Complaints
Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
12/20/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Date of transaction: 2/14/2024, 4/9/2024, 3/22/2024, 3/25/2024, 3/25/2024 and 3/28/2024. The amount charged by Optimed Health: $*********.What the business commited to provide you : Health Insurance What the nature of the Dispute: Over charged without my permision. Optimed health the month of February, March and April charged my debit card *** bank) a total of ********* USD and different days and different amounts. When I called them to complain they acknowledged it and said they were going to return it to my account, but they have never done it. I have called countless times to ask when they will return my money, they transfer me to a supposed executive, they ask me ******al questions and tell me, in a few days you will have your money back but they never return this money. Today I called again, already desperate, and the first ****** who answered acknowledged the debt, even told me the amount, and replied that they would return it to me very soon, without giving me a date or a customer service number. I called a second time, a woman answered and we had a serious conversation, where she acknowledged that they owe me $********* dollars and also that they would reimburse me $1,536.50 from ******************** that they charged me for an emergency I had with my daughter and that they did not want to cover, so I decided to pay it since they are charging me since 4/22/2024 and I do not want them to send me to collections as it has happened to me before because this insurance never works and never covers my visits to the doctor. I tried to resolve it directly with Optimed health, they always acknowledge the overcharged amount over the phone, but they never deposit the money in my bank account.I attached bank statements where highlight shows the ammount charged. Also I attached the agremment and the card that they send me online. They never send us a phisical card despite the fact that we have asked for it many times.
Business response
01/16/2025
Good afternoon,
Please see the attached response including backup documentation.
Regards,
Compliance
Initial Complaint
09/30/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
The Insurance plan for my spouse Attoy and myself does work for us, we having a difficult time with our doctors finding and accepting the planInitial Complaint
09/13/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
I called them on 04-18-2024 and purchased health insurance through them. After finding out one week later that I qualified for state insurance, I cancelled their insurance. Their policy clams that I can cancel their plan within thirty days. But I needed to show proof of my new insurance. They sent me a link to show that said proof. After doing so, they said that I will be refunded within ten business days. Unfortunitely, I believed them and I didn't check my account. Come to find out, they charged me $383.99 for April 2024. Another $368.99 for May, 2024 and tried to withdraw another $368.99 for June but I stopped the payment in time. I was on the phone with numerous personel trying to get my money back. The last person that I talked to, said that it was MY fault that I should have followed up with them sooner. They are a complete SCAM! My wife is disabled and I have a limited income. I certainly need them to refund my money.Business response
09/23/2024
Good afternoon,
Attached please see our response.
Feel free to contact me with any questions.
Initial Complaint
09/11/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I already filed a complaint against the broker, Quick Health, but the insurance carrier, United Group Programs Inc/Optimed Health, is also unethical in processing their claims. Although I am paid through Sep 2024, Quick Health unjustly terminated my policy on Jul ***** and back-dated the cancellation to May 31, 2024. Now, Optimed Health tells me they are no longer contracted to process claims with Quick Health as of May 1, 2024. They will not discuss any claims with me. Quick Health has confirmed that is not correct. Also, on Aug 29th and Jun 14th, 2024 Optimed posted on BBB, in response to someone elses complaint, that they are the *** for quick health. They pre-authorized my out-patient procedure on May 13th, 2024. The medical Review Specialist, confirmed part of their process is to assure insurance is valid at the time of the procedure. They also submitted a negotiated amount on May 15th committing that they would pay the estimated negotiated amount of $12,809.07 for the hospital services. They are now telling the hospital that I did not have coverage on May 30th for the hospital charges. However, they already processed the corresponding outpatient surgery for the same date, May 30, 2024. I have the *** showing it was paid (meaning applied against my deductible). Per my insurance plan I paid the $350 copay which covers: 1 outpatient visit including the ***************************** Surgery, and Anesthesia. They are denying all Jun and Jul claims. Due to their fraud, I will now be getting bills for over $110K in which they should have paid.Business response
09/16/2024
Please see attached response.Customer response
10/07/2024
Complaint: 22269258
I am rejecting this response because:****** or support team,
This was the last notice I seen on my complaint. I have been checking it weekly but I missed the 9/16 update. Can I still respond to the business' response or do I need to submit a new complaint? This is my response:
Their response does not address the issue with Optimed Health. They are only pushing the blame to the broker. I am already aware that Quick Health handles the billing and premium collection. That is why I logged a BBB complaint against them first. This complaint is specific to Optimed Health who processes claims for Quick Health. In your response to me you say that you are no longer the *** for Quick Health as of 5/1/2024. Note your response is not publicly displayed; it only says see attached document. However, you have publicly responded to other complaints on the BBB site on Jun 14 and Aug 29th, 2024 that you are the third party administrator for Quick Health. In addition, I have EOBs that have been processed by Quick Health for May 13 and 30th, 2024 confirming you are still processing claims. I have also submitted letters from ***************** indicating Optimed Health is still discussing these claims with Optimed Health, but they just say my account is cancelled without clarifying any termination date. I have received no updated insurance card which clearly identifies Optimed Health as the claim processor. You have not responded to the issue and you have provided no contact info for the person responding to this complaint; Compliant Manager, ********* *******.
***** ******
Sincerely,
***** ******Business response
11/01/2024
Good afternoon, *** *****,
I hope this message finds you well.
I wanted to provide an update regarding Ms. ***** ******, who initially enrolled in the Cambridge Preferred Plan on October 13, 2023, with an effective date of November 1, 2023. Ms. ****** made several requests to adjust the policy's effective date, with the most recent change being to January 1, 2024, under the *** Essential Plan. All requests were made prior to the original effective date.
Ms. ****** has made 14 total payments, 10 of which have been refunded, leaving a net balance of 4 payments. This corresponds to 4 months of active coverage. Additionally, I have reviewed her account in the portal and can confirm that claims have been successfully processed under her plan.
Please feel free to reach out if you need any further information or assistance.
Best regards,
***** ********Regards,
******
Initial Complaint
08/27/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
I purchased an insurance policy on September 7, 2023 to become effective on February 1, 2024 for a total of $2,150 Before I could even use the policy I got a call that they stopped supporting it and I had to get a new one. They promised to refund me the whole policy amount within 60 days. I never received it. I called and called and called for over 6 months and still haven't received it. Now, with the policy I had to pay more for ($3,729) and it began on March 3, 2024 I can't really use because they claim it was the cloud strike that screwed their servers but it's been almost 2 months with no fix.I've had to pay out of pocket for my expensive prescriptions and no one knows when it will be fixed. I had to mail in my claim but honestly I don't trust them to pay out when I never got my refund. My credit card was also charged $3,6?? Something but thankfully declined by the company roughly August 27, 2024. I called the customer service again and they said it wasn't them. I got a text today from the customer service number saying my insurance premium wasn't charged to my CC and my insurance will be canceled if I don't pay. I paid for a year of insurance on March 3, 2024 so I should not be charged for anything currently.Business response
08/29/2024
Good morning,
OptiMed is the Third Party Administrator responsible for processing claims only.
The enrollment and billing are handled by Quick Health. We have forwarded the complaint directly to
Quick Health.
Sincerely,
*********************************
Initial Complaint
08/05/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
I do not have any medical insurance so I registered for their insurance. I was promised all kinds of coverage but hardly anything is covered. I called and was told in order to get a refund and to cancel, I needed to call Horizon at ************. I have called and waited on hold for HOURS and never get to talk to a person. After over an hour, the number disconnects! I explained my frustration to OPTIMED *************) and was told there was nothing they could do. I keep getting billed $339/month for a plan I do not want.Business response
08/28/2024
see attached documentsInitial Complaint
06/12/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
The original date of signing up for this insurance was on 3/22/2024 . The insurance was intended as a temporary plan for 3 months since I was laid off from my job in February. We clearly specified this to the customer service rep stating that this was all we would need. The total cost was $2,679.00 for my husband, son and myself. They immediately took out the full $2,679.00 from our bank account on 3/22/2024. They sent us our paper cards which were supposed to just be temporary and never received a hard copy. The paperwork also stated that they were Quick Health and not Optimed Health which seemed strange. It also stated that we would be charged again on 9/20/24 and quarterly after that which I have included in the attachments. This company is very deceptive and seems to be a scam. They had different names on our bank statement as well. Then we noticed that they were fraudulently withdrawing $2,679.00 on 5/9/2024. I called and spoke to a representative who told me he would fix the issue and that we would be refunded in a month. One month has gone by and we still have not seen any reimbursement. Then on 6/3/2024, they took an additional $2,679.00 out of our account. My husband immediately called our bank and we closed our bank account while they continue to conduct an investigation. I have tried a handful of times to get assistance and a better understanding of what is going on with these charges and with getting a refund. Unfortunately, the customer service reps have been extremely unhelpful and there has been absolutely no resolution. They have been rude and disrespectful. I have attached all the paperwork and documents to support this claim. This company seems to be a scam and the ****** reviews prove this. I only wish that in my vulnerable state of getting laid off and losing my families insurance that I had done a better job of researching this company. I appreciate any help that you can provide.Business response
06/14/2024
Good afternoon,
OptiMed is the Third Part Administrator responsible for processing claims only.
The enrollment and billing are handled by Quick Health. We have forwarded the complaint directly to Quick Health.
Regards,
*********************************
Initial Complaint
05/24/2024
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
I had a HSA account through **********************, on 5/16/24, I closed the account and was supposed to receive a refund for 950,22. It normally should take ***** hours, to process the refund. I received a message that it would be deposited on 5/20/24, I still haven't received my refund.Business response
06/03/2024
Good afternoon,
**************** had an Employer funded HSA account and requested a disbursement on 5/16/2024. The request was forwarded for processing and the request for the disbursement was submitted on 5/20/24. The disbursement was settled in ******************** account on 5/28/24. We apologize for the delay due to our Third Party who processes HSA disbursements.
Sincerely,
*********************************
Compliance Manager
Initial Complaint
05/17/2024
- Complaint Type:
- Billing Issues
- Status:
- Answered
I have been attempting to contact Optimed health to discuss my health policy and everybody I have spoken to tells me I have to contact the person that sold me the policy. That person has not worked for this company for over 2 years. I want to cancel my policy but no one will help me. I cancelled the debit card that was being used to pay but now they have written a fraudulent check for the payment. A check was written with a comment that authorization was received. This is false. Unsure how they got my checking account number?Business response
06/04/2024
Good morning,
Mr. Sink purchased an OptiMed MEC 3 product via a Third-************ on May 13, 2022 and paid the first payment via a debit card.
On July 1, 2022, ************ reached out to our **************** Team requesting removal of his debit card for future payments and was provided instructions on how to access the member portal to update his bank account information to begin paying the monthly premium via ACH.
Beginning July, 2022,the monthly premiums were paid via ACH. Please see the attached report.
May 21, 2024, a call was received requesting cancellation of the policy and a cancellation request form was sent via email.
Mr. Sinks policy was cancelled, effective 6/1/2024.Feel free to contact me if any additional information is needed.
Sincerely,
*********************************
Customer response
06/05/2024
This bill was still being paid by a debit card and this was verified by my fiance with her bank. She canceled the debit card and then the insurance company sent a check to the bank stating it had been approved by her. The payment had never been taken out in this manner before. We did finally get hold of the insurance company and was able to cancel. I believe the "check" that had been written against her account should be refunded.Business response
06/14/2024
Good afternoon,
In our first response we supplied documentation that a change was made effective 7/1/2022 to change the premium payments to be paid via ACH. Attached please find the document supplied with the first response. Please note on the attached document that last four digits listed are 2393 for the payments beginning 7/1/2022.
I have attached an additional document notation recorded on **************** account of the requested information to change the method for the premium payment.
Beginning 7/1/2022 all premium payments were paid via ACH from the 2393 account.
On May 21, 2024, a call was received requesting cancellation of the policy. Mr. ****** policy was cancelled, effective 6/1/2024.
Feel free to contact me if any additional information is needed.
Regards,
******
Initial Complaint
03/25/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
I signed up for this the last day of February 2024, I was told this was the last day of open enrollment so I need to sign up. I was promised that this company would cover my expensive prescription and they were just waiting on paperwork to have y doctor fill out. Low and behold just after the 30 day ***** they did not cover the medication. I called several times within the 30 days being told the same thing about the paperwork. I have been told people understand my predicament but administration will not approve the refund because of the time frame. Nobody has the authority to refund me my money even though I was told incorrect things several times.Business response
03/29/2024
Good morning,
Attached please find our response to ********************** complaint.
Sincerely,
*********************************
Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩
Customer Reviews are not used in the calculation of BBB Rating
Contact Information
Want a quote from this business?
Get a QuoteCustomer Complaints Summary
22 total complaints in the last 3 years.
14 complaints closed in the last 12 months.
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.