Approved Predetermination doesn't speed up reimbursement
by Just Me on Nov 19, 2024
1 out of 5 stars
It's been over a year and I still can't get coverage, even thought you take my money every month. I'm a veteran of 28 years of service for this country. Now that Canada life has taken over, it's been a year and I'm still paying out of pocket for medications. I completed positive enrollment and after 6 months of misery I was finally able to submit a claim. It worked for 2 months then all my info was deleted and now my family is not covered again. I spend hours on the phone but no one answers. The website does not work, I can't update my profile or submit claims. So what does a veteran do, I guess my only step is the media, I've sent messages, complaints, contacted my member of parliament but here we are still dealing with this very sad excuse for insurance companies. I would love for someone preferably a top executive to contact me to explain why they can not do their job.
John
As a pensioner. Have to wait weeks for return cash. Draining for us and very little reward for dental. Always 0% coverage or very little 5K for dental UT 150 for me? Now I am sick. 3-hour wait on the phone? The government controls these people.
I absolutely hate this company Canada Life. Not one time ever when having to deal with an issue were representatives helpful, they don't care about anything but taking your money. They will do anything in their power to avoid paying your claims.
Here is my story... I recently started a new job where Canada Life is my benefits provider. I have 100% coverage through my plan for prescription drugs plus not that I need it my wife has 80% coverage through her benefits provider. Anyways went to use my benefits for the first time, my pharmacy went to submit my drug claims for the diabetes medications I had 4 prescriptions, they covered 2 of them partially, the cheaper ones and then my other 2 they didn't cover at all. Apparently, they need further information before covering anything. What the hell??? I pay through my teeth for my benefits. They are telling me they want to see what my Manitoba Pharmacare deductible is and won't cover my meds until they get this information. Why does this matter? First of all my Manitoba Pharmacare deductible is around $7000 for the year, I come nowhere near spending $7000 in a year on medication, even if I did my insurance wouldn't even be billed because once you meet your deductible Manitoba Pharmacare pays for your drugs I would pay nothing for them nor would Canada Life as my Pharmacy would see my deductible of $7000 was met and wouldn't bill Canada Life. What an absolute unnecessary waste of time this is it's completely unnecessary and irrelevant. It's just Canada Life doing everything in their power trying to avoid having to pay for my drugs however I still pay Canada Life for my premiums through my teeth, through my employer's payroll deduction, they take your money with no problems though.
God in heaven helps you if you ever need to call their call center to speak to a representative. I wasted my 1-hour lunch break at work today trying to talk to a representative to no avail only to be on hold for 55 minutes holding for the next one and I had to hang up after wasting an hour waiting for help because I had to get back to work. I was so angry. That is a wait time that is absolutely ludicrous and unacceptable. That is not Customer Service. I work 8 am to 5 pm daily, if I can't talk to someone on my lunch break that is an hour-long what the heck am I to do to talk to a representative. Do I need to take a day's holiday off from work just to be on hold for 3 hours to try and get to speak to someone??? This is pathetic! You should not be on hold for any more than 5 to 10 minutes top. This is a serious problem for Canada Life! Don't believe me about the wait times call them yourself and see. Hire more representatives because whatever you are doing Canada Life is not working and is absolutely maddening to me as a customer but it will all just fall on deaf ears as this Company doesn't care a worth spit for its Customers.
Told me I was covered for a TENS machine. I provided more than they asked for in documents. They still denied my claim. They are not fulfilling their duty as a benefits provider.
I paid around 2000/year. This plan said it's will cover 80 percent of fees for the drug, but when I claim for that. It's only paid me 20 percent of the full price. Just bad, and the bad web log in entry. Don't trust this company.
I have to submit health claims 5 times before getting payment for 1 chiropractor visit. It was submitted in September and paid for in December after submitting it 5 times. In a time of Covid wouldn't cover a hospital stay and expected me to be in a room with 4 other patients. Paying $350 per month for my plan and only letting 80% coverage on limited things is a waste of money. This company is terrible to deal with! The website is not user friendly, long wait times on hold and waiting months for payment...
Went off on short term disability, expected to last 2 weeks and my claim was approved. I was required to extend my benefits, and this is where they earn their 1 star. It has been over a month. They don't return calls, they don't respond to emails, customer service hangs up after waiting in a queue, they don't reserve your spot in line. The agent assigned to my case doesn't answer her phone or call back, doesn't respond to emails. 45 days, 8 emails, over 30 calls. I haven't talked to a single human being yet and my coverage hasn't been extended.
I am happy with the coverage and protection it offers.No hassels with premiums.
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No clear, complete, instructions to ensure you submit everything to them that they require to process your claim in a timely manner and if they need you to re-submit the same information to them that was included in your initial predetermination request, which drags out reimbursement. They seem to give you more information with each call you make to them, inquiring on the delay. It would also be helpful if they included the details of your coverage for that item, in the predetermination response, e.g. Up to $150 coverage once every year. They do not send updates as to the status of your claim, you must sign in daily to see if it is still pending or not, and no added info is added there... their system can cause financial hardship if you are relying on a quick reimbursement... Much easier to deal with a company who pays the service provider directly. Benefit coverage should improve more, annually, to keep up with the always increasing high fees charged by service providers for services required.