ComplaintsforElixir Insurance Company

• Initial Complaint

  12/22/2023

  Complaint Type:

  Order Issues

  Status:

  BBB unable to locate business

  More info

  December 21, 2023 Elixir was my Medicare D insurance until December 31, 2023. I lost me Medicare insurance on October 31, 2023. It was reinstated on November 20, 2023. Doing Open Enrollment for Medicare in October, I chose another Medicare D program call WellCare that starts January 1, 2024. I have to pickup five prescriptions and was told I had no presciption insurance. I called Elixir on December 10 and was told Elixir had dropped me because I had chosen another Medicare D company. I spent today $95.99 for five presciptions. CVS used a discount card or it would had been a whole lot more. I ususall spend $4.15 per presciption under Medicare. Elixir had no right to drop my presciption insurance the way they did.

  Customer response

  12/22/2023

  December 22, 2023

  I ONLY WANT THE COMPANY TO EXTEND MY COVERGE LIKE THEY ARE SUPPOSED TO UNTIL DECEMBER 31, 2023.

• Initial Complaint

  09/30/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I am in receipt of the fourth late payment notice for my Medicare Part D policy from Elixir Insurance. When I received the first one I called and was told they had not received my May 2023 payment. Since I pay both my premium and my wife’s via online transfer I knew it had been paid so I asked them to correct the error. It was not so I sent a copy of my bank statement showing the transfer information. There was no correction made yet again so after the third dun I used their online complaint system to explain their error again. The response was a letter that said if I was having difficulty paying my bill I could ask Social Security for help! I don’t need help paying a bill I do not owe! I just need someone at Elixir to correct their error! Now I have received a fourth bill from them as there seems to be no one capable of this correction. Please help! Thank you!

  Business response

  10/13/2023

  Elixir Insurance Company (Company) apologizes for the time and any inconvenience concerning the issue raised.  Company's Billing team has found the missing check.  The check was posted to a very similar id number with one-digit difference back on 5/31/23. This was due to human error
  
  Company's Billing team moved the payment over to the correct member, *** * ******** Complainant).  Now both members - Complainant and his wife - show a credit of $52.80 (those funds will be utilized when we bill for November premium payment on Monday, 10/16/23).  Members accounts' will be current after Monday, 10/16/2023. Thank you.

• Initial Complaint

  07/31/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Elixir Insurance raised my prescription premium nearly 300% from last year without notice. they said they sent out notices but from the testimony I've read many people didn't receive one either. I had to cancel my policy because I felt this was an exorbitant amount and had I gotten a notice there's no way I would have renewed my policy. Now I have no Prescription coverage and will be penalized when I enroll in another policy. Thank You

  Business response

  08/09/2023

  Elixir Insurance Company ("Elixir") is in receipt of the complaint where Complainant ******* ("Complainant") alleged that Elixir raised his prescription premium nearly 300% from the prior year without notice.  Per Elixir's records, the Annual Notice of Change ("****") was mailed to Complainant on 9/12/2022, the **** outlines the change in premium along with any other changes. Elixir spoke with Complainant on 6/7/23 and explained to Complainant the ******** guidelines around not enrolling in a ************ Elixir then confirmed that member was disenrolled from the Elixir plan on 5/31/23. Complainant had no further questions. Elixir considers the matter closed and hopes that the BBB has enough information to close its file as well. Thank you

  
  

• Initial Complaint

  05/18/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My insurance has Elixir as the ** pharmacy. I had my procedure done in September 2022. When the doctors office tried to bill Elixir, they denied the claim, even though its listed as covered in my insurance.I have filed a grievance and now an appeal. They want me to pay them and then reimburse me. Which doesn't make sense. They continue to give me the run around despite multiple phone calls from *****, my ***** **** myself. I am now in collections

  Business response

  07/13/2023

  [BBB transcription via email]

   

  Elixir is a pharmacy benefits manager and as such follows the instructions of its clients for processing and administering members prescription drug benefit. Elixirs **************** Team confirmed that they have been in contact with member and that as recent as May 18, 2023 Elixir confirmed that it does not pay the doctors office directly.  Elixir confirmed that the way the plan is set up, there is an option for direct member reimbursement (DMR), however, that would require member paying the claim and then submitting a DMR request to Elixir.  Elixir does cover the prescription at issue at 100% but only if the prescription is processed by the pharmacy, and not through the doctors office. All of this information has been relayed to Complainant. We hope that the BBB has sufficient information to close this complaint. Thank you.

• Initial Complaint

  05/08/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My medication refill request was denied for refill. This is unacceptable due to an unforeseen incident being that my home started on fire and all of my medication was in the home and needs to be replaced. Please help. Supervisor: Brianne Agent: Ciji Denied: doesn’t allow early refill/ doesn’t cover lost damage Request for override denied. Member ID: ********** Group: ******* BIN: ****** PCN: PartD Grievance Reference # **********

  Business response

  05/25/2023

  Elixir Insurance Company ("Elixir") is in receipt of the Better Business Bureau Complaint from Complainant A. Ramirez ("Complainant").  Elixir appreciates the opportunity to respond as follows: 

  The Elixir plan, a Medicare Part D plan, does not generally cover lost/stolen/damaged medications except in limited situations.  Yesterday, Elixir contacted Complainant to advise him of what would be required to satisfy the request - either a Fire Department report or a Home Insurance claim. Once Elixir receives that information from Complainant, the Elixir Medicare PBM Oversight team will review for approval. 

  Should Complainant have any other concerns, Complainant can reach out directly to Elixir. We hope that the BBB has received sufficient information to close its file. Thank you.

• Initial Complaint

  03/28/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Elixir Insurance increased my Premiums over 50% I was not given any notice. When I found out by receiving My credit card statement I complained to Elixer They told me i could not do anything and just to cancel my credit card Payment i did this and now they are having My Social Security cheque garnished in the amount of Sixty dollars a month I am only prescribed one drug that costs 12 dollars a month without Insurance Why should I pay 60 dollars a month

  Business response

  05/09/2023

  Elixir Insurance Company (“Elixir”) is in receipt of the BBB complaint from ** ******* (“Complainant”).  In the complaint, Complainant alleged that Elixir did not provide notice of the change in premium.

   

  Elixir is confirming that it mailed the Annual Notice of Change – which identifies all changes to a member’s plan including a change in premium – on 9/13/2022.

   

  On 01/23/2023, Elixir received the online disenrollment.  However, the disenrollment was denied because the request was done outside of the annual enrollment, and no qualification for an exception such as the Special Enrollment Period was provided.

   

  On 01/30/2023, Complainant requested to change the payments from credit card to Social Security Deduction and this request was accepted on 03/01/2023. Please note that such request can take up to three months to be accepted. While that request is being processed, members are still responsible for the premium payment.

   

  On 02/02/2023, we received a new online disenrollment and the disenrollment was denied for the same reason it was previously denied back in January 2023.

• Initial Complaint

  01/17/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I became eligible for ******** 10-22.My premium for Elixir part D was ***** in October, November, and December 2022. In January 2023 I received an invoice for a monthly premium of $60.10! My coverage TRIPLED in cost with no explanation! After speaking with an Elixir representative (I have his name), he stated a letter of increase was sent out in September 2022, but I did not receive it due to coverage not beginning until October! I want a special enrollment period to change *********** would anyone stay with them when you can get the same benefits from many other providers for under $20.00 a month! I would like resolution since I was told the increase letter was never sent to me. I intend to file a complaint with my states QIO, and ******** needs to investigate this company. To all the other complainants, how about a class action lawsuit? They are taking advantage of seniors, knowing most cannot change plans until open enrollment in October. Highly unethical company!!!

  Business response

  02/01/2023

  Elixir Insurance Company ("Company") is in receipt of the complaint from L.  **** ("Complainant") where Complainant stated that Company failed to provide advance notice of the premium increase from plan year 2022 to plan year 2023.Elixir appreciates the opportunity to respond as follows:
  
  As background, Company is a ******** Part D plan sponsor and as such, Company must adhere to Centers for ********& ******** Services ("CMS") rules and regulations. Specifically, with respect to the Complaint at issue, CMS requires Part D sponsors to send Annual Notice of Change ("****") documents to all applicable members. The **** must outline specific information about the plan including premium information. Company's records show that Complainant enrolled on September 19, 2022 for Initial Enrollment Period of 10/01/2022 and that the **** was subsequently sent to Complainant on October 5, 2022,Company mailed **** to the address that Company had on file for Complainant.

  
  In short, the Company met its obligations to Complainant consistent with CMS standards and requirements. We hope that the information provided is sufficient for the BBB to close its file with respect to this complaint. Thank you.

• Initial Complaint

  12/30/2022

  Complaint Type:

  Delivery Issues

  Status:

  Resolved

  More info

  Never notified of a 150% ******** Part D coverage increase for 2023. Elixir claims automatic notification but none was received as claimed. Most comparable plans had premium reductions or slight increases.

  Business response

  01/30/2023

  The business requests the consumer's date of birth and Member ID so that it can pull up his file.

  Customer response

  01/31/2023

   I am rejecting this response because:
  
  not an answer. a request for more information. here is the information requested: DOB **********. Member ID: **********

  Business response

  02/01/2023

  Elixir Insurance Company ("Company") is in receipt of the complaint from **  ***** ("Complainant") where Complainant stated that Company failed to provide advance notice of the premium increase from plan year 2022 to plan year 2023.Elixir appreciates the opportunity to respond as follows:
  
  As background, Company is a ******** Part D plan sponsor and as such, Company must adhere to Centers for ********& Medicaid Services ("CMS") rules and regulations. Specifically, with respect to the Complaint at issue, CMS requires Part D sponsors to send Annual Notice of Change ("ANOC") documents to all applicable members. The ANOC must outline specific information about the plan including premium information. Company's records show that on September 14, 2022,Company mailed ANOC to the address that Company had on file for Complainant.
  
  In short, the Company met its obligations to Complainant consistent with CMS standards and requirements. We hope that the information provided is sufficient for the BBB to close its file with respect to this complaint. Thank you.

  Customer response

  02/03/2023

   I am rejecting this response because:

  while there may have been a single mailing, it is very likely that that one particular piece of mail was lost by **** and never delivered. Since Elixir does have an email address on file and does use it for various communication, why was an email not sent in addition to a single piece of paper mail?

  I find it odd that there was no email communication of such a large payment increase (favoring ELixir) but the company relies on a single paper mailing.
  

  
  

  Customer response

  08/22/2023

  [BBB - Response by phone.]

  The business allowed the consumer to change his service, so he feels the matter is resolved.

• Initial Complaint

  12/29/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Elixer has just surprised me by tripling my monthly premium, increasing it from $20.30 to $64.90. This surprise came to me by ground mail on Christmas Day (12/25/2022). My husband and I immediately phoned Elixir and reached a customer service representative. This Elixir representative confirmed the increase and insisted that Elixir had mailed customers prior notice of this increase back in September. My husband and I replied that we never saw this prior notice and do not want to continue with this insurance at this bloated rate. Elixir’s representative advised us that nothing could be done about this problem because ********’s open enrollment period closed on December 7. Immediately after concluding this phone call, we went online and completed a ******** Fraud complaint.

  Business response

  01/27/2023

  Elixir Insurance Company ("Company") is in receipt of the complaint from *. ****** ("Complainant") where Complainant stated that Company failed to provide advance notice of the premium increase from plan year 2022 to plan year 2023. Elixir appreciates the opportunity to respond as follows: 
  
  As background, Company is a ******** Part * plan sponsor and as such, Company must adhere to Centers for ******** & ******** Services ("***") rules and regulations. Specifically, with respect to the Complaint at issue, *** requires Part * sponsors to send Annual Notice of Change ("ANOC") documents to all applicable members. The ANOC must outline specific information about the plan including premium information.  Company's records show that on September 12, 2022, Company mailed ANOC to the address that Company had on file for Complainant.  On page 5 of the ANOC, company identified the changes to Complainant's monthly premium in a section titled "Changes to the Monthly Premium."  In that section, Company specified the monthly premium of $20.30 for 2022 versus the monthly premium of $64.90 for 2023. 

  Company hopes that this information is sufficient for the BBB to close its files. Thank you. 

  Customer response

  01/27/2023

  I am rejecting this response because:
  This problem was resolved, but NOT by Elixir.  It was resolved by ********, which granted me a Special Enrollment period that allowed me to choose a plan from another plan sponsor.  Meanwhile, I understand that others who have confronted this problem have not been able to resolve it.  With this in mind, I have advocated that plan sponsors do more to avoid this problem, such as (1) providing the notice on bills (both online and by ground mail) sent to their clients and (2) providing clients the means of acknowledging receipt of notices sent them.  In other words, this system of providing notices is currently an open-loop system whereas, considering the consequences of errors (such as lost mail) it needs to be a closed-loop systerm
  
  

• Initial Complaint

  10/17/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Elixir is a Part * ******** insurance providing company. the family member that has their insurance is an Alzheimers patient that is on hospice in a skilled nursing facility in ************ ** Trying to end this insurance policy has proven fruitless; including trying to contact the company online and HOURS on the phone on hold. we sent a letter to the company with no response. my name is ********************************* ******************** ************) The patient / insured's name is *****************************. Any advice you can give would be greatly appreciated

  Business response

  11/23/2022

  To Whom It May ************************************ are in receipt of the complaint from ****************** ("Complainant") to disenroll ******************. I am confirming that the easiest way for a member to disnroll from his or her current ******** Part D plan is to sign up for another plan of their choice. The Centers for ******** & ******** Services will automatically disenroll a member from Elixir Insurance Company once that member enrolls in another plan. Members may also disenroll from the plan any time from October 15th - December 7th by submitting a disenrollment form. Thank you. 

   

  *************************;

*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. ↩