Sun Life Health Insurance Reviews
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I have SunLife dental through work. Visited my dentist and received a bill, so I called SunLife to ask what is up. Was told my dentist was out-of-network even though online he is listed as in-network. They claimed the website is not kept up to date and that I should call to verify network participation before being seen. So then I ask why my cleaning was not covered 100% even though my benefits list 100% coverage for both in and out of network for cleanings. I was told there is a maximum amount they cover, but they did not know where that number came from, only that it is printed on the explanation of benefits, and that I can always have the dentist pre-authorize work to have a complete understanding of what charges will be. So now for every dental visit, I am expected to call SunLife to verify dentist participation and then have my dentist pre-auth the work being done. What kind of chaos is that...
We made 3 policies in 2013 for our 3 kids and were told that they were education saving accounts, we lost the account details and recently made an online account and then found out that the alleged education saving account were actually Critical Health Insurances for which I have been paying $200+ every month for 10 YEARS! That's 27k+ total which is insane. What 9 year old (and younger) needs extra health insurance. Bunch of scammer don't recommend -1/10
I am in the processing of electing new dental coverage through a new employer and Sun Life is the only option available for me. In order to ensure the basis of coverage for In network and OON since they are listed as the same coverage amounts, I called Sun Life to ask some basic questions pertaining directly to that. The specific question was about TYPE III level services such as in my case a crown I will need. The plan states that it covers up to 50% of annual maximum regardless of the provider being in or out of network. Based on what my dental office stated they could potentially submit charges that would result in not a full 50% being paid. The office did not include or exclude any provider on the basis of network which didn't help me answer my question. My next step was to ask Sun Life directly how that would work, the basic question being does Sun Life pay the 50% on their end before I pay my remaining 50%. The associate at first handled the question well by telling me what my dental office told me which was to get a predetermination once I was insured. She eluded to "coding" in the office potentially excluding coverage but didn't specifically state that it wouldn't be covered. I asked if they were contracted amounts and how that was enforced when handling billing for OON providers. Once I asked this and pushed the topic further she told me she could not discuss anything regarding coverage since I am not a customer. What this said to me was that Sun Life didn't want to answer my questions specifically to ensure my satisfaction as a potential future customer. There was nothing wrong with what I asked and I was prevented from asking for further information about it. I then asked for a supervisor and she insisted that I could only receive a call back. I insisted back to wait on hold to speak to them. 3 times during that exchange, after I asked for a supervisor, she said she couldn't hear what I was saying based on it being "muffled". After I asked her name she then asked for my name, becoming authoritative as if she felt attacked by me for asking questions and requesting a supervisor. I waited patiently on hold and she returned within 1-2 minutes stating there was no supervisor available. I left the call in frustration. It is extremely concerning how some providers operate, such as Sun Life. Based on customer service, I can confidently say that her approach and response to my questions and denial of allowing a supervisor to intervene shows that if you are able to avoid this company for dental coverage then you should. No one should be treated with disdain for asking basic questions regarding coverage and expecting clear answers.
The stress to have to deal with finding out your medication is not covered or required pre-approval is insane. Despite receiving a fortune from the employer and employees to provide coverage, they get away with a lot of not covered items.
I called Sun Life health insurance before having my AMH blood test done, to see if it would be covered by my insurance plan. The representative said that it would be covered at 80%. I went ahead and had the test done a few days later and paid $108. I got a receipt as I thought that I was going to be reimbursed the 80%. I submitted the claim online with the receipt to Sun Life. I checked online on the claim and was shocked to see it say that this expense was not covered by my plan! I called and spoke to another representative and she said that it was covered 80% only if I went to a commercial lab and not a fertility clinic. WOW. What a scam. I looked up commercial labs and it said that all labs are considered commercial as long as they used commercial tests. What a joke and a great way not to pay out benefits. Next time I will get it in writing. Very frustrated and annoyed.
I've been with Sun Life for over 8 years ONLY because it is the only option my organization offers. If you have literally any other choice take it. They make it very difficult and confusing to make claims. I'm guessing they just hope people give up so they don't need to payout. The website requires 2 different access ID/certificates to get into and for some reason, my password is constantly reset (without my approval) or the account is locked and you need to call the phone line. The phone line connects you to the UK which can't access your info if you live elsewhere. They then transfer you to an automated line that has a ton of very vague options for you to choose from. You are then on hold for a long time (every time I've called) before you get to talk to a person. You are asked to confirm your identity and I think I have given every single bit of information I have... Only to be denied access because the email that the claims are sent to us different than the one I registered with. More to follow on this... I am covered by my company under a different medical plan. The "benefits" are for my family. Other than being the name on the plan I have literally nothing to do with it. I am away in remote locations multiple times a year and unable to access my Sun Life. All my claims are for my spouse or dependants. The only person who is able to access and approve the claims is me. I have asked and they will not let her access, change, make claims, or do anything on the account. Again, I could be gone up to 8mo a year. Without getting to personal, my spouse has had major life-changing surgery. The claims we make are very straight forward with lots of information (from doctors) to back it up. Sun Life fights tooth and nail with us on every claim. There is always a loophole or a fine print on why they can't pay it. Most of the claims can be submitted online... But if they decide it is questionable (all of them) then you need to physically mail in receipts etc. It's 2020, which is completely unnecessary and again just a deterrent. To summarize: - They deter members from making claims - will fight over every claim - customer service is atrocious - benefits are expensive and provide less than competitors - beneficiaries have no access whatsoever I would never recommend Sun Life to anyone and would switch in a heartbeat if I was able. Look elsewhere.
Since I got a new employer, I had to switch to Sun Life. I have had nothing but huge problems with them. After months of paying for a family plan, my fiancé had dental work done only to find out we had to pay all money out of pocket because Sun Life was saying that we were not covered. After many many calls with them, they finally saw that we were in fact covered and had been this whole time. Fast forward 5 months later and we still have not been refunded the money. They are now trying to claim that they paid us out. Incredibly rude cutting me off when I tried to explain what had happened. They do not listen, do not refund or properly cover you for multiple claims. I will be cancelling my coverage and will never deal with them again. I will go back to my previous insurance company which is wonderful, respectful and I never have issues with. Sun Life, maybe you should treat you clients with respect as we pay for the seats you sit in.
Biggest scam! They got 25 years of my payments and denied my policy at the age of 56.
I see so many complaints here and on other forums but clearly, they don't care. They do not want to pay their customers. Deny claims at any cost. Claimed for a pair of prescription glasses and they denied saying the seller we bought glasses from is barred and they expect us to know this. No notifications from their side considering I have an app and I received numerous notifications from them. After I complained they said it's not their fault it's the seller who is a fraud. Worst customer service. How can they blame the seller who is cheating us by not telling when they are doing the same thing.
Has anyone else had the issue with Sun Life did they make you get a form filled out for a prescription that your Doctor gave you by that Doctor. This has a cost associated with the charge, depending on the Dr office.
So riddle me this, why does the doctor that prescribed the medication have to fill out a form for Sun Life to cover the medication????
Money grab?
If my health care professional says I need the medication, how is Sun Life able to hold my health hostage.... for what?????
This makes no logical sense to me.