Complaints

The 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:07/09/2025

  Type:Service or Repair Issues
  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 been trying to get your company to look at the coordination of benefits of my primary insurance and what they are going to pay for my teeth, and the people that are in the email are extremely incompetent and saying the same thing over and over again. I have been paying for 16 months in premiums to use this as my secondary insurance so I can get my teeth fixed. YOUR COMPANY IS THE ONLY THING THAT IS HOLDING ME BACK FROM GETTING MY TEETH FIXED. I paid the full waiting period so I can use the major services, and they are not even giving me clear answers on what they can and will pay towards it after my primary pays. I am disgusted, and I am about to take this public and tell everyone I know not to use EMI Health. My primary already put through a EOB and they stated what they would pay, we filled out all the paperwork your company wanted us to fill out and they're still saying " we cannot give a predetermination of benefits when a COB applies" Okay so then you asked us for paperwork, we sent it and you STILL cannot resolve and tell how much youll pay

  Business Response

  Date: 07/15/2025

  An EMI Health representative has reached out to ****** and to the provider to give the correct information that was requested. There were multiple phone calls and requests that were not handled correctly. The employees involved are scheduled for training and coaching to correct the issues. We apologize for the many issues with getting this information.

  We did receive a predetermination on 07/01/25, and based on the information received in the predetermination ****** will have a $25 DED and COINS of $750. EMI
  will pay $427.68.

  Please let us know if you haven't received the information you need or if you still have questions.

• Initial Complaint

  Date:01/17/2025

  Type:Order Issues
  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.

  This company is messy. The call center, which employs numerous people that have no idea about your insurance or how it works, is open from 6am but the enrollment line doesn't open until 9am so you can't get any answers. I've called 4 times about COBRA benefits, and emailed twice(no response), and still do not have the answers I need to ensure I remain enrolled. My former employer refers me to EMI about the premium, while EMI refers me to the employer. I need to pay my premium and ensure my coverage continues, but EMI has made this impossible and risks my access to healthcare

  Business Response

  Date: 01/28/2025

  We received a term via file for this individual in mid-December. We
  sent out the COBRA application to the member 12/17. There were calls from the individual asking about the application 12/26, so another COBRA application was emailed on 12/26. We
  received the application back through email on 12/30. We
  responded back to the member on 12/31 letting them know they were enrolled.

• Initial Complaint

  Date:03/25/2024

  Type:Service or Repair Issues
  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.

  *** randomly canceled by Dental Policy out of nowhere and claimed that my policy was not on autopay. Yet, my vision policy was also on auto pay and it continued to be charged. I received a random phone call today claiming I didn't have dental coverage anymore. I called *** twice and called the Marketplace twice because *** claimed they could not reinstate my policy without a enrollment specialist from the Marketplace. I did not change any policies with *** with dental or vision, yet my vision has continued to remain active and on auto pay for my account, but my dental stopped randomly? I've been on the phone for over 2 hours playing this game. Both policies were on autopay yet the *** rep claims my dental coverage was not showing on autopay. I've never logged in manually to pay my bill, since both policies were on autopay. My credit card statement shows dental was paid on the 2nd every month in all of 2023 and vision was paid the same day on the 25/26th. Your service is not worth an A+ rating and your customer service rep just spoke in circles and claims it's my issue of autopay since he said there's nothing showing auto pay in the system.

  Business Response

  Date: 03/26/2024

  Member was not randomly terminated by ***. *** received a termination from the Marketplace on 12/16/2023. Consequently, *** mailed member a termination notice on 12/17/2023 notifying member of said cancellation. Members autopay was auto-cancelled due to no active account. An auto-generated email was sent to member on 01/02/2024 at ************************ at 04:01:17 AM MST notifying member that the autopay had been cancelled. Member was last invoiced on 01/10/2024 indicating a $0.00 balance due to no coverage.Member did not contact *** until 03/25/2024 at which point member was advised there was no 2024 enrollment for him and to reach out to the Marketplace.

  Today, 03/26/2024, *** has received a **** (Marketplace complaint) Escalation requesting review for reinstatement effective 01/01/2024. According to the Case narrative, members mailing and email addresses on file with *** match ***, indicating the termination letter and email notifications were sent to the correct addresses.Members main complaint on the **** is his enrollment in autopay. Yes, member was enrolled in autopay, however, as previously stated, it was auto-cancelled due to no active account, due to the termination received from ***. No error on ***s part. *** notified member timely of policy being cancelled. Member was also accurately advised to contact ***/Marketplace to inquire about obtaining coverage for 2024.

  In the Case narrative, member mentions Vision coverage,which is a totally separate policy from the dental policy. The vision policy was purchased directly through EMI Health. The dental policy was purchased through The Marketplace. Since they are separate policies, they are billed separately as well. Cancellation of one policy does not affect the other whatsoever. On members call to EMI Health on 03/25/2024, member states he had an agent assist him in re-enrolling in coverage for 2024. The *** rep advised member the policy was not renewed for 2024 and that is why it is showing as cancelled and referred member to ***. Member confirmed he would contact the *** and then call us back to make payment. Member called EMI Health again on 03/25/2024 and spoke with another *** rep stating he got a random phone call from a guy stating he no longer had the dental coverage. Member stated the *** was also confused as to why the policy was terminated.

  Ultimately, member is confused. He asked why he is being billed for a policy that has been terminated, which the *** rep was unable to answer. He has two separate policies. He is currently being billed for the vision-only policy. The *** rep confirmed the dental was termed 01/01/2024 and the last payment for the dental was on 12/1/2023 for $22.60. It was never explained to the member why there were separate charges or that the Vision continued and the dental stopped. Due to receipt of said Escalation, EMI Health has processed and closed the case,reinstating member 01/01/2024, requesting a new invoice, and will be sending member a resolution letter tomorrow (03/27/2024) advising him of his account reinstatement and premiums owed. 

  One other option would be for the member to also get a direct individual policy with EMI Health which would waive any waiting period that had been met on the previous plan, this would allow the member to deal directly with EMI Health without the Marketplace as a go between.

• Initial Complaint

  Date:05/30/2023

  Type:Service or Repair Issues
  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.

  This business took advantage of us and would not resolve our claim. Our account failed to be renewed although we were under the impression we had insurance. We were put on another plan and were told we still had dental insurance. We were taken off our direct payment plan without being made aware and our premium was not paid. We were not notified and had dental work done we believed was covered by insurance. When brought to their attention they denied us resolution because our premium was not paid even though it was not our decision to not pay it. They have taken advantage of us in order to not make payments to dental work that was done. This is a despicable company. do NOT fall fpr their trap and enroll under a different provider.

  Business Response

  Date: 05/31/2023

  The policy in question was through the Federal Marketplace (Exchange). All enrollments go through healthcare.gov and are controlled by the government. ***** appeal to the Marketplace and received the following response.

   HICS CASE E2310444489/ ******************** Rev for reinstate.Account has been reviewed and member has been correctly terminated for non-payment of premiums 01/21/2023. Member never effectuated policy. Member was invoiced 02/10/2023. Payment was due by 03/01/2023 and payment was not received. Term Notice mailed on 03/07/2023. Member can be enrolled again if Marketplace approves member for *** or future enrollment. Case Closed. Res *** sent 05/26/2023.

  If ***** would like to pay back premiums and reenroll in the policy we can try to appeal to the marketplace on her behalf.

  Customer Answer

  Date: 05/31/2023

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that the resolution of backpacking for coverage is satisfactory to me if they could submit an appeal on our behalf.
  
  Sincerely,
  
  *******************

• Initial Complaint

  Date:02/06/2023

  Type:Billing Issues
  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 sent in multiple requests to cancel my insurance policy, all of which were ignored for over 6 months while the company still continued to charge my card every month. I called to find out why my requests went ignored and was told they had no answer and to resubmit my cancel request. I did and still no response. When I finally received a response, they backdated my cancellation to my original request date which meant they owed me a refund for the months I was still charged despite requesting to cancel multiple times. I specifically asked for a refund via paper check as I have since closed the account that was being drafted to stop being charged for coverage I did not wish to continue. I have emails where I was assured a paper check would be sent but then I received an email that they deposited the refund to my closed bank account. I have contacted EMI demanding to know why they did this despite assuring me they would not. No good answer, they are telling me its out of their hands since they have already deposited the refund. They say I need to find a solution with my bank. I have been dealing with this for over 6 months and the company is trying to get me to give up so they can keep my money.

  Business Response

  Date: 02/07/2023

  Thank you for the opportunity to respond to the concerns of ********. The premiums were refunded back to the cancellation date as requested. The refund was put back on the credit card that was being used to pay the premiums. We show that the refund was received on the credit card.

  Customer Answer

  Date: 02/07/2023

   
  Complaint: 19343047
  
  I am rejecting this response because: the refund was deposited to a closed account that I no longer have access to at a bank I no longer deal with. I was explicitly assured I would receive a paper check since i requested this refund method with plenty of notice and explained it was because the account was closed. but the refund was deposited to the closed account anyways. I will not be contacting the bank to fix it since it is neither the bank nor my fault. The business needs to correct this since it is solely their incompetence that got us here. 
  
  Sincerely,
  
  **********************************************

  Business Response

  Date: 02/07/2023

  The refund went through so from our records the refund has been received. We didn't receive a rejection or notice that the account was closed, and the refund was not returned to us. It is standard practice to refund amounts to the same credit card or account that was used to pay the premium.

• Initial Complaint

  Date:01/09/2023

  Type:Service or Repair Issues
  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.

  EMI Health will not cover my basic OBGYN visit because they say it is an exclusion to the plan. They are charging me almost $400 to have seen my gynecologist when I was originally told it would be just a specialist copay. When I talk to customer service to understand why they wont pay for the visit, they simply say Im not a doctor; theres nothing I can do to help you.

  Business Response

  Date: 01/10/2023

  Thank you for the opportunity to respond to the concerns of ********. We have researched the issue and found that the claim was denied based on the submitted diagnosis on the claim which is an exclusion to the plan document. We have requested notes from the provider to see if the notes show that the diagnosis is correct. 

  If the current diagnosis is incorrect, then ******** can request that the provider submit a corrected claim with the proper diagnosis but with the current diagnosis the claim was denied correctly.