Land of Lincoln Health

I purchased Land of Lincoln insurance through the [redacted] for my daughter shortly after she was born. Because of the condition I was in, I applied over the phone. Unfortunately for me, the representative on the phone enrolled me but made a variety of errors within my initial application. My daughter was eventually dropped from her Land of Lincoln policy because of an oversight through the [redacted]. After many phone calls I was able to retro-actively re-activate my daughter’s policy through the [redacted] for the month of June when she was dropped (the first time). The problem was my daughter needed a well check up to receive shots during the month of June. The claim for June was sent to Land of Lincoln in June. Land of Lincoln initially denied the claim. After retro-actively renewing her policy, Land of Lincoln again denied the claim during the month of June despite there being an active policy. After months and months of me calling and talking to supervisor/ dispute resolution, and many more customer service agents I was finally able to get the policy moved to be reprocessed a third time in the month of October. Meanwhile my daughter’s pediatrician was threatening to send us to collections because they heard nothing from Land of Lincoln about payment. I’m angry that I needed to make 7 months of phone calls to hear they are finally getting to her claim. Supporting documents were in hand since the month July. It seems that my daughter’s account was not handled well and in a very untimely matter. I write this complaint because it should not take 20 phone calls for my claim to get processed.

Revdex.com Chicago & Northern Illinois 330 Lower Wabash Ave Chicago, IL 60611       RE: Case [redacted]   To Whom It May Concern:   Land of Lincoln Health received case [redacted] regarding an eligibility issue.   The member has been reinstated to active coverage and all...

incurred claims will be paid in accordance with the member’s policy. The member’s payment has been received and posted to his account.   Best Regards,   Land of Lincoln Health

I signed up for LOL and dropped [redacted] because of the rising premiums. It appears to be good insurance on paper. However as of January 1st(my effective start date) I still have no insurance. I paid my first month premium the last week of December with my debt card and they are still saying they haven't received payment. The payment posted to my bank account December 27th. I am starting to wonder if dropping [redacted] was a mistake. I spent 1.5 hours on the phone yeasterday waiting for customer service and finally talked to someone with a call back promise? I am not angry but it seems if you are paying for a service you should at least be able to use it. Not in my case. I have to reschedule my doctors appointment and pay out of pocket for prescriptions until I get the "call back". Customer service is awful!

Complaint: [redacted]
I am rejecting this response because:
Sincerely,
[redacted]The Market Place I called in January and again on today knew that I have a totally new plan.  Not Land of Lincoln.Thank you,Revdex.com

I made a payment and they cashed the check and I was told my policy is now canceled because I missed the date. They would not even listen to why I was late and I have not received my money back. So now I have no insurance and I have to pay cash for all medical visits and medicines and at the end of the year I will be the one paying for it with our taxes not Land of Lincoln . How is this fair?????

HORRIBLE EXPERIENCE. Beware these 3-TIER policies. Just because it says your local hospital is "in-network" L.O.L. only pays 45%. Had to take an ambulance to another hospital 35 minutes away because that hospital is in the "preferred network." The out of network deductible is $10,000, so forget getting anything out of network paid. There was no savings with this horrible insurance company over my previous company. I have over $2000 in ambulance fees alone because they are not "in-network". Even their PREFERRED hospital has not been paid (4 months later) for a 3-day stay there because they didn't "call" them to let them know I was there with an emergency admittance. The hospital has tried several times to submit the authorization code to them, but L.O.L. says the code is wrong. ? Also, after many calls from myself and my doctor's office, L.O. L. keeps listing him as a specialist, not as a family doctor (making my co-pay $125, instead of the $50 it should be for a family doctor

I've been a customer since January 1st, 2014. We signed up because we wanted to support the [redacted] we thought the idea of a nonprofit CO-OP was a good idea, and the prices we got for premiums were better than I could get through my employer sponsored coverage. Unfortunately, this has been the WORST health insurance and customer service experience we've ever encountered.

Obviously, Land of Lincoln is a new company. They're trying to figure things out. But, that does not excuse them for their poor customer service, and slow processing of claims. At this point we can only recommend that people STAY AWAY from them.

Here are some examples:

1. When you call customer service, you are actually speaking to the company [redacted]. Land of Lincoln contracts out to them for the actual benefits adminstration. These customer service people, while nice, are not well informed as to the policies, and how the system works. If you have a question, you are often put on hold while they talk to a different department. You often have more information and knowledge than the [redacted] which is a problem.

2. Their website often doesn't work, and trying to pay online is a big problem. If your payment fails, you have to call customer service, and pay with your credit card over the phone. They have acknolwledged that it is a problem, but there is no fix in sight. Even after paying my premium on time, for about 5 months, I would receive a letter postmarked the 10th of the month, saying I hadn't paid my premium. I'd have to call to confirm they received it. Features of the website (accumulator, messaging, etc.) have been non-functional, or are just poorly designed. [redacted] (the company that handles the benefits website) doesn't use technology well, and therefore the experience is poor for customers.

3. When they say they will mail you something, it often takes about 2 weeks to leave their system and arrive at your door step. Postal service isn't that slow, their systems for automating mailings, EOB's, and pre-certification letters are just slow.

4. Claims. We used an in-network hospitals service for a test in Feburary of 2014, they've only now figured out how to actually PAY the claim properly this last week (October 2014). My EOB has changed 3 or 4 times as they make payments, rescind payments, have write-offs, and correct things. You can never tell when your claim will be paid, or if it will be paid correctly.

5. Our Out of Pocket remaining value was unknown to the Customer Service team. They thought it was one number, the next day it changed, and pharmacies when calling to check how to bill, get a different number. We literally spent 10 hours over a few weeks calling, calling back, speaking to managers, and escalating, including 3 way calls with the pharmacy, to try and figure out how to bill things. Their system had marked our prescriptions as PAID even though they hadn't been, and that caused our Out Of Pocket remaning value to be wrong. We actually figured it out and had to explain it to them.

6. The website to determine if a doctor is in-network is confusing. Often when calling a doctor, they'll tell me that they AREN'T an in-network physcian. I've had to make calls to the billing offices of doctors to confirm with TAX ID numbers to figure out if they're part of the newtork. Part of the problem is that they use [redacted] as their network system, and some physicans are unclear on what this is. It's often a roll-of-the-dice when starting to use a new provider.

7. Trying to speak to a person from Land of Lincoln is difficult. If you navigate the phone-system correctly, you will be put into a voice mail system, where you can leave a message. That is the only way to get an actual Land of Lincoln employee on the phone. I've had to send blind emails to people, leave voice mails for the [redacted] (he never called back) and just generally be a pain-in-the-[redacted] to get someone to respond.

Overall, it has been a horrible experience, and we are counting the days until we can CANCEL our policy and move onto my employer sponsored insurance. That being said, we have found a couple of the employees ([redacted] - the new VP of Member Services, and [redacted] - supervisor at [redacted] to be nice and work hard to resolve our problems. But, we shouldn't have to actually spend this much time to get the basics of our insurance company to work.

I think they honestly want things to work. They want to help. But, until they bring their benefits adminstration in-house, or add more customer service people that work for Land of Lincoln, we can't recommend them as an insurance company. The third party benefits admistration company [redacted] that they use is NOT a good company to work with, and the fact that they have no real stake in the success of Land of Lincoln, makes the whole experience very negative.

Stay away, unless you want a hair-pulling experience. Something else I dislike, is that their company motto is: "Life is Complicated, Your Health Insurance Shouldn't Be". The fact that I've spent so much time trying to figure out my insurance company, and the amount of times my wife has cried out in frustration, tells me that their motto is wishful thinking.

The website and the customer service is a joke. You go on to process a payment and after 2 or 3 tries you MIGHTget it to work. I have tried calling several times over the last month and a half due to the fact that my payment did not come out of my account. I finally reach someone and after a half an hour I am told that my insurance has been cancelled. They wouldn't process the payment and reinstate my insurance and didn't care that it was their website that is defective.

Called for help with member benefits. Found myself in Texas call center 20+ minute wait time. Bad connection with one operator. Lisa hung up phone on me when asked to escalate call.
I'm a current member and will take my business elsewhere at next open enrollment. They can do better with nominal effort.

Revdex.com of Chicago & Northern Illinois [redacted]       RE: Case [redacted]   To Whom It May Concern:   Land of Lincoln Health received a second rebuttal to our response to case [redacted] regarding precertification for a medical procedure.   The rebuttal lists dissatisfaction with hold times, which were elevated toward the beginning of last month when the complaint was filed. Our new medical management vendor has increased staffing by a significant margin and is training additional intake and clinical associates, with hold times expected to normalize within the next two weeks once staff on boarding is complete.   Best Regards,   Land of Lincoln Health

I've had this plan for a month and have been unable to talk to the customer service agents over the phone. Because of the "high volume" of calls, you are asked to leave your phone number. I was never called back after several hours last week and have been waiting for 3 hours today. I need assistance finding a physician because the website is not very helpful and the physician offices are confused about the insurance. I have had so much frustration before even having to deal with billing that I am willing to switch insurance companies before it is too late. I've wasted $300 on a month's premium and over 10 hours attempting to figure out their system. I can't afford to waste any more time or money. I hope this helps someone thinking about this insurance company! Hopefully they can get their act together by next year.

Revdex.com Chicago & Northern Illinois 330 Wabash, Ste. 3120 Chicago, IL 60611 RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding a plan termination and refund. ...

LLH receives enrollment information from the Health Insurance Marketplace, and in this particular case we received a termination date of 2/29/16, not 1/1/16. The Marketplace is the “source of truth” for eligibility and we cannot override their enrollment data. Therefore, the member will need to contact them at [redacted] and request to open a HICS (health insurance casework system) case. If approved by the Marketplace for a termination date of 1/1/16, LLH will be able to process a refund. Unless this update is made, the member is considered as having coverage for the month of January and no refund can be issued. Best Regards, Land of Lincoln Health

Rep. Jan [redacted]s staff suggested LoL when my experience with [redacted] was so terrible, Granted, I have---thankfully---never needed to actually use the insurance---but the past several months & I've had trouble paying the premium by phone (no excuse for an over 15 minute wa8it time), and an employee told me they've sold their websites, So that's why I got a 'Secure Connection Faild' notice. I am mailing in my payment----but it got me thinking...what if I actually needed to use my insurance? What **. We really need single payer.

Complaint: [redacted]
I am rejecting this response because:
Sincerely,
[redacted]
The Market Place I called in January and again on today knew that I have a totally new plan.  Not Land of Lincoln.
Thank you,
Revdex.com

1 star isn't even fair. Negative stars and there should be a class action lawsuit against Land of Lincoln. They're the worst health insurance company I've ever had, and I've had all the major ones over the last 5 years. Do NOT buy this insurance, as you likely will end up feeling like you don't even have coverage. I have probably spent 40 hours of my time this year resolving the never-ending issues and filed 2 formal complaints with the Department of Insurance. Here's what I've experienced:
1) In Feb. '15 my wife delivered a baby. We gave the providers our LLH policy for policy in effect in Feb '15. The providers called LLH to verify coverage apparently and LLH rep's, being the geniuses that they are, gave the providers my new LLH plan info (we switched on 4/1 to a new LLH plan before these issues all came to light). SO of course, LLH claims denied all the claims because the policy wasn't effective in Feb '15. Even better, an LLH rep told me they wouldn't have done that. Very odd, because in Feb, I DIDN'T KNOW MY NEW POLICY INFO! How could I have given it to all these providers! Long story short, we had to spend our time calling all providers, explaining that they should submit the claim with the correct policy at the time of the services, and to NOT verify coverage via LLH so that LLH couldn't give them the wrong info again.
2) On 4/1 we started our new LLH Plan purchased through the SHOP marketplace (state exchange). We were signed up for Automatic debits. Every month SHOP took payment (we have the bank statements to prove it). Then in May/June we learned that our employees were being told their plan was inactive by their healthcare providers. We called LLH and SHOP, who pointed the finger at each other, and wouldn't talk to each other. Our CEO forced them onto a conference call together after a week or so of getting the run around from both parties and we find out that our plan was cancelled basically for non-payment (we paid every month AUTOMATICALLY). We never received cancellation notice - fIllinois Statutes require cancellation notice be sent prior to policy termination. We were told that SHOP & LLH would resolve it within a week. This debacle took more than 6 weeks to resolve and 40 hours of our staff's time before SHOP and LLH were finally able to figure out that they were having an issue with the "systems" between the two so although we had been paying SHOP as we were supposed to, LLH wasn't recognizing the payments. For almost 2 months, we basically didn't have coverage. One employee had to postpone his son's surgery, people had to pay out of pocket for prescriptions, and everyone did their best to avoid seeing a healthcare provider (basically we didn't have the benefit of having the coverage we'd paid for all along). We called LLH almost daily during the ordeal and I can't even tell you how many times LLH managers were supposed to call back and never did. We had to call all our providers once this was resolved, and ask them to resubmit claims for the last 2 months since they'd all been wrongfully denied during the cancellation.
3) Due to my wife delivering a baby in Feb '15 on our prior LLH plan, we basically maxed our Deductibles and out of pockets. After starting the new plan 4/1 with LLH, I submitted to the paperwork to make sure my new policy reflected the deductibles and out of pockets we had met. It took LLH 4 months to update our new policy even though we switched policies with LLH, not from another provider! Again, dozens of calls, dozens of different answers every time we called, tons of promised timelines missed.
4) It's now 9/3/15, and although LLH Member Services basically tells me we have met our deductible and out of pockets when I call them, and then another rep says something different. Meanwhile the Explanation of Benefits I keep receiving, dated just last week, from them say $0 STILL for deductible and out of pocket. Finally, today, I insisted that an Issue Resolution Specialist send me a breakdown for every member of my family in writing since Members Services.
5) They denied two claims just recently saying member name/ID mismatch, dependent not listed on policy. Again, spoke to Issue Resolution Specialist who pulls up the claims submitted by the actual providers and she saw no mismatch or incorrect info and so had to escalate it within their claims department. Another hour wasted hand-holding LLH on every single Claim we have with them.
6) Given the amount of times you have to call LLH to get claims handled, you'd hope calls and customer service were efficient. Nope! Huge wait times and member services is nearly useless and sounds like they never graduated high school. On top of that, there's little to no follow up or initiative from them, even once they acknowledge their was an issue on their end.
7) I'm out of space - I could keep going.
Summary - Pay more and get coverage that's actually usable. Someone sue LLH and make it a class action

Revdex.com of Chicago & Northern Illinois [redacted] RE: Case [redacted] To Whom It May Concern: Land of Lincoln Health received case [redacted] regarding precertification for a medical...

procedure. The procedure in question did require medical management review, and LLH approved the authorization request with confirmation number [redacted] A copy of the authorization letter has been emailed to the provider. Best Regards, Land of Lincoln Health

Revdex.com Chicago & Northern Illinois 330 Lower Wabash Ave Chicago, IL 60611       RE: Case [redacted]   To Whom It May Concern:   Land of Lincoln Health received case [redacted] regarding the timeliness of medical claims payment.   Effective 1/1/2016, LLH pended all...

2016 claims while we conducted an audit to ensure accurate processing. The audit was completed on 2/28/2016 and we lifted the claims hold on 2/29/2016. The member has a total of nine claims on file, five of which were successfully paid out on the 29th through checks [redacted] which have been mailed to the appropriate provider. The member’s additional claims are currently in process and will be paid shortly.   Best Regards,   Land of Lincoln Health