New York State Catholic Health Plan, Inc.

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution is satisfactory to me and the matter has been resolved
Sincerely,
*** ***

Revdex.com:
complaint ID *** has been resolved by filing an appeal with the NY State of Health department
Sincerely,
*** ***

Revdex.com:At this time, my complaint, ID [redacted] regarding New York State Catholic Health Plan, Inc. has been resolved.
Sincerely,[redacted]

Revdex.com:At this time, I have not been contacted by New York State Catholic Health Plan, Inc. regarding complaint ID [redacted].Sincerely,[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.  I received the check on February **, 2016.  Thank you Revdex.com.
Sincerely,
[redacted]...

[redacted]

Revdex.com:At this time, my complaint, ID [redacted] regarding New York State Catholic Health Plan, Inc. has been resolved.
Sincerely,[redacted]

Review: This later regarding my father [redacted] 77 yeas old live by him self in residence of [redacted]. For the past 5 years he is the client for the Dry Harbor Adults care at 6[redacted]. An this is his live. His health provider recently became the Fidelis care of NY. When we sing the contract with them, only one concern we have- 6 time a week he will go to Adults day care center. I will repeat my self again. My father live alone, my mother- his wife past away 4 years ago. So this day care center all his live know. This Monday I receive the phone call from Dry Harbor that his day's were cut off. and know he aloud to go there only 4 time's a week. My father have a lot of health issue and staff in day care are very professional and have good care about my father winch I really appreciate. I start to call Fidelis phone ####-###-#### to find out what happen? sins Monday no results. I left thousand of massages with my phone number and still nothing. I was trying to unintended this move. But they cut his services with out explanations not only for Day care services, but his home care services as well. Maybe my father became young and health and he does't need more of this services? But unfortunately this is not the case. He has dimensions, beginning of Alzheimer and know he even more upset with all situation. And I'm really afraid about his health conditions. I did not ask much , just to restore what he has before, because look like know Fidelis take away his live his, air. Please help. Maybe you can reach them and have the explanations why this happen to my father. This is not good care from Fidelis. I'm really unset my self. This is my father and I need to help him as much as I can. So this is only one solution I have know through you. Please I need your help, understanding and support.Desired Settlement: Desired Settlement: Explanation of Charges

Consumer

Response:

At this time, I have been contacted directly by New York State Catholic Health Plan, Inc. regarding complaint ID [redacted], however my complaint has NOT been resolved because:

[Your Answer Here]

I still don't have the clear answer from Fidelis why they cut of 2 days from the Adults Care Center for 77 years old person. He went to this facility more then 5 years and it's like his family know, and know he is by him self which it will create a lot of health issue. I relay believe that your company will hep me to restore those days. But....

Thank you

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

Sincerely,

Business

Response:

Thank you [redacted],

Fidelis is still reviewing the complaint listed above and has been in contact with [redacted]. Thank you for the additional information. Fidelis will complete a written response and get it to you as soon as there is a final resolution. I wanted to touch base with you to advise of some of the delays in regards to getting you this response.

Thank you-

Review: In November 2015 my premium went up $11.39, which I have no problem with. Mind you, I have paid every monthly payment as scheduled with no discrepancies since January of 2015. I have automatic payments set up to come out for the original premium amount. When the premium went up, they took the original amount on the automatic payment. I called up to pay the rest over the phone and correct the auto payments that are being made to reflect the new premium amount. When I called the first time, the woman over the phone refused to take payment as she explained they don't do that, I'm going to have to do it over the phone. I tried calling the automated payment system over the phone and there was no option to pay for a remaining balance of a single premium payment, it just kept prompting me to make 2 full payments to cover the next two months. I called back and spoke to a different woman, still she directed me to the phone, when I told her that didn't work, there is no option for what I'm looking to do, she referred me to their website with no help or explanation or walk through on how to do this. I finally figured out where to go to make this payment but there was still no option to correct the automatic payments to reflect the new premium payment. The next month came along and the same thing came along, but I got fed up because no one seemed to want to help me to correct the situation so I put if off for a few days. I didn't realize, and with the holidays I was distracted. I had an emergency room visit for my daughter (who this insurance is for) in the first week of January. I went to make the $11.39 payment a day or two later and found out my coverage had been cancelled.... even though they took most of the payment for January. This coverage had been canceled for $11.39 discrepancy!!!! This companies customer service is HORRID. I am an honest person, and I certainly give credit where credit is due, and have NEVER been so appalled at the lack of service provided by a professional organization, whether for profit or not for profit. When I called to get clarity of the situation, and hopefully fix it, they denied to help me with my issue telling me there's nothing they can do, I repeatedly asked for supervisors or management and they couldn't even do that, they went ahead and blamed the NY state of health. They told me to call them. I called them, and they blamed Fidelis care. I called Fidelis care back and again they tried to blame the NY State of Health. Apparently back in February 2015 I reenrolled through Fidelis Care directly so NY State of Health had nothing to do with this but Fidelis care kept trying to tell me that they did. I finally got through to someone named Melody, who did what I asked and got on a 3 way call with me and NY State of Health and that's how we figured out they had nothing to do with this. Melody, was very nice and told me that she would put through an appeal for me to see if the coverage can be back dated to January 1 2016 and that she would call me the next day. 2 weeks went by and I never heard back from her. I called today and got through to a nice gentleman who again insisted that this was all MY fault and that there's nothing that can be done. He did however, help me on the process of fixing the automatic premium payments, on which is still a hassle to do. All in all, I will re state my utter disappointment and aggravation with the lack of customer service provided and the hassle of their systems.Desired Settlement: Backdated coverage of my child's health insurance to 1/*/16

Review: This is the health insurer I chose through the NYS Health Marketplace. I have made 3 payments - one for @12.74 in November for December [redacted] coverage, another for $108.00 also for December coverage (they claimed they made a mistake). And I made a third payment in December for January coverage in the amount of $146.89, which should remain the same for 2016. However, I have placed phone calls and been on-line for no less than 5 hours trying to resolve the issue. I went to fill scripts yesterday and I do NOT have coverage!Desired Settlement: I want them to insure me! Refund monies paid for December, and pay for my scripts purchased during the time I was supposed to be covered.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved.

Sincerely,

Review: I submitted application for Child Health Plus insurance for my children in May **, 2013 with [redacted] in [redacted]. location. I was told that I will received the insurance ID cards within 4 weeks. When I submitted the application, I told [redacted] if he can not help me, I can withdraw the application and go to another insurance company where Child Health Plus is offered. [redacted] said " I am licensed insurance agent. I will get everything done." As today, July **, 2013, I still have not receive anything from the insurance company. When I called [redacted] in July **, 2013 to check on the status of the application, he told me that I have to call the customer service to find out myself. I called the customer service 2 times, they can not find anything in the system. There is no record of my children's application. I called [redacted] again on July **, 2013. He told me that he has to talk to his supervisor to find out what happen with my application that he will give me answer by July **, 2013. I never heard from him. So I called him again on July **, 2013. He told me I have call his supervisor, [redacted] , to find out. And I called [redacted] on July **, 2013 and spoken with him. [redacted] said that he will check and call me back. The odd thing about the whole convension is he never ask about any detail information about my application. He said he is on the field. Today is July **, 2013, I still not have answer about my application. I was tried to call [redacted]. But he is not picking up the phone.Desired Settlement: I would like to know the status of my application and an apology. This process has dragging on for too long. For more than 2 weeks, I can not get a straight answer from [redacted] representative.

Consumer

Response:

At this time, I have been contacted directly by New York State Catholic Health Plan, Inc. regarding complaint ID [redacted], however my complaint has NOT been resolved because:

they forgot my application. I have to fill out new application. I am still waiting for my children's insurance to be approve.

In order for the Revdex.com to appropriately process your response, you MUST answer the question above.

Sincerely,

Review: I was a member of their Silver plan in 2015. The monthly premium amount was $129.54. On November **. 2015 I logged onto the NYStateofHealth site to renew my coverage. Due to a change in income, I was no longer eligible for that plan ,so the system terminated me effective that day. I paid the December premium to the company on November **, 2015. Since I was not covered by them in December, I called on December **, 2015 to request a refund of that premium. I was told that it would take approximately 1-2 weeks to receive the check. I called again on January **, 2016 because I had not received the refund. The customer service rep told me that the request had been forwarded to Finance on December **. No status update had been entered by them since December **, 2015. I was placed on hold and was told that they were reviewing it. I asked to be contacted by phone regarding the status. I did not hear back and called again on Januar **, 2016. The customer service rep said that there had not been an update to the status since December **, 2015 which he didn't understand either. He placed me on hold to talk to his Supervisor. He told me that his Supervisor would escalate the matter to Finance and that someone should get back to me either later that day or the next. No one has.Desired Settlement: I'd like a refund of my December 2015 premium payment in the amount of $129.54.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me and the matter has been resolved. I received the check on February **, 2016. Thank you Revdex.com.

Sincerely,

Review: I was a member with [redacted] in 2015. For 2016 I renewed through the New York State of Health Marketplace website. I got a letter in the mail stating that my plan was renewed. Jan ** I go to the pharmacy to refill a prescription, only to be told that I don't have insurance. I call [redacted], and they tell me my insurance has been cancelled by the marketplace. I call the marketplace, they say everything is in order and that my insurance should be active. I call [redacted] back and they discover an error. New York State of Health sent them two letters. One to cancel 2015's enrollment and one to activate 2016's enrollment. [redacted] received the activation before the cancellation, and so it was cancelled. I'm told I need to call NYSH back to resend the enrollment documents. I do, and they resend. a week later my insurance is still not active. [redacted] tell me to wait 2 days. I wait 2 days, call back, still not active. they tell me to wait 2 days. I call back 2 days later, still not active. It is now February ** and [redacted] has still not activated my insurance. I have paid premium for 2 months, but I have no valid insurance coverage. I need to see the doctor, but I cannot go. I need medication, I cannot get it. Every time I call [redacted] they transfer me to a supervisor who ensures me the insurance will be active in 2 days, but it's not.Desired Settlement: I would like a refund for January and February up until the day my insurance is activated. and I want my insurance activated immediately.

I live in New York City, and need physical therapy. There are no physical therapist within an hour and a half from me, that accept [redacted]. On [redacted] website, they have about 50 therapists listed, however when you call them up, the phone numbers either don't work, or the providers don't actually accept [redacted]. I filed a complaint with a [redacted] supervisor, and 2 weeks later they sent me a letter back with a new list of local physical therapist. However, none of these new providers actually accept [redacted] either. I had the same problem when needing a hand surgeon. Only one [redacted] surgeon in New York accept [redacted] and he is terrible. This spring I needed an [redacted] surgeon, and had to travel 2 hours to Bay Ridge to see the only one in New York accepting [redacted]. The surgery took place in a optician office, as the surgeon, who would normally this kind of surgery in a hospital setting, where [redacted] was not accepted, was scrambling to find the necessary knifes and tools to accommodate me.