ComplaintsforOneShare Health

• Initial Complaint

  04/18/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Im a 27 year old healthy female. Im self employed and the cost of private health insurance is wild, so I looked into different options for my family of 4. I found OneShare. My in laws also used them at the time which further persuaded me. I canceled after 6 months. Theyve also canceled now because of similar complaints. They dont help cover anything, even if they say they will. If you file an appeal/dispute, they will always turn it down and take months to do so. I have been going and back and forth with them for 8 months about an ** bill. They say it wasnt life threatening and I shouldve gone to urgent care, which I did and they have evidence of that, but are ignoring it. I am left with 3k in bills even though my deductible was $500. Hospitals and doctor offices will charge them at 3x the normal cost as though they are insurance, OneShare will deny any obligation in helping cover the bill, then you are left with an insane bill. You are better off paying cash because you will pay about 1/3 of what it wouldve been with a cash discount. Basic check *** for my toddlers cost $400, when it shouldve been $150. Bloodwork was over $400. A thyroid ultrasound was also over $450. One trip to the ** without any answers and zero testing was over $3,000. They are beyond useless and extremely rude to deal with. They are far from the ***************** they pretend to portray. Theyve had countless lawsuits against them. Please look into it. A quick ****** search will pull up so many. I shouldve done better research.

  Business response

  04/19/2024

  Hello, 

  We apologize for any frustration. At this time, we have taken all information into consideration and have contacted our member directly with a resolution. We hope this determination is satisfactory.

   

  Thank you, 

  OneShare Health

  Customer response

  04/19/2024

  I just received this email from OneShare this morning. Im not satisfied with their response. Im glad theyre going to review it again, but it took them 8 months to come to a decision about an ER bill. They also didnt care or respond until they heard from you. 

• Initial Complaint

  04/11/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  September 26th 2022 I was involved in a motorcycle accident. I went to the hospital and found out I seperated my shoulder. On my membership guideline it is a 500 dollar visit. That's fine. I needed to have surgery, found out the price before hand and had to get pre approval from one share that it would be covered. They said it is covered under my guide lines. I had the surgery and then recived bills for over 35k$. I sent the bills to one share and it would be months in between with no contact from them. I was basically the middle man between the hospital and one share. After a year they paid out a few 1000$ but I was still receiving bills for 25k. It is 4/4/24 and I am still trying to get this resolved. The hospital has sent the remaining 17k to collections but have since placed it on hold after numerous calls and letting them know what is happening. My so called compliance manager for one share. Named ***************************** is extremely difficult to reach. I've called over a dozen times and have only spoken with her once and the hospital has reached out numerous time and never answers or returns the calls. They have no communication and if you just wait and do nothing so will they. You have to call every week to see what is happening and most of thr time you get the same response that it is being processed. But doesn't tell you what just your account. After doing my research and seeing the lawsuits agasint this company and complaints I felt like I should also do the same. I would have done it sooner if I had known this would have taken so long. Every time you talk to a representative they say things will be handled according to guidelines and I am well with in my membership guidelines. I don't understand how it can take over a year and half to be complete.

  Business response

  05/01/2024

  Hello, 

  Our teams have been trying to contact our Member to come to a speedy resolution. We have and will continue to reach out to the member.  

  Thank you

  OneShare Health

• Initial Complaint

  03/29/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have had one share health member id # ********** for about 2+ years originally paid $727 per month. Then it went to over $800 per month. I had cataract surgery on my left eye 8-30-2023 and on my right eye 9-6-2023 Dr. ************************* in ********* Tx. The surgery was a success. ************** and his staff did a phenomenal job. I did the prenotification as required by one share. Submitted all receipts and billing to them. I spoke with them at least 5 times and always got the runaround. They never shared one cent of my surgery. My agent told me it should have been 100 percent covered. This is a terrible company that takes the consumers money and never actually share in any reimbursement for any medical procedures. I canceled my policy3-28-2024 and will seek legal counsel in this matter. This company should not be in business.

  Business response

  04/17/2024

  Hello, 

  Thank you for taking the time to answer our emails, we want to apologize for your frustration. Please know that we are working diligently to resolve this matter for you as quickly as possible. Please do not hesitate to reach out to our teams if you have any additional questions. 

  Thank you, 

  OneShare Health

• Initial Complaint

  03/12/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was a member of OneShare since January 2023-Dec 2023. Before I bought into it I asked all the questions - what/when and how much was covered - especially for an emergency. They said emergencies were covered so I took the insurance. I know how costly emergencies were and that is why I wanted to be covered. I lost my job due to health reasons in 2022 and could not afford local insurance. I asked every question. I had an accident in July 2023 where I fell and broke my hand. When I called I asked where to go they said anywhere. I asked if there was a place affiliated to get in plan pricing, they said the good thing about them is there is no in network so I can go anywhere. They told me nothing else, I asked questions and they were positive on every answer..I had to see a orthopedic doc and again I asked who, they said anyone since there was no in network to worry about. I called the doc office to make an appt and they never heard of this coverage, they called OneShare then called mee back to explain I had no benefits for this event. First I heard of that!I called the plan and spoke to several people to explain that I was upset and I asked all the right questions before I purchased this plan. A manager got on and reviewed my initial phone call and then agreed to pay for this event. Now, this is March 2024 and I am receiving calls and bills....and just today I received a Patient Sharing Explanation of Sharing and it says that they will pay for nothing - zero. I am so upset. I have a call into them but they will not call me back. I just want them to pay, my fills are at least 1k. I had to pay for doctors visits, blood work, etc over this past year but this is the last straw. They have so many rules that there is no way that they will ever cover anything. For example: if you get an x-ray done only one person can see it - if they have a process of 2 people viewing the x-ray they will not pay. There is no hospital that is not going to have these x-rays rechecked. Same with blood work - IF you have bloodwork done they will only pay for it if the doctors office does all the analysis, they cannot send it off to another company. This is unheard of and of course you only hear of this when they do not pay so you are stuck. I pad them over 5k and they have NEVER paid anything - nothing!

  Business response

  03/18/2024

  Hello, 

  We understand your concerns. Our teams have been in contact with you and all issues have been resolved.

  If you have any other questions, please reach out to our teams for additional assistance.

  Thank you,

  OneShare Health

• Initial Complaint

  02/15/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have been trying to cancel membership since 12-14-23 yet they continue to bill me. I have an email dated 12-15-23 that my account will cancel ********. Yet they billed my credit card January 14. I called to make sure the account was closed and would not be billed further. They told me I would not be billed. I was billed again 2-14-23. I emailed them and they are saying the spouse on the account is still a member. I advised I called last month and was assured the account was closed and would not be billed further. Im waiting for a reply. I want a refund on the February payment. If you could help me in any way I would appreciate it. Thank you in advance.

  Business response

  03/07/2024

  Hello, 

  We have sent an email to our member for additional information and awaiting response to better assist our member with their complaint. 

  Thank you

  OneShare Health

• Initial Complaint

  11/29/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have paid membership dues for a year on time every month . I have been trying to get a share request processed for months now with no luck . I have called and spoke to several different people and have submitted, share request form , itemized bill , corresponding codes , and statements with the amounts I paid out of pocket . They continue giving me the run around and I have not received any financial help whatsoever. If they arent going to help with cost sharing then I want a complete refund from all membership dues .

  Business response

  12/05/2023

  Hello,
  Thank you for contacting OneShare Health regarding your concerns.
  We hope to have a resolution soon.
  We will be in contact with you directly as soon as we come to that resolution.
  In the meantime, please do not hesitate to contact our teams for assistance.
  Thank you,
  OneShare Health

• Initial Complaint

  11/28/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Have paid into one share since February of 2020 thru November of 2023. More than $16,000 has been paid into one share.May 25th 2023 ******** had an appointment with the Breast health center at ******* and ****** hospital in ******. When she arrived and was seen by the doctor she was told the leaking mass on her breast was a cancerous tumor. She was escorted directly to the ** and after being admitted, CT scans confirmed the Cancer. She was quickly admitted and taken directly to ICU where she spent the next 6 days then 3 additional days in a standard room before being discharged. After beginning to pay/share some of the hospital bills, without any notice, or any explanation, then not only stopped paying the bills but I have not been told they have taken back the payments made to date. ******** was to begin Chemotherapy treatments on June 9, Prior to her initial treatment, ********************* requested from One share an authorization to begin treatments, That was provided and approved by One share prior to the initial treatment. Now I just learned they are not paying and have said the treatments are not eligible for sharing. Again, no notice, no explanation. From May of 2023 to present, I have sent in at least 15 share requests with long letters explaining every detail possible about the sequence of events. Never once have any letters been responded to. In order to get any information I have to sit and call while to customer service person tries to guess at what is going on. Its almost always, "Its still in review" wait a little longer. These are classic stall tactics used by many of the scam companies masquerading as a legitimate business. The customer service person is always friendly but cannot answer to the real status and no one is available that can make any type decision. And, they claim to be **************** You have found ways to avoid paying the hospital cost but do the right thing and pay the previously approved Chemotherapy and cancer treatment costs.

  Business response

  12/05/2023

  Hello,
  Thank you for contacting OneShare Health regarding your concerns.
  We hope to have a resolution soon.
  We will be in contact with you directly as soon as we come to that resolution.
  In the meantime, please do not hesitate to contact our teams for assistance.
  Thank you,
  OneShare Health

  Customer response

  12/20/2023

  One share has done exactly as they always do. No detailed information or response and simply add additional stall tactics. They say we will review and get back to you but never do. I send formal disputes for each of their sharing determinations that simply state, " Services submitted on the share request are not eligible for sharing" Again, no explanation just a form letter and another stall.

  Today I finally received a call from ****** who says she is the supervisor of the dispute area. She finally explained some details. She told us that during the 5 year cancer look back to see if there was any evidence of a pre-existing condition, that our PCP doctor had recommended a mammogram yet had not had one. That was 7-8 years ago and certainly was not why ******** got Cancer! 

  In late 2022, ******** had three separate teleconference consultation with One Shares own Clever health network doctors. They are the ones that misdiagnosed and misled ******** with an improper diagnosis of " classic post-menopausal breast cysts.". They never once suggested she see a specialists, never referred her for further evaluation, never suggested CT scans or Xrays. Nothing! Even after ******** made 2 followup calls for a total of three full consultations for the same issue. And One share says ******** didnt get a mammogram 7-8 years ago? 

  So I have asked to have an appeal of the one share decisions that we believe the be incorrect and against the guidelines. 

   

   

   

  Business response

  01/03/2024

  Hello, 

  As we discussed on the phone, the next steps are being taking for a determination. 

  When that resolution is available, you will be notified. 

  Thank you. 

  OneShare Health

  Business response

  02/28/2024

  Mr. and ***************, we are sorry you remain unsatisfied. Please know that your file has been thoroughly reviewed by multiple groups at different stages who have all reached the same conclusion. This is not a decision we take lightly. Sharing determinations are made based on the member guidelines, and we understand that this does not always result in the member's preferred outcome. Nevertheless, we seek always to apply those guidelines accurately and fairly. 

   

  Thank you, 

  OneShare Health

  Customer response

  02/28/2024

  I am rejecting this response because:   

  Your member guidelines says the following;

  Cancer:
  If a Member has never been diagnosed or received treatment for any type of Cancer, the
  diagnosis and/or treatment of Cancer is Eligible for Sharing if diagnosed after a 90-Day Waiting
  Period from the Members Active Date.
  If a Member is diagnosed with Cancer within the 90-Day Waiting Period, the diagnosis and treatment related
  to that specific Cancer, or recurrence or metastasis of that Cancer, are Not Eligible for Sharing.
  If a Member has been diagnosed with or received treatment for Cancer within five (5) years prior to the
  Members Active Date, all Cancer expenses are Not Eligible for Sharing.
  If a Member was diagnosed with or received treatment for Cancer more than five (5) years prior to the
  Members Active Date, diagnosis and/or treatment of a Members newly diagnosed Cancer, which is unrelated
  to any prior Cancer, are Eligible for Sharing after the 90-Day Waiting Period, if the following conditions are met:
  Member must provide Medical reports which indicate that, during the five (5) years prior to the Member Active
  Date, there was no diagnosis of Cancer; no ongoing treatment for Cancer; no future treatment was prescribed,
  recommended, or planned; and the Member has followed the guidelines for preventive screening of Cancer
  and the guidelines for a healthy lifestyle as recommended by the attending Physician.
  Limit for all Cancer is $500,000; each Incident cannot exceed the Maximum Limit Per Incident.

   

  ******** was never diagnosed with any type cancer prior to May 25, 2023 more than 2-1/2years beyond her membership date. She was NOT prescribed any type of cancer screening. It was SUGGESTED, by her PCP that she get a mammogram 7-8 years ago however Mammograms are NOT a prevention just a POSSIBLE detection method. They are prone to inaccurate readings both positive and negative.  The best approach would have been a thermal image however that was not suggested nor prescribed. Our contention is that ******** has had a very healthy lifestyle, healthy diet and continues to live a very Christian ***** She did not disobey any doctors orders she merely chose not to use Mammogram as a technique for detection. ******** has several friends that have had regular Mammograms and have developed Cancer that was not detected during a mammogram. Her PCP should have discussed this at length with ******** and discussed alternative methods of screening if he felt it was required.

   

   

  Business response

  05/02/2024

  Mr. and ***************, we are sorry you remain unsatisfied. Please know that your file has been thoroughly reviewed by multiple groups at different stages who have all reached the same conclusion. This is not a decision we take lightly. Sharing determinations are made based on the member guidelines, and we understand that this does not always result in the member's preferred outcome. Nevertheless, we seek always to apply those guidelines accurately and fairly. 
  
  Thank you, 
  OneShare Health

• Initial Complaint

  08/08/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  We purchased health care share program paying over 700 a month and they have covered no claims in the whole time weve been with them. They are a scam and we want all of the money weve paid them from the beginning of the policy back so we can pay our bills outright that they have not paid. They misrepresent themselves to consumers and cheat out of premiums and dont pay what they represent themselves. I have also contacted news organizations to investigate their practices and warn consumers and Christians as they are targeting Christians with this. Shame on them! I will shake down every tree until they have resolved this to my satisfaction! Dates in question are the entirety of the policy.

  Business response

  08/08/2023

  Hello, 

  ******************************* and our Compliance team have been in communication and are working on a resolution. 

  Thank you, 

  OneShare Health

• Initial Complaint

  06/21/2023

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  My kid broke his thumb diving for presents Christmas eve. I was at work. 2-3 days later i took him to urgent care. that doc recommended specialist since my boy was six year old. we went to tulsa bone and joint. One share won't pay the bill, under $600. i was paying over $900/month for more than a year. One share requested medical records. i completed, signed, and returned their form 'medical records release form'. they still won't pay the bill. my desired settlement is for one share to just pay the bill.

  Business response

  07/05/2023

  Hello, we have reached out to our member via email and advised that the bills in question have been reprocessed per program guidelines.

   

  Thank you, 

  OneShare Health

• Initial Complaint

  05/10/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I was with OneShare for a little over a year. I was paying $209/month at first. Later it was raised to $249. During the first year, I injured my foot and had to visit the *** According to the plan I had, I was only responsible for $300 for any ER visit. The 3 separate bills came to roughly $1200. I went round and round with them for 8 months. Submitted the same paperwork more than once, filled out their forms, etc. I was denied any reimbursement to this simple transaction. My conclusion - if they cannot/ will not navigate a simple ER visit and reimburse the way they advertise, what chance is there that I would receive any reimbursement for something bigger. I dropped them. Thankfully I saw their true colors before being with them for years and years and losing significantly more money to this tight fisted, very unChristian secular entity. Let your Yes mean Yes. They agreed to pay. They need to pay. They didnt. They failed in the eyes of God.

  Business response

  05/16/2023

  We have made numerous attempts to contact consumer but have been unsuccessful in our efforts

  Customer response

  05/16/2023

  I am rejecting this response because:   It is not relevant. They only started contacting me after I decided I wasnt going to accept their rejections for my claim any longer, and cancelled the credit card that they were charging. Once they recognized that they were no longer being paid by me, they started calling. I NEVER received this sort of contact from them when it was just related to my claim. When they send me my roughly $800 for the basic ER visit claim which they have received all the necessary paperwork for, I will open my ear to further discussion. Or a letter explaining in plain terms why my claim was rejected. Until such time, I will despise them, and I will not allow my policy to continue, no further payments will be given, and I will tell everyone I know exactly what I experienced. 

  Business response

  05/25/2023

  we are a little confused as to how we can resolve the situation with the consumer but the consumer refuses to speak to us.  We are happy to do what ever we can to amicably resolve this issue,  but we can't do it without communication.  

   

   

  Customer response

  05/25/2023

  I am rejecting this response because:   The opportunity to discuss is long gone. Why does it take a submitted complaint to BBB to light a fire under your ***** to suddenly care about what a customer has to say? Why, during the many months of correspondence, was I receiving run-arounds, repeated requests for the same documents, more than one letter of rejection for sharing eligibility, only to recently be told my ER visit was not potentially life altering and therefore was not approved. I COULDN'T WALK. WHEELCHAIR IN THE HOSPITAL AND CRUTCHES FOR 2 WEEKS THEREAFTER. Granted this info was not provided because there was no forum or inquiry along these lines to provide it. I wasnt asked about how the injury affected my life. But I did recently submit really gross photos of my swollen bruised ankle, shin, and foot, and supposedly my case was opened back up in light of this new data. And then I was asked to get more forms and documents from one of the service providers. Again. Really? Why are we still asking for paperwork? What does an NPI number have to do with whether or not this is eligible for the sharing eligibility? And if this number was needed, why wait so long to ask for it. Why wasnt it asked for a long time ago when all the other paperwork was provided? Why not ask for it before sending the letters of ineligibility? Why wait till after I make a stink to ask me to get it from the service provider? I know why. Its yet another one of those, Lets hit the ball back into the customers court so when/if they stall out and dont do the leg work of getting the info from the service provider, we can say that we cant approve the sharing because he didnt give us all the info we need. Well played. Im done. You cannot redeem me as a customer and I will be spreading the word about my experience. 

  Customer response

  08/21/2023

  This issue has not been resolved. Resolution would be them reimbursing me the balanced owed for the ** visit which is just over $800, since they advertise that an ** visit only costs member $300, and they pay the rest. As I stated in earlier messages, the total cost for the ** visit was about $1200. This should have been a simple case. I provided all the documents they asked for. Even provided the same information more than once. And then after being told that it was ineligible for cost sharing because it wasnt considered a necessary ** visit and was not potentially life altering, I sent them pictures of the massive swelling and bruising which looked like a broken leg. Kinda needed that to be x-rayed, etc. Dr thought so too. But thats so weird that the Dr wanted to x-ray it when it wasnt a very bad injury (insert sarcasm). 
  

  They did actually send me a check for just over $100 a couple weeks back. So thats a step in the right direction. Perhaps due to the pictures I sent? Who knows. But there does not seem to be anything else on its way. Not that I care. Therere the ones that lost because I canceled my membership and Im spreading the news like wildfire.  But they should be paying all of the balance that they owe based on the rules and agreements between us when I signed up to the program. So Bait-and-Switch is still alive and well. Even in ********* organizations. If money is involved, you cant trust any corporation. 

  Business response

  09/08/2023

  Hello, 

  The three bills that we have on file have been processed and shared per program guidelines, which was communicated to you via email May 18th. 
  Two bills from date of service 8/11/2022.
  One bill from date of service 8/17/22.
  
  If you are being balance billed for these bills, please reach out to ************************************* with the statements so that we can further assist. Unfortunately, we do not have a facility bill on file or either date of service, which historically would be your larger bill. In order to have that one processed and shared, we need the facility to submit the bill or for you to provide an itemized bill. If you have any questions please contact us. 

  Thank you, 

  OneShare Health

*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. ↩