Emblem Health

Terrible. I signed up for this insurance to see a specific doctor on their «approved» doctors list. I am locked into the insurance for the year, and now they are saying they won’t cover the doctor even though he is STILL ON THE EMBLEMHEALTH WEBSITE! It’s essentially fraudulent marketing.

If you think your dentist will accept the ridiculous reimbursement rate for an exam and cleaning, wait until he sends you the difference of the bill.
Do NOT consider Emblem GHI for your dental insurance carrier. I learned the hard way.

Before posting this review I looked at all the other reviews. All I can say is that almost all of them are very accurate. There is no exaggeration or hype. Emblem Health is not very good.
My advice for whatever it’s worth.
The law says you need insurance otherwise you pay a fine. If you are considering Emblem Health I would due your due diligence, that means check out what you will be using. Make sure that your primary care physician actually takes the insurance. Make sure that they are accepting NEW PATIENTS! As others have said their website may NOT be accurate.
If you go to the HMO you will need to get referrals for everything. If you don’t use their doctors you will have a hard time.
Not to waste your time but this insurance company needs to be at the bottom of your list. If you choose to go with them you will see what everyone who posted a review is saying. If you see a Dr once in a while for a cold etc you will be ok. When something happens and you say thank god that you have medical insurance you will realize that you just made one of the biggest mistakes in your life. Ive been a member for a long time and I will soon be looking for another insurance company.
At one point in time Emblem Health was good but over the last few years they have gone down hill. Be prepared to hear the word NO, and more.
If you go out of network make sure that you have money, a lot of money.

Total crooks. They won’t even pay for federal mandated health services like cholesterol blood tests or colonoscopies. And through their primary care physicians at primary care offices! I don’t understand why the Attorney General’s office isn’t putting these people in jail.

I recently got kicked off of my parents insurance which was Empire Blue Cross Blue Shield, my job offers Emblem Health and so far every experience I’ve had with this company has been a disaster! First off, I was initially supposed to be covered by them December 1^st and didn’t get my id number or card until December 24^th! Every quality doctor I’ve called on their so called «find a doctor» portal does not accept my insurance, all I’m left with are the shitty ones. To make matters worse my doctor prescribed me some ear drops which I had to pay 100 dollars for as a deductible. A disaster

I’ve been with Emblem Health for almost 25 years,
since the were called H.I.P. Things went down when the profit motive
set in.
First they replaced the older more highly paid doctors with young foreign doctors.
lacking people skills and running sloppy offices, many subscribers left at that time,
Cut to 2015
You practically NEVER see a doctor — EVEN YOUR OWN PCP keeps visits
as short as possible or palms you off with a «nurse’s visit»
It’s takes months to see a specialist and you will often be directed to
a NEW useless «profession» a «Physician’s assistant».
They require less training than a nurse and are utterly useless.
I am not basing this review on one bad experience
but years of watching this insurer decline into uselessness.
One never gets anything I would call a complete physical.
There is ZERO preventive medicine being practiced.
I get the impression my doctor (of 8 years!) doesn’t even spend 5 minutes
reviewing my file before waltzing into an examining room.
I had to REMIND her, I hadn’t had a blood test in over a year.
She often lies, at this point, when a treatment isn’t working or
plays a game, I call:“Try and blame the patient.”
(Suggesting you are not taking your meds, or taking them at the wrong time,
not taking the right amount, or not taking them long enough. As if YOU
have a death wish?)
Emblem Health is CURRENTLY the worst insurer I have ever had,
Rock bottom

Avoid them if at all possible. We were forced to go to them after Vytra ceased to exist. They are no help at all!!! We have been fighting a bill since ⁰³⁄₂₀₁₅!!! All they have to do is send an adjusted EOB and they keep telling us to call the hospital and the hospital keeps telling us to call Emblem. EEEEEEEEEKKKKKKKKKK!!! They really, really, SSSSSTTTTIIIINNNNKKKK!!! would use worse language but it would never get posted. For your own sake, stay away! They don’t know what they are doing and will hopefully go out of business too!

I just tried to sign up for EmblemHealth and everything was going well until I got to the payment section. There was a fee for a pediatric dental plan that I did not need nor request added to the plan I did choose. I could not remove it through the website so I called customer service. I was told that the pediatric dental plan was added and there was no way to take it off! Seriously? You make your customers pay for stuff they don’t need? And on top of that, you have customer service reps who are unbelievably nasty for no reason. Glad I found out before I signed up. There’s no way in hell I’m becoming a member. I’d rather go without insurance than deal with such an unprofessional company.

Living in New York City of all places one would think this insurance would be so much better than it is. This is the insurance that most city and federal workers have (teachers, sanitation, postal, cops, firemen). Called today re: hearing aids to be told I have limited coverage under durable medical equipment. When I called 6 providers rep. gave me of course hearing aids is not this. I called back and actually got someone (Rebecca) who told me to try HearUSA. I called them, but no one got back to me yet, so we’ll see. Also my daughter has a very rare eye condition (1 in 200,000), causes blindness. She sees her Dr. every 3 mo. but we wanted her to see another specialist who has actually had a patient with this condition. Well of course no in network Dr. so we pay $ 1200.00, Emblem approves $ 151.00, deducts $ 150.00 out of net work deductible and sends us $ 1.00 ck.

EmblemHealth – if you a reading this, I hope you cannot sleep at night because you are putting your members through the ringer when they try to get help for serious medical issues. As many other members have noted, the lists provided lazily by EmblemHealth with participating providers are full of WRONG information. I would say only about HALF of the doctors listed actually are taking new patients or actually have the phone number EmblemHealth lists them as having. So you can spend hours dialing through the list, and all the operators can tell you is «I’m sorry m’aam that’s the most updated list we have.» Hire some people and go through the lists to make sure they are correct! Most doctors worth their salt also do not participate because the pay-​out rates are so low. My chiropractor takes me almost out of charity, because Emblem only pays him $ 23 per session. Also, getting the tests you need is an odyssey. My PCP prescribed an MRI, for instance, and a week later, no response from Emblem. They say the PCP must provide more documentation when I called them to find out what the heck had happened. But they told ME this, not calling the doctor. Now I have to waste more time acting as middleman, and I still don’t have my test. Horrible, horrible, horrible.

Emblemhealth is horrible! I was told in the emergency room that it was critical I have hip surgery as it was collapsing in on itself. When I called emblem they were very nice and emailed me a list of ortho surgeons in my area. I called every doctor on the list and was informed they did not accept this insurance. I searched and searched but could not not find anyone who was not more than an hour away. I called emblem again and again, they were so helpful and emailed me a list of surgeons who also did not accept the insurance. I wrote them a message begging for help. I’m in excruciating pain. They gave me an email address that does not work. A phone number for patient advocate, but is not and another name of a surgeon who does not accept the insurance.
I wrote to my congressman and asked for help, we’ll see what happens. At first I thought they were ignorant but now I believe that they’re evil

I have a health plan through the NY State Health Exchange. Emblem makes mistakes left and right. I have to spend lots of time on the phone managing the processing of my claims, partly because of Emblem’s incompetence. They seem to throw up bureaucratic barriers to make it difficult for me to get health care paid for.
I’ve had to file two appeals — each of them two-​page letters.
Terrible value, this health plan is an abomination.

Extremely frustrated!!!
I have to start with that none of psychologists is taking this insurance !!!
I called to get info to where to send claim forms for psychologists sessions.
1.I was given the wrong address! Therefore, I send all the bills and was waiting for months for checks I never got!
I included my phone on it. Nobody cared to call!
2.I was NOT TOLD told that the provider is suppose to fill out the CMS 1500 form!
and then i would send it with bills to get reimbursed.
Luckily, after 2 month of frustration, I got a rep on the phone who knew what he was talking about.
Strangely, my psychologist had no clue what to do ether!

Not just the worst insurance company. The worst company to deal with period. Customer service double charged my credit card and I’m waiting 3 weeks for check refund. They refuse to refund my credit card. The worst customer service ever!!!

I’ve had this insurance for about a year since I started working and it’s just as bad as the free Medicaid Fidelis I had when I was unemployment. The doctors I’ve visited haven’t been very good and now I have to co-​pay for visits. Sometimes I cannot log into the emblem health website while other times it’s down for maintenance. Twice in one day while I was trying to reach a customer service representative, I was hung up on. This is a pretty bad company to be quite frank.

Emblem Health is possibly the most horrendous health care insurance ever… and I work for the company. well with Advantage Care Physicians.
Patients become so frustrated and it is understandable because they try to call their PCP’s office and only get the corporate office. And in the corporate office, we are not given direct numbers for medical offices. I am sorry to say this company makes patients run around a lot and it is disgusting.

I actually read some of these reviews before choosing EmblemHealth; if you are like me and reading this now thinking «all insurance companies are terrible and do these things,» you should know that when people say no doctors take it, they are not exaggerating.
Before I signed up I searched the website of each plan available to me on the exchange to see how many participating pcps, obgyns, etc were within 5 miles of me. Emblem did not have the most but they had enough (about 150 pcps including all the top hospitals) and they were the only company to cover all the medications that I take so I signed up, assuming it couldn’t be that much worse than previous terrible insurance plans I’ve had.
Last week my PCP said I need to see an orthopedist. I got a list from Emblem’s website of 48 orthopedists within a five-​mile radius of me and called all of them (some were in a group practice so I did not make 48 phone calls, but it still took two days) and NONE of them take my insurance.
When I called Emblem the cs representative said that they will not remove a doctor from their list unless the doctor personally calls them and asks to be removed. So, they are committing what I believe must be fraud by listing numerous doctors who do not take their insurance and refusing to update the list. They are also not actually covering the minimum services required by law if they don’t contract with any providers offering those services.
Their rep told me that if I couldn’t find anyone within 30 minutes of me who takes Emblem I could go out of network, but the doctor would have to agree to their reimbursement rates. Obviously if the doctor were willing to be reimbursed at whatever rate they offer, fill out the paperwork, etc. they would accept the insurance. And, last time I checked it’s not my job to negotiate reimbursement rates with physicians.
Pretty much every bad thing that other reviewers have stated has also happened to me, but I am trying not to be too repetitive so I’ll just say that they do deserve negative stars and major legal action.

The WORST health insurance ever!
«This thing is working» — Obama April17, 2014 for his so-​called signature Affordable Care Act
The richest country in the world with the most available resources has resulted the national healthcare system to a dilapidated state. Obama Care has crippled the nation with unnecessary penalty fee tacked onto your tax income filing for those without insurance. Three levels of care based on members’ income: gold, silver and bronze as many doctors, clinics, specialist doctors and radiology, CAT scan, MRI, Ultra Scan exams do NOT accept Obama Care. Abject pain! Waiting two weeks after day one of open enrollment on October 1, 2013 from the website server being overloaded with huge influx of subscribers resulting in error messages every day. I am one of millions who currently have no health insurance from their employer, therefore I have no choice but be subdued to O’ DUMMY CARE! I feared the looming registration deadline of March 31, 2014 and refused to pay the stupid penalty of having no insurance at tax filing time. Fast forward to January 2014, I received my first bill with only one week time allotted for payment. What kind of company allow its members for only one week for payment? Credit card company have 2.5 weeks allotted time!
I never received a written list of member benefits, NYC doctors listing directory, nor a member rights and responsibilities booklet like any standard health insurance company would do to newly subscribed members. I called the hotline number to speak to a representative who was not confident and not knowledgeable as she was very narrow-​minded to see only one part of my file in her system. Repeatedly she expressed: «go online and pay for your bill, you need to go online okay!!» Hello, woman I ALREADY paid in full my bill why can I get a written list of member benefits, NYC doctors listing directory, member rights and responsibilities booklet? I am entitled to such basic services. Again, the woman turned a blind eye repeating stated «go online and pay your bill, well I see you can go online as well I’m not sure. Ahh…» so she could not handle my call putting me on hold and like a light switch stopped repeating this nonsense and immediately put the order for my requested paperwork to be sent. It was like talking to a thick wall.
Emblem Health is the WORST health insurance company with incompetent people!

Worst worst worst worst worst worst worst insurance ever! I couldn’t be more infuriated with a company. They charged me for two months at one time TWICE and still haven’t refunded the money for starters.
I have Emblem HIP and they gave me a doctor as my PCP that doesn’t take their insurance. Then, they finally gave me a doctor that does take it and I thought they switched me over to her but turns out later that she doesn’t accept emblem and isn’t in their records. I called the doctor and she confirms that she does take it so Emblem customer service people tell me that the DOCTOR needs to call THEM to update her information and that they can’t switch her to my PCP until she does that. In the meantime, I am waiting for this to get resolved and the doctor calls them to update the info and Emblem cannot find ME in their system… WTF???
All of this is so that I can finally get a referral and go to the dermatologist to check out a rash that I’ve been waiting months to check out. This is not worth paying $ 330 a month for!!! I would rather go to a dermatologist and pay out of pocket but I HAVE to have insurance according to Obamacare and since I’m an independent contractor I have to have health insurance to keep my real estate license. The customer service people are unbelievably unhelpful on the phone as well. Let’s seriously make a petition and take these idiots down. They are complete charlatans. Who’s with me?!

Very frustrated that for 15 years I had excellent insurance at an affordable rate, not cheap, but affordable. With Obama care I now pay more for lower quality care and less selection of doctors. After a year with Emblem I guess it will do.
Unfortunately a number of my favorite doctors don’t take this insurance and I feel bad that the negotiated marketplace doctor’s fee Emblem pays seems very low. I have no choice but to take this insurance and just hope to stay healthy as I have no idea how this insurance would be in a health emergency.