Complaint Review: US Health Group - Fort Worth Texas

Purchasing self health insurance, is hard enough, with limited avenues for service. Freedom Life aka US Health Advisors, stated they could provide me health insurance at a reasonable rate (cheapter than Obamacare). Options are a must, if Obamacare providers for services needed are minimum if available at all. Pricing-Durng our phone interview, I was told one price. Once the applcation process came back, i was told a higher rate for the premium. That is normal. Also during our call, I was told the deductibel and what the coverage was as well. Forced membership into club-So imagine my surprise, when I get the insurance card and realize, i am forced to join and pay a monthly fee to a membership club, of which was not explained during the interveiw process. Policy coverages-Second, the policy coverages were quite different, even more than explained once I began to utilize the coverage. Once, I began to go to providers, I quickly learned the insurance policy covered minimual, if anything. Imagine my surprise, to pay for an insurance policy, I'm discovering once getting EOB's are denying doctor visits, routine exams and blood work. EOB's-When the EOB's began arriving, we found duplicates for the same day, same service and same amounts; yet, different EOB' numbers. The invoices from providers were not matching the EOB amounts submitted? One would think the provider invoice amount should match the insurance EOB amount, showing what was biled by provider? Two separate premiums-Should you require an upgrade, one receives two different premiums billed individually during a one month cycle. Deductible-The basic policy is one deductibel. If one requires an upgrade the deductible is changed from their program to Cigna. They allege the deductible is $5k in network.

So imagine my surprise when I began receiving EOB's that showed my out of pocket not only exceeding 5k; but again, minimual, if any, coverage on the visits. Yes, calls were placed to confirm the provider was in network prior to seeing them. Mysteriously, after receiving the EOB, that same provider can not be located in network.Need out of network? On the upgrade the deductible is suppose to be $10k. So again imagine my surprise when I began receiving EOB's and invoices from providers, that clearly exceeded 10k, which minimual, if any payment by the insurance provider. Communication-Try calling the office for information! They are open 8-5, M-F. The lines are usually always busy and ask you to call back. Try sending an email, they usually tell you to call in or you don't get answered.

In fact, the employees regularly told me "corporate does not want us using email, they want customers to call in, they don't want a papertrail". Cost-From my experience, I would not recommend this coverage, if you actually need medical coverage. The cost for one person on the basic is approximately $600. Plus, your cost, what is not covered when you actually use the service. Second, the premium cost, if you upgrade was approximately $1200 for one person! Plus your cost, what is not covered when you actually use the service. From our view, there is likely close to LESS than 10% that was covered under the coverage we paid for. Do recall, we paid for 100% once we reach $5k. We have exceeded 5k and still paying; because the charges were refused (yes, even in network cost, ordinary cost, necessary cost). We are beyond frustrated and hope people don't make the same mistake we did. Find a coverage that provides the services you pay for. According to our documentation we did not.