Meritain Health

Really why is this place still in business? Over 18 months and no information on the status of my claims! I have to call them at least 3x a month and rehash all the issues. Why is this my job and I’m not even on their payroll? If I were on their payroll this place would be a hell of a lot better! Beyond bad… they are unethical, untruthful, unreliable and probably thieves because they are holding on to my money!

Absolutely, ridiculously bad. So far, I’ve called to verify that each of the doctors for myself and my daughter were covered before going in for services. So far, I’ve had to fight them for coverage for each of these doctors that they verify are in network when I get EOBs and bills stating that the doctors are out of network. I have not had one doctor visit/​claim where I have not had to call to fight about coverage for a claim, and it takes 6 months to resolve the issue with at least 6 – 7 calls on each claim. If you have a choice, stay FAR, FAR away. Absolutely the worst insurance company I’ve ever, ever had to deal with.

Awful! Meritain is the secondary health insurance carrier used by my work. It is so unfortunate that I have to use them. Every time I submit a claim, something always goes wrong. Every. Time.
I am pregnant so I am currently incurring lots of medical bills, some of which I pay up front and then submit to Meritain for reimbursement. Here is only one example of Meritain’s horrible claims process and customer service:
I recently submitted about 5 bills to Meritain with their claim form. The claim form asks whether I had paid the bills and thus required payment to be sent directly to me. I paid for the bills, so I checked that box. After not receiving any reimbursement for 2.5 months, I called to follow-​up. I was told that 2 of the payments were inexplicably sent directly to the hospitals and that I would have to contact the facilities to get my money back and 3 payments were inexplicably sent to an old home address after I had updated my mailing address with Meritain multiple times. Despite THEIR mistakes, Meritain then states that I have to wait 30 – 45 days from when the checks were sent (all different dates for each bill) and then I have to call to request new checks to be issued. I am shocked and upset at the amount of additional work created for me b/​c of THEIR mistakes. In some ways, I feel that they purposely make mistakes and require me to correct/​follow-​up with them, so that something falls through the cracks, and I don’t get paid. I feel like they make you go through extra hoops on purpose. I have requested to speak with a manager/​supervisor about the disorganized way the company operates, and such people are never available nor do they call me back when I request a call back.
More recently, I submitted a few claims in for reimbursement and received a fax verification that my claim went through. A week later, I called to confirm that the claims were being processed (at this point, I feel like I have to babysit). I was told that they cannot locate my claims. I am unbelievably frustrated by how disorganized this company is. I again requested to speak with a manager/​supervisor and was again told that one was not available. I was told that a manager would contact me… we’ll see if that happens because I was told this before and it never happened.

Meritain is our Third Party provider managing our Aetna insurance. After some hoops to jump through for my 4 YO’s Care, Sasha and team from the customer service department were able to resolve the issues. Thanks Sasha for all your help!

Biggest waist of time ever they accept none of my claims so I pay allot monthly for no f*****g reason I’m gonna cancel tomorrow and sue them, what’s also weird we wanted aethna but ended up automatically with this place somehow … They keep sending letters we need more information about this claim, even my docs office have been fighting with them now and they said this has to be the WORST insurance they have EVER experienced, you guys are CRIMINALS

I have had the worst experience with them and I just googled them to see if there are others with the same experience. Looking at their reviews, there are… beware, they WILL NOT pay you for claims they say they will, even when you call they say they will, but somehow the check never comes. The worst, its been 6 months!!!

So far… not a fan. I had to go through a set of circus hoops to get a phone number. I have yet to receive my insurance cards. I wanted to call them. CANNOT find a number unless I go to google. No phone number on their website. You cannot talk to a human when calling unless you know your ID#. Well, I don’t know the ID# as I don’t have my card. I want a card. Can’t find a phone number. Found a phone number. Need my ID#. OMG. This is the first month having this insurance. It can only improve from here. Let’s just hope it does.

WORST INSURANCE EVER. If your employer offers this insurance, it’s because they are cheapskates. Don’t take it. Purchase your own insurance on the marketplace. Meritain are criminals. They don’t cover any ultrasounds for pregnant women or bloodtests. Want to know if your baby is going to have cystic fibrosis or other genetic diseases? It’ll cost you $ 3,000 because Meritain doesn’t deem it medically necessary. RUN.

Nightmare to deal with worst health insurance I ever had. They have not paid my claim after 4 months and do all they can to avoid paying.
Customer service people are not helpful. I got a runaround and they got paid.
Read the other reviews they are correct. STAY AWAY!!!

After several attempts to find a doctor through there find a doc site I am just going to drop my insurance. They list dozens of providers that are not accepting patients or are 5 to 6 weeks out for an appointment. They will also list providers that treat the condition you are concerned with but when you call them they do not actually handle that branch of medicine. Very disorganized and frustrating to work with. They also do not like to pay providers. I was billed for care that they should have paid and did not. I had to call several times to finally get them to pay their end. Unprofessional and just not worth the headache.

Submitted some final claims and closed my account. The website is much better, no extra hoops this time, and reimbursement didn’t take as long to arrive. Still not great, but much better than before.
Plus one star…

i was so frustrated with dealing with this company that I decided to look online to find out if other people had experienced anything similar. Well, I can see that this company has a history of incompetence. i just got off the phone with them again. My husband is a provider who has been waiting for his payments for several months. Each time, they come up with some sort of road-​block to prevent that from happening. They are the only company that we deal with who requires a w-​9 (and we work with all the mainstream insurance companies such as Anthem, Aetna, Cigna, and Humana). That added a week to the process. They couldn’t find the claims — so we ended up processing them electronically, then faxing, then mailing until they finally seemed to have them. Then they processed everything on a virtual credit card which they neglected to tell us about. I had to call to find this out. Then I cancelled the virtual credit card and asked for an actual physical check and a week later we are still waiting. The first claim was filed back in December of last year, so you see this has been going on for some time. Today they said «the check is in the mail». I cancelled the virtual credit card on May 1 and they said they mailed the check on May 4 and today is May 7 so maybe the check will come tomorrow or next week. Here’s hoping!

I’ve had a horrible experience with this insurance so far. They don’t seem to know what they are doing. They charged me for a greater deductible than I have and took a long time to make the adjustments. Unless you like being overcharged, bad customer service and being put on hold for a really long time then don’t get this insurance.

I am going through the absolute worst experience with Meritain. They are so unorganized and have taken their time to «process» that suddenly they are deciding to deny my $ 25k worth of bills for an ICU accident stay saying my time has lapsed. I have spent hours on the phone with these people over the previous months only to be told that they are processing and «cutting a check» when in reality they never intended to due so. The story changes with the rep that you talk to. Records were sent that nobody seemed to look for until I spelled it out for them. Totally disorganized and dishonest in my opinion. If I get stuck with these bills and ruined credit because of their lack of organization and care I will pursue legal action. Seeing the reviews looks like I might have a class action on my hands. Let me get this straight… you take my money for a premium but refuse to pay when I need to use insurance? No good.

This is a horrible insurance company. The claims processing is slow, they refuse to reach out to providers when they need additional information (they’d rather let your claim deny, with no assistance to rectify the issue) and the customer representatives are very vapid. I highly recommend staying away.

The absolute worst insurance company I have ever dealt with. Claimed in February that a pre existing condition prevented me and my dr to submit a claim. Are they not in the country where the new affordable care act was passed and PRE EXISTING CONDITIONS DO NOT APPLY ANYMORE TO THOSE WHO INSURED THE MIDDLE OF JANUARY ?
I would rather pay a fine and carry no insurance then have these morons as an insurance provider.

I advise you to stay clear of Meritain Health. They get one star for being pretty easy to get an English speaking rep on the phone.
however, their claims processing is incredibly slow. So slow in fact, that when I switched to a different insurance company, my bills incurred 3 months later were paid and settled by my new company while Meritain was still fussing about earlier bills. And fuss they did. They will try to deny every claim they can, saying normal protocol are «deemed experimental» and «unnecessary». My surgeon’s nurse has better things to do than sit on the phone with these people, yet Meritain wasted countless amounts of her time. They played this ridiculous «convince us» game with my oncologist’s office over everything. It was an embarrassment.
In addition, throughout my medical issues, I received several letters and annoying phone calls from a «Meritain Case Manager», who claimed to be contacting me to «help» me to «make sure I was receiving proper treatment». What a joke. The guy was ruthless, calling constantly during my recovery, while I was asleep, trying to recover and rest, asking questions that most certainly were not meant to «help» me, but to make sure I wasn’t spending any more of Meritain’s money than absolutely necessary. I finally called him out and told him while I respected the fact that he was an RN, that I knew Meritan was signing his paycheck, that my well being was not on his agenda and that it was clear he was keeping tabs on my issues. I asked him to leave me alone and he then proceeded to bother my wife. Ridiculous.
If you have any choice, I advise you to look for other health care. This place stinks.