Complaint Review: MercyCare Health Plans - Janesville Wisconsin

This report applies to the whole year of 2017 regarding Mercy Care Health Plans / Mercy Care Building in Janesville WI. I need to expose how this company does business using facts, so other's can make an informed decision on doing business with this company. This applies only to the for profit business office known as the Mercy Care Building. 

They promote having lower prices than competitors for health insurance policies such as the Marketplace "Obamacare" plans, as well as the Senior supplement plans for Medicare. You get what you pay for could not be any more true in these instances. For example, if you signed up to become effective with the health insurance as of 11/01/2017, they will gladly take your first premium payment. December 2017 rolls along, and you still will not have gotten anything in the mail, except for MAYBE another premium bill. I say MAYBE, because that is another issue that we will touch on later here. So yeah. They've taken your money, but you have no insurance cards, no acknowledgement from them what-so-ever that you even exist to them. When you call to ask what is going on, you can expect to wait on hold for 20 minutes before getting someone who will tell you that they have a new system and they are having issues printing out cards. They have no time frame for when you might get your insurance cards. In the mean time, you have no card to present to the doctors office or pharmacy. Isn't that wonderful customer service?  Even better yet, to start the year off, they were over two months late getting insurance cards sent out to paying members. The excuse for this instance- "We took in more people than we could handle so we haven't gotten the cards sent out." Not your customer's problem. Stop making excuses and DO something about it. People are paying a lot of money for a service you are failing to provide.

Now, on to the premium bill nightmare. November 2017. No premium bill arrives until the last few days of the month. It has the wrong dollar amount due on it by a few hundred dollars. The premium is due on December 1st 2017. About a week and a half later, 12/6/17, a letter arrives saying that they had a system issue and the wrong dollar amount was printed, and the correct amount is on this statement. But hey, your due date is 12/1/17, even though this letter is dated 12/5/17. Call the 800-895-2421 number on the bill and you again get someone who can only offer to take a credit card payment over the phone. No. I mail a check in. I don't trust using my card number over a telephone and giving it to god only knows who.

All of this falls on the heels of them taking several months to process insurance medical claims. So long that you get a letter in the mail from the doctors office saying they billed your insurance, but haven't heard anything from them, so the balance is now YOUR responsibility. It shouldn't take your customer calling to ask why in the hell an 8 month old insurance claim is still not finished, only to be told they don't know why other than they are backlogged with claims. They just don't care. Even though you are being billed now and treatened to go to collections. And don't forget the times you will have to call because they denied your claim by mistake saying you will have to pay the money. Or the time that they processed a yearly wellness wrong causing you to owe money. They tell you that your colonoscopy will be covered in full at 100%. If the doctor finds a problem while doing this 100% covered colonoscopy, the whole thing turns in to colonoscopy that is not 100% covered, costing you big, big $. This is no way to operate a business. They obviously have leadership problems and a severe lack of knowledgable leadership. I honestly do not know how they stay in business. I will not be staying with this company and will never go back, no matter how cheap their insurance plans get.  You've been warned.