ComplaintsforElixir Insurance Company

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Initial Complaint
02/17/2022
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
My problem is with Elixir Insurance, **** **** ****** *** ***** *** ********** ****. As of January 1st 2022 my policy with Elixir was canceled, I chose another Medicare plan. Elixir sent me a letter stating this. All of my payments for 2021 were received by Elixir except for January 2021. After speaking with my bank I was told Elixir never cashed that check. I have sent another check to cover that payment. I mailed that payment on Monday, February 14, 2022. With that check/payment I assumed my obligation to Elixir has been fulfilled. However, today February 17, 2022 I received a bill for $42.70 !! I've had my bank print out copies of all the checks Elixir has cashed and I've sent these copies to Elixir. It has been so difficult dealing with this company. It has truly been a horrible experience. Upon receiving of my payment of $14.30 for January 2021 I would request that elixir take me out of their Medicare system. I would also request a letter of apology from Elixir.
Business response
03/28/2022
(BBB transcription of email from business)
I tried to respond but it was not allowing me to. Our records show that Elixir Insurance sent two invoices to the Complainant on 12/17 and 1/25 for balances due of $50.80 and $14.30, respectively. It is possible that another Elixir entity, i.e., ****** ******** may have sent the invoice for $42.70 but we cannot say for certain. In any event, Complainant’s check for $14.30 was posted to her plan on 2/24 and she now has a zero balance due. Thank you.

Customer response
03/28/2022
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Initial Complaint
02/17/2022
Complaint Type:
Service or Repair Issues
Status:
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.
In January 2022, Elixir increased my premium from $16.00 month to $72.00 a month, a 400% increase. 4 1/2 times last years price. Clearly a bait and switch, aimed at Seniors who have the most to lose. Since this is Medicare, you can not just drop the insurance, as it will incur a life long penalty. So I am stuck the policy until next Open Enrollment. I contacted Elixir Customer Service multiple times in attempt to switch to a lower cost plan but no resolution. I was told the prices were competitive with other companies. However this claim is false, the average price of **** * Medicare is $33.00. Elixir will claim they sent notice of the increase, however, there are numerous reports to BBB with same complaint, so I suspect this claim is false as well. I don't expect Elixir will be able to operate at these high prices for long and when next years Open Enrollment comes along, most people will change to a more reasonable plan. Elixir will then drop the price again and lock people in only to repeat the scam in a couple of years. Stay away from this company, they prey on the elderly.
Business response
03/18/2022
Elixir Insurance Company ("Elixir") is in receipt of the BBB complaint received from member ** ****** ("Complainant"). Elixir appreciates the opportunity to respond as follows:

Our records show that an Annual Notice of Change ("ANOC") was mailed out to member on September 8, 2021. We do note that the mailing address on the ANOC is different from the mailing address that Complainant provided in his complaint. We do note that an update came through the member's online portal on 6/27/2020 to have the address updated. However, a little more than a year later, on 7/19/2021, Elixir received a file from the ******* *** ******** * ******** ******** ("***") to have the address changed to the address we sent the ANOC. If there was an error in the mailing address that would be something to address with ***.

We hope this information is sufficient for the BBB to close its file. Thank you.
Customer response
03/20/2022
I am rejecting this response because:
I find it unacceptable that an increase of 400% was handled using US Mail with no way to confirm whether the notice arrived or not. I receive numerous emails from Elixir on various subjects, but the one time it is of most importance to ensure information was shared, Elixr choses to use US Mail where there is no way of proving whether they sent. Elixr clearly wanted to hide this rate change because given all the information most people would have dropped Elixr as there are a number of plans for far less with the same benefits. Given there are numerous complaints filed with BBB with same circumstances I question if the notice was really sent.
Initial Complaint
01/31/2022
Complaint Type:
Service or Repair Issues
Status:
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.
These people doubled my Medicare monthly premium after the enrollment period was over in January 2022. They never sent me anything telling me they were going to do this . If they did I would have changed my insurance during the enrollment period of October 3021 to December 15 2021.
Business response
02/25/2022
Elixir Insurance Company ("Elixir') is in receipt of the complaint from Mr. **** and responds as follows. Complainant is correct that there was an increase in his Medicare Part D plan premium. Elixir communicated the change in premium to all members when it mailed out the Annual Notice of Changes. A member from the Elixir Member Billing team will reach out to Mr. **** regarding the premium increase. Thank you.
Customer response
02/25/2022
I am rejecting this response because:

They never sent me anything if they had I would have gotten another insurance through open enrollment. I knew nothing of the increase until January payment . By then open enrollment was closed . It’s not the first time they have failed to send me notifications. On at least two occasions they failed to send my monthly bill to me , and I had to email them on both occasions. These people are wrong and they know there wrong ! Why would I put myself through this . It’s not that hard to change insurance during open enrollment, and that’s what I would have done . I have no use for this company . As far as I’m concerned there a bunch of crooked liars .
Initial Complaint
01/07/2022
Complaint Type:
Order Issues
Status:
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.
Elixir Rx Insurance is UNETHICAL and a usurious company. BBB needs to look into their unethical practices. They have (with no notice to me, no agreement on my part) raised the monthly premium for their Rx Insurance 300% -- yes that's right THREE HUNDRED PERCENT!!! They never asked me if I agreed to this, never contacted me at all to let me know about this obscene raise in premiums. They are the most unethical, sloppy, uncaring company and should be fined for their unethical practices.I am contacting my bank tomorrow to get the January charge of $49 reversed. As I said, I NEVER agreed to this. AND at this time when everyone is struggling, these low lives decide to emulate that criminal Epi Pen company and EXTORT consumers. It is usury plain and simple.I will find another more ethical company for my medication insurance.
Business response
01/28/2022
Elixir Insurance Company is in receipt of Ms. ******** Better Business Bureau Complaint. Elixir has reviewed the complaint and appreciates the opportunity to respond as follows:

****************** is correct, there was an increase in premiums for the Elixir Insurance Company *********** that she is a part of. The change in premium, however, was not 300 times that of the original premium. Specifically, page 1 of the Annual Notice of Changes (ANOC) identified the change in the monthly premium from $15.60 to $51.50. If that increase was not satisfactory, ****************** was notified via the cover page of the letter that ******************, had from October 15 until December 7 to make changes to [her] ******** coverage for [the] next year.

We hope that the above information is sufficient for the Better Business Bureau to close its files.Thank you.
Customer response
02/01/2022
I am rejecting this response because: I never had any prior notice from Elixir of an increase. They raised the premium MORE than THREE TIMES the current rate. What kind of company does this? AND Elixir also has a $480 deductible!! They are beneath contempt. I've left this disreputable organization.
Initial Complaint
01/05/2022
Complaint Type:
Customer Service Issues
Status:
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.
I was not notified of a triple increase in premium amount until after open enrollment for part d ******** ended. I contacted ******** and they said this was a negligent Marketing practice, but Elixir will not allow me to switch to a cheaper plan. Their business practice is taking advantage of senior citizens on fixed budgets. All I requested was a slightly cheaper plan as every dollar counts for retired individuals.
Business response
01/26/2022
(BBB transcription of emailed response from business)
Elixir Insurance Company is in receipt of ****************** Better Business Bureau Complaint. Elixir has reviewed the complaint and appreciates the opportunity to respond as follows:
****************** premium for the Elixir Insurance Company *********** increased. However, the new premium is not 3x that of the 2021 premium. In fact, Elixir mailed out an Annual Notice of Changes (ANOC) which identified the change in monthly premium from $15.80 to $36.80. The cover page of the letter noted that ****************, had from October 15 until December 7 to make changes to [his] ******** coverage for [the] next year. Given that Elixir had not received any request for changes by ****************, coverage continued under the new monthly premium of $36.80.
We hope that the above information is sufficient for the Better Business Bureau to close its files. Thank you.
Initial Complaint
12/24/2021
Complaint Type:
Product Issues
Status:
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.
December 20, 2021 Receipt of Bill I am a Senior with Medicare Part D with company Elixir. Shocked to open a bill indicating that it will go up for 2022 from $15.50 to $51.50 monthly. Without warning. When I called them, they said that they had sent a warning about this in September. If they did, I never received it, because I certainly would have changed insurances. I think an increase like this should be deamed illegal. Thank you for your resolution in this matter.
Business response
01/20/2022
(BBB transcription of email received from business)
Elixir Insurance Company is in receipt of Ms. ******** Better Business Bureau Complaint. Elixir has reviewed the complaint and appreciates the opportunity to respond as follows:

Ms. ****** is correct, there was an increase in premiums for the Elixir Insurance Company Part D Plan that she is a part of. Also as Ms. ****** stated, she is correct that our company mailed out an Annual Notice of Changes. The cover page of the letter noted that Ms. ******, had “from October 15 until December 7 to make changes to [her] Medicare coverage for [the] next year.” Specifically, page 1 of the Annual Notice of Changes (“ANOC”) identified the change in the monthly premium from $15.60 to $51.50.

We are working with our mailing vendor to see if we can obtain confirmation on the exact date in which the ANOC was delivered. However, we are certain it was mailed to Ms. ****** and as the ANOC indicated, if she had any desire to change Part D plans, she would have had to do so within the timeframe provided in the ANOC consistent with Centers for Medicare & Medicaid Services.

We hope that the above information is sufficient for the Better Business Bureau to close its files. Thank you.
Initial Complaint
10/29/2021
Complaint Type:
Order Issues
Status:
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.
The *** Foundation has been picking up the cost of my ********. I pay no co-pay and have pharmacy receipts to prove it. However, Elixir has used almost $*** in co-pays against my doughnut hole. They said even though a foundation is paying for the medication, it still goes against the doughnut hole. That makes no sense. In certain aspects, they are actually double billing that way. I found this out when I tried to get another medication filled and they said I was in the doughnut hole. I have not been in the doughnut hole for 7-8 years so I was stunned. Then they said I had been in the doughnut hole by 5/11/21 which means their records show that I used $**** in drug costs by May, 2021. Ridiculous. If the *** Foundation is paying Elixir Insurance for the medication, then it seems highly unethical that they should turn around and list me paying a co-pay (when I pay none) of $***, $***, $***, and $***.) Why are the copays different? This is all suspect, and I don't for a minute believe I'm in the doughtnut hole, I don't get that many prescriptions because I'm intolerant to meds The ******** is paid solely by the *** Foundantion but Elixir is acting as if I paid the co-pays and the Elixir paid over $**** twice. The whole billing isn't even consistent.
Business response
11/23/2021
Elixir Insurance Company has reviewed the complaint an* has determine* the following:
1. Complainant *. ***** ("Complainant") is a member of an Elixir Insurance Company ******** **** * plan. The plan is therefore governed by the Centers for ******** and Medicaid Services rules. Complainant has Low Income Subsidy Level 4 also known as Extra Help and the medication referenced in Complainant's complaint has been processed correctly under her plan with the Extra Help.

2. Our team has checked to determine if Complainant is a **** of the Pharmacy Assistance Program ("PAP") in addition to the Extra Help to facilitate with costs of the drug at issue, and we have confirmed she does not have PAP.
3. We have also confirmed that there are no Coordination of Benefits from another plan. The last record of a Coordination of Benefit was from 8/1/2011. It is possible that the payments were lower in the past as a result of the Coordination of Benefits.

4. It is correct that Complainant's ******** drug plan has a coverage gap, also known as the "Donut Hole"). This means that there is a temporary limit on what Complainant's plan will pay/cover for drugs. An individual enters the donut hole when the combination of what the member has paid plus what the pan has paid is over a threshold amount for covered drugs. For the 2021 plan year for instance, if the total amount paid by the plan an* member reaches $4,130, then the member hits the coverage gap. Per company records, Complainant entered into the donut hole after the 5/11/2021 Rx date was processed. At that time, a total of $******** was paid out which consists of $******** paid by the plan an* $****** paid as copayments by Complainant.

Based on the foregoing, the information provided to Complainant that she is currently in the donut hole/coverage gap is accurate and true. Elixir is adhering to the CMS rules with respect to the application of the donut hole/coverage gap. We hope that the information provided is enough for the BBB to close its file for this complaint. Thank you.
Customer response
11/24/2021
I am rejecting this response because:

The response from Elixir is untrue. Coordination of Benefits from another plan were through the *** Foundation. I made that very clear in every phone call & correspondence. I didn't pay anything as my RX receipts prove. The *** Foundation paid it. This insurance company doesn't seem to know what is going on..
Business response
12/06/2021
Elixir maintains its position with respect to Complainant currently being in the GAP stage. Elixir has no additional information to provide. Thank you.
Initial Complaint
09/02/2021
Complaint Type:
Billing Issues
Status:
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.
December 2020, called Envision/Elixir to cancel/dis-enroll Part D insurance beginning January 2021. The representative assured me this would be taken care of and to expect a dis-enrollment form. I called in January, February, March and April of 2021 because Elixir continued to bill me. I did not receive the dis-enrollment form and the representative told me to fill out the online form. Eventually, I received a letter from Elixir stating that I will be dis-enrolled starting 02/01/2021. I requested January 2021, but the bills stopped and all was okay. Then the bills started coming again, July 2021, August 2021 and now September 2021. Could you intercede on my behalf and request Elixir to stop billing me? Thank you.
Business response
09/27/2021
Elixir Insurance Company is in receipt of the complaint from Ms. ******. Our team has reviewed and has determined that due a new system being used by Elixir Insurance Company, Ms. ******’s complaint was stuck in a pending status resulting in the creation of new bills. The billing team is aware of the issue and has been working on refunding or writing off premiums for individuals due to this error for the months prior to August. We apologize for the inconvenience and ask that Ms. ****** disregard such bills. In regards to the disenrollment that Ms. ****** submitted, our records indicate the following:

·         On 12/06/2020, the member called Elixir Insurance Company to check the premium balance and requested a disenrollment

·         On 02/20/2021, Elixir Insurance Company received the disenrollment request via an online submission. However, the disenrollment form did not have applicable SEP (Special Enrollment Period) and was therefore denied.

·         On 04/01/2021 The disenrollment was received again and due to the system error back in December it was re-submitted.

The member was dis-enrolled on 8/31/2021.

Thank you.
Customer response
10/06/2021
I am rejecting this response because:

More clarification is needed in regards to my actual dis-enrollment date. Per Elixir response, it appears my request for dis-enrollment was caught up in the new system being implemented by Elixir. The response also stated that "The member was dis-enrolled on 8/31/2021." I recently received a letter from Elixir (dated September 27, 2021) that stated "You will be disenrolled starting 09/01/2021." I am confused as to why my dis-enrollment date is not retro back to my initial request for dis-enrollment. Also, in April 2021 I received two letters that stated "You will be disenrolled starting 02/01/2021." My dis-enrollment date should reflect retro back to my initial requested date. By the way, I received another Elixir bill on October 5th. Regards!
Business response
11/02/2021
(BBB transcription from email received from complaint handler)

My understanding is that there was an ongoing system error that resulted in the member being billed. Member can disregard the bills. In our system, we have updated to reflect a $0 balance owed. Member should not receive any additional billings. With respect to the disenrollment date, it corresponds to the date it was approved and that is after we received the disenrollment request with an accompanying approved SEP reason for disenrollment. Thank you.
Initial Complaint
08/23/2021
Complaint Type:
Product Issues
Status:
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.
In December of 2020 I asked to have my account cancelled. I noticed that they had not done so by March. I contacted them and they said they would look into it. They did not. I called the in April to ask them what they were doing. They said they would get it cancelled and send me a refund after I threatened to report them. They sent me 4 months premiums of a total of *****. Today I got 2 letters from them; 1 dated August 10 where they state that I was disenrolled on 01/01/2021. The other is dated Aug 12 and it states that I would be disenrolled 07/01/2021. I checked with ******** and they said that they show disenrollment 07/01 and they would take out for up to 3 months. I just called them and spoke with a lady who said she would look into it and asked for a call-back number in case we got disconnected which seemed inevitable. We are now in the 9th month and they are still either hopelessly bumbling or just trying to stall me out. It's not a lot of money and I'd like it back, Thanks D
Business response
09/27/2021
Elixir Insurance Company is aware of the complaint from **************************. Our team has reviewed and has determined that due a new system being used by Elixir Insurance Company, Mr. ************ complaint was stuck in a pending status resulting in the creation of new bills. The billing team is aware of the issue and has been working on refunding individuals due to this error. We apologize for the inconvenience and ask that ************************** disregard such bills. Elixir Insurance Company has already refunded ************************** on June 17, 2021 in the amount of $57.20 and Elixirs billing team is working on refunds for *** and June premiums as well. Thank you.
Initial Complaint
07/30/2021
Complaint Type:
Service or Repair Issues
Status:
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.
I am insured with Elixir Insurance Company for my ******** **** * drug program. I have been trying to speaking to a supervisor and have been prevented from doing so. I have Elixir's own statement showing that I have met my yearly deductible (I have paid over $500 and the deductible is only $400). Never the less, Elixir refuses to correctly account for this deductible and and wants me to pay even more and will not address this issue despite over 4 hours o the phone with them. They promise to phone back and so one ever does.
Business response
08/18/2021
Elixir Insurance Company is in receipt of the complaint for **************** ("Complainant"). Elixir appreciates the opportunity to respond to the Complainant's concerns.
First, for the plan that Complainant is a part of the deductible is listed as $445.00 for drugs that are in the Tier 3 - Tier 5 categories. Based on company records, Complainant's total out of pocket in copayments through August 14, 2021 is $661.28. The total applied toward the deductible was $423.50. Please note that Tier 1 and Tier 2 copayments do not apply to the deductible (Complainant has 5 of 11 medications in the Tier 1 and Tier 2 categories).
The reason why Complainant is told that she has and then that she has not met her deductible is due to the fact that claims are constantly processed and then reversed. Therefore, Complainant will meet the deductible when claims in the applicable tiers are processed but then once the prescriptions are reversed, Complainant is back in the deductible stage. Company records show 6 different reversals in the system that helped put Complainant back into the deductible phase where it then showed that Complainant has not yet met her deductible. We hope that the foregoing information helps to provide the necessary clarity for the BBB to close its file. Thank you.
Customer response
08/30/2021
You did not receive a reply from me only because this is the first communication that I have received from you since I filed my complaint. My complaint has not been resolved. I am still unable to communicate with anyone from Elixir who is able to provide me with accurate and truthful information.

Business response
09/02/2021
Elixir Insurance Company has no additional information to provide. The company maintains its position as relayed in its first communication response to Complainant. Thank you.

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