure.Business Response
Date: 05/23/2025
The complaint has been investigated and outreach attempts to the appropriate party have been made. We will pursue additional attempts with the party. To prevent the release of protected health information (PHI), we are unable to disclose the details of the investigation or communications with the party. The outcome and resolution will be communicated directly with the appropriate party.Initial Complaint
Date:04/08/2025
Type:Status:AnsweredMore info
Complaint statuses
- 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.
Essence policy required specialist for diabetic eye exam, which I used one in their network. They also only allow one Vision visit per year. In the process of the diabetic eye exam the provider did an eye refractive test to determine needed prescription for glasses. When it was submitted Essence paid all but the refraction charge, stating it needed to be done by a "Routine Vision Provider" which would have required a second vision visit to a provider which is not allowed under policy. It makes absolutely no sense to have a diabetic eye exam and NOT be able to determine a prescription for glasses. Also last week I could access my claims and history on their website, and today everything is blocked! I have no access to my history with them.Business Response
Date: 04/11/2025
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint has been investigated and outreach to the appropriate parties has been made. To prevent the release of protected health information (PHI), the Plan is unable to disclose the details of the investigation or communications with the member.Customer Answer
Date: 04/24/2025
Complaint: 23175379
I have reviewed the business' response and am rejecting it because: They did not make a decision all they said was they referred it to someone. Again poor customer service on their part. Guessing they are going to keep referring it until it goes away.
Sincerely,
***** *******Initial Complaint
Date:01/03/2025
Type:Status:ResolvedMore info
Complaint statuses
- 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 have a Essence ******** advantage plan.On 12/16/2024 attempted to get refill of my Dexcom G7 sensors from CVS. When I called CVS to check status of the refill on 12/26, i was told there the refilk was not done because there an lssue with my insurance(Esscence Healthcare) and my doctor that was being addressed and CVS would call me back when refill was ready. On 12/30/2024 i checked with CVS and refill was still not ready due to insurance issue. I contacted ****************** to see what issue was, and was told that they did not have a current Prior Authorization. When i inquired what was that,I was rudely told that that prior auth is only good for 6 montbs and my old prior auth expired around 12/14.and my doctor needed to submit a new one. Contacted my doctor on 12/31 (via mychart message) to have them submit prior auth. Recieved message from doctor office saying they attempted to do tge prior auth with esscence but recieve message saying I had not active coverage. Contacted Esscence to verify my coverage was active and they suggest having doctor do the prior auth via phone. Relayed this info to doctor and recieved message from doctor stating that prior auth was pending & insurance wanted ** notes from last visit(whiched was faxed over). Then reccievef callfrom esscence stating prior auth was denied. Called Esscence to find out why it was denied. I explained that i am a diabetic on a insulin pump which uses the *** readings to help decide my insulin dosage,including to help keep my blood sugar from dropping dangerouly too low. (a problem with insulin pumps if you receive too much insulin). The *** did not give a reason why the prior auth was denied but promised that it would be escalated since my insulin pump depends on the ***. Not sure why ******** denied prior auth ,especially since they had approve one in June 2024 and no major change to my health. It should not take 2 week to refill a *** sensors( running low and is vital to monitoring my diabetes)Business Response
Date: 01/10/2025
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint has been investigated and outreach to the appropriate parties has been made. To prevent the release of protected health information (PHI), the Plan is unable to disclose the details of the investigation or communications with the member.Customer Answer
Date: 01/12/2025
Better Business Bureau:
I have reviewed the business' response regarding complaint ID ******** and am satisfied with this resolution.
Sincerely,
*********************************Initial Complaint
Date:03/28/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 joined Essence Healthcare PPO in January 2024. I sincerely regret doing so! While I realize they are new to ********, the provider directory they represent is a fraud. I have tried to use a dentist, four dermatology practices, and receive prescription eye glasses at ******** which is the only eyeglass provider listed. While all of these providers were listed in the "directory", NONE of them have ever heard of Essence Healthcare nor did they accept it as insurance coverage! With respect to the dermatologist quest, I have spoken with Essence **************** three time begging them to find me a dermatologist who accepts this insurance. They have never followed back up with me.They also offer $500 a year for over the counter expenses. This is a joke as the card is either defective, or providers like ******* or ********* have never heard of them. I have spoken with Essence regarding the fact that my card does not work. They promised to mail me a replacement card two weeks ago. So far, nothing has arrived.I cannot believe how they could boast a "5-Star" rating when my experience with them has been just horrible!Business Response
Date: 04/04/2024
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint has been investigated and outreach to the appropriate parties has been made. To prevent the release of protected health information (PHI), the Plan is unable to disclose the details of the investigation or communications with the member.Initial Complaint
Date:03/25/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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.
When I spoke to an Essence Healthcare representative in December 0f 2023 in preparation for picking a ******** plan for 2024, I was told that the Essence Healthcare Flex Card had a quarterly amount of $625, resulting in an annual amount of $2500. I recently was told by Essence that the amount has now changed to only $1500 annually. The $2500 I was originally quoted on the phone in December was apparently the wrong amount. I'm not sure if this was done intentionally or accidentally, but either way it affected my decision to choose this particular health care plan.Business Response
Date: 04/01/2024
The complaint has been investigated and outreach has been made to the appropriate party to understand the concern. To prevent the release of protected health information (PHI), we are unable to disclose the details of the investigation or communications with the party. The outcome and resolution will be communicated directly with the appropriate party once the investigation is complete.Initial Complaint
Date:03/15/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 received a $110 card as a benefit of being a customer of this company. When I tried to use it, the card does not work.Business Response
Date: 03/21/2024
The complaint has been investigated and outreach attempts to the appropriate party have been made. We will pursue additional attempts with the party. To prevent the release of protected health information (PHI), we are unable to disclose the details of the investigation or communications with the party. The outcome and resolution will be communicated directly with the appropriate party.Customer Answer
Date: 11/18/2024
I was never contacted by the business, my issue is not resolved.Business Response
Date: 11/26/2024
The complaint has been investigated and outreach attempts to the appropriate party have been made. A letter of resolution has also been mailed to the party. We will pursue additional outreach attempts with the party. To prevent the release of protected health information (PHI), we are unable to disclose the details of the investigation or communications with the party. The outcome and resolution are communicated directly with the appropriate party.Initial Complaint
Date:01/22/2024
Type:Status:AnsweredMore info
Complaint statuses
- 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 have my Beneflex card through Essence Healthcare and I tried to purchase strawberry Glucerna and they didn't have it. All they have is vanilla and chocolate and ******* would not pay for it. They said it will take 30 days to look into my account to see why it's not approved. Glucerna is an over the counter item.
I would like for them to enter it into their system so I can buy it at *******.Business Response
Date: 01/29/2024
We appreciate your notification of this complaint
as we take concerns from our members seriously. The complaint has been
investigated and outreach to the appropriate parties is in progress. To
prevent the release of protected health information (PHI),the Plan is unable to
disclose the details of the investigation.Initial Complaint
Date:09/11/2023
Type:Status:ResolvedMore info
Complaint statuses
- 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 switched my healthcare to Essence in August. Applied for the the first card August 10. Here it is a month later, and still no card, despite requesting a second one 10 days ago. My effective date was to be September 1. I called customer service, they directed me to the website to print out a temporary card. Didn't work. What use is the website application if it doesn't work? A third card requested--I requested it be sent expedited. **************** says they can't do that. Not much customer service--especially since I'm in the same town as their headquarters.Business Response
Date: 09/14/2023
Hello,
We appreciate your notification of this complaint as we take concerns from our members seriously. The complaint has been investigated and outreach to the appropriate parties has been made. To prevent the release of protected health information (PHI),the Plan is unable to disclose the details of the investigation or communications with the member.
VP Internal Audit and Chief Compliance Officer
Customer Answer
Date: 09/20/2023
Hello. I received my insurance cards through the regular ***** not expedited. I suspect these are the cards that were requested in AUGUST.
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