Terrible Service-Empty promises
by Tonekaboni on Jun 28, 2024
1 out of 5 stars
I am enrolled with our company health group plan. But this is the worst insurance I've ever dealt with. There's no service at all. For claims, you get denied multiple times if manually submitting even if it's clearly covered. You have to call just to have it get through. No flexibility or care at all with the customer. Even the clinics I go to says the same thing - difficult. I was also previously enrolled with our company group retirement plan. Same thing. The people you talk to are just robotic and no sincere care to help customers get the best value from the benefits they are foremost entitled to.
First of all, the staff are not knowledgable. If they decide not to pay a claim, they could give you very stupid reasons. For example, my dentist claimed on my behalf a charge that I had to pay upfront. Here is the list of the reasons Manulife staff provided to avoid reimbursing me what I paid.
1. First call, the customer service agent said that we can't pay the dentist directly - I said they don't require you to pay directly to them, you just need to reimburse me directly what I paid to them.
2. Second call to follow up: new customer service agent: it is not processed because the address on the claim is different from the address on your profile. Ok, can I update my address? No, only your employer can update your address, (this was their answer after they knew that my husband (plan holder) has quit his job) and now they wanted to make it hard on us since my husband cannot call his employer for such stupid reason. I decided to call my dentist and make them change the address on my claim to the previous one (since we still own that home but it is rented out). The dentist changed the address and now I thought it should be good. I submitted myself online.
3. Third call to follow up about the status of my "new" claim: a new customer service agent: I see a note about the address. I said: yes that was the previous claim but now the address on the claim matches the address on the profile. The agent: oh I think it's nothing to do with the address. I think you claimed this diagnosis dental exam last year and now you are not eligible for it. Well, you paid only $19 for that claim and I have a balance of $140 left. Can this cover the cost? No, since you made a claim that's it, regardless of the amount paid, you cannot claim again. And finally, I had to give up since I found it a waste of time for myself.
For everyone who is seeking to get covered. Do Not go with Manulife. And if you do, please know that you will have to pay from your pocket for insured items and you have to beg them to get your expenses covered and be ready to hear different excuses every time you call.
I waited for 2.5 hours for someone to answer the call and finally gave up. Was able to get a hold of someone a month ago when I called but that took 40 minutes and they were extremely unhelpful. They just repeated talking points without answering a single question. On top of all that they refuse to direct bill paramedical services (e.g. physiotherapy) even though they claim to do direct billing when you call them. Submitted claims sit unchecked for weeks and there's no way to get in contact with them without waiting for hours on the phone. I'm embarrassed to be a customer.
They have too many untrained new employees that do not know what they are doing yet. Several agents promised to call back within 3 days. NONE did and some did not even make notes that they had talked to me. 8 calls and 4 emails, escalated to get issues answered. In August they increased their rates than in January they reduced the benefits allowed... Not cool.
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I have health coverage through my employer with Manulife. I recently purchased CPAP mask for my CPAP machine. I have been using CPAP for more than 10 years. CPAP is not listed in covered items on the mobile app however Manulife agent advised me it is covered on the phone. I applied for reimbursement, however It was not paid after 20 days. I followed up several times, and they asked me Doctor's prescription and diagnosis report. So I found the old diagnosis report and Doctor's prescription. Then submitted the documents. It is about one month that I am following reimbursement and each time the agent says within 24–48 hours it will be paid but nothing happens. They lie all the time. They didn't tell me why it was rejected at first place and now 10 days after submitting documents still I am waiting. This is the worst health insurance company I have experience with.....terrible…