Security Health Plan

We did receive our refund in full along with a letter stating they would bring the issue up at their next board meeting to assure clients don't have this problem in the future[redacted] ***

This matter is now being handled through Security Health Plan's grievance process. After the appeals and grievance committee has thoroughly reviewed and considered this complaint, I will send you a copy of its decision.Sincerely,Security Health Plan of Wisconsin*** ***

RevDex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below
[To assist us in bringing this matter to a close, we would like to know your view on the matter.]
The response I received from Security Health Plan is below, the matter is still not resolved
"This matter is now being handled through Security Health Plan's grievance process.
After the appeals and grievance committee has thoroughly reviewed and considered this complaint, I will send you a copy of its decision
Sincerely,
Security Health Plan of Wisconsin
*** ***
Regards,
*** ***

We did receive our refund in full along with a letter stating they would bring the issue up at their next board meeting to assure clients don't have this problem in the future.[redacted]

Review: My husband had coverage in WI and we moved to HI and now have coverage here. When we cancelled the coverage in WI they ended up charging us again and then the plan was terminated. When we called to get a refund they transferred us numerous times to then finally tell us the refund is going to our WI address---hello we aren't there anymore! In order to change our address they have to summit a request to their resolutions department which will then call us back 5-8 business days later to "possibly" get it resolved! I want our refund and need this taken care of ASAP!Desired Settlement: We get refunded and this issue with people moving from one state to another don't have issues cancelling by getting screwed out of their money.

Consumer

Response:

We did receive our refund in full along with a letter stating they would bring the issue up at their next board meeting to assure clients don't have this problem in the future.[redacted]

I went into urgent care with extreme back and leg pain. The urgent care doctor did an MRI and found a bulged disc. He sent a referral to see a neurosurgeon. He said that I should be seen within the week. Security Health plan said that referral approvals take up to 14 days. I spent hours on the phone, most of the time on hold. I keep getting the run around. What a horrible experience.

Review: Security Health Plan is billing my husband and I for dermatology services (skin tag removal) that have been preformed for many years in the past as part of our services agreement, although subject to deductible.

This year, which we just found out yesterday, they have said they decided they are no longer covering these services and are classifying them as "cosmetic".

They did not notify us in advance that this coverage had changed and when asked why they didn't notify us, their response was "that would be impossible to do for everyone".

How can a patient know what services are no longer covered, if they are not notified in advance. Especially, when the services have always been covered in the past.

Their response was that every patient should call before every appointment to be sure the services will be covered. My response was, "how do we know what services are going to be provided - prior to the visit?"

There advertising says "promises kept - plain and simple". Obviously not so.

During my last communicate with them yesterday, they said I could appeal the denial of coverage of charges, and explained the details which would include another doctor visit to get the doctor to document why the skin tags were removed. So basically, we would have to pay for another doctor visit for them to deny in order to try to appeal their original decision. So the appeal will cost of more money.

These practices are unethical and should be illegal. How can a patient make good financial decisions regarding their health services, if they are working with a company that will NOT be upfront with them regarding their billing practices and coverage of services. Changes in services should ALWAYS be communicated to customers.

I repeatedly asked them to cover the charges - and told them that in the future, now that we know these services are not covered, we will accept responsibility for payment if we desire the services in the future. But without being notified of the change in services, we should not be responsible for something that was always covered in the past.Desired Settlement: The charges should be covered for the dermatology services that were performed - same as every year - because we were not notified of any changes in their service coverage until AFTER receiving the services and billing from Security Health Plan.

Business

Response:

This matter is now being handled through Security Health Plan's grievance process. After the appeals and grievance committee has thoroughly reviewed and considered this complaint, I will send you a copy of its decision.

Review: I am a current customer of Security Health Plan. I received a letter several months ago saying that my policy was going to be cancelled as of January 1st, 2014 because it did not comply with the new health care laws (ACA). I looked into the costs of a new policy and found I could no longer afford to have one, due to rates being increased substantially.Security Health Plan sent me a letter stating that since I hadn't purchased a new plan, they elected to automatically enroll me in a new plan they chose for me, starting Jan 1st, and I would be receiving a bill.They never contacted me to see if this was ok with me. I never signed any forms. They enrolled me in a plan without any consultation, then told me I would have to send a written letter or call them to cancel it.The plan that they picked for me, and put me in without my knowledge or consent would cost me $400 dollars more than my current plan. I cannot afford this.I am very upset that they just chose to automatically enroll me in an insurance plan, without every asking me, and without me signing anything. Can this even be legal? I was planning on letting my insurance plan expire and this company took action otherwise that was in their interest and not mine. I did not agree to this.Desired Settlement: I would like to know if their practices are even legal in doing so.Is it legal for them to enroll me in a health insurance plan without ever contacting me in anyway. Is it legal for them to enroll me in a health insurance plan without my signing any forms saying I agree to this.I am upset that I have to call or send a written letter to get out of this, when I never agreed to it to begin with.

Business

Response:

This letter is responding to a complaint filed by [redacted] with the Revdex.com of Wisconsin, which Security Health Plan received from your office on December 13,20 13 (letter is dated December 9, 20 13). We respond to the complaint as follows: