Health Option One is a rip off. For those who have pre-exisitng conditions and can't get major medical insurance or maybe self-employed, companies like this prey upon us. I purchased this "insurance" in good faith being told it was a limited medical benefit suitable for those who had pre-exisitng conditions and/or self employed. I have found out otherwise. Now, I am close to $30, 000 in the hole with medical bills they did not cover.
I needed a procedure. I had to change doctors as my doctor was not a provider on their list.
Health Option One was contacted by the doctors office on their providor lise for pre approval of the procedure, a facet injection of the vertebra. It was approved by their representative. The procedure was done. Cost was about $3, 000.
The claim was submitted by the doctors office with the appropriate CPT codes for billing. The claim was denied. Reason: Radiology proceudre only. This was appealed and then denied again.
How can a company approve a procedure and then deny the claim? I am stuck with the bill.
Also, it is difficult to get through to anyone to talk to about an issue. In addition, I was told they would cover ER visits. They did not. Claims for two ER visits have been faxed twice with the confirmation that fax was sent twice. The third time, the hospital billing representative sent the fax. They have consistently denied any claim as not covered.
Beware. Do not purchase this insurance. They are a total rip off. I am reporting them to my state's insurance commission. I don't know what else to do.
Trying to get assistance through the hospital. For those of you who don't know, hospitals receive funding for those patients who are unable to pay. There is usually a lot of paper work to fill out and documents (tax returns, proof of income, etc) but it is worth it if you can get some help. Talk to your health care facility's business manager to find out if there are programs available for self pay patients.