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Initial Complaint
01/24/2025
Complaint Type:
Product Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I just obtained this insurance last month and received a healthy benefits card for $50.00 a month. I tried to use the card at ******* today and it was declined.I called Devoted and they told me they no longer had this benefit. I received no notice in any form about the card being withdrawn. I believe the healthy benefits card was false advertising to get people to sign up.I would like to know why I wasn't informed that the healthy benefits card was no longer a benefit.
Business response
02/06/2025
February 6, 2025

Dear ****,

Thank you for reaching out regarding your concern about the Healthy Benefits Card. We appreciate the opportunity to address your concerns and provide clarification.
I reviewed your account and our records show that you first enrolled in Devoted CORE ************ (HMO) effective December 1, 2024. In 2024, this plan included a $140 per quarter Food & Home Card benefit. However, as of January 1, 2025, the Food & Home Card is no longer included as a benefit in this plan.
Each year, ******** Advantage plans may adjust their benefits, premiums, or coverage. To ensure members are informed of any changes, we send an Annual Notice of Change (****) letter. The **** is a required document that provides details on plan modifications for the upcoming year, including any additions or removals of benefits. Our records confirm that we mailed your **** letter on November 12, 2024, which included information about the removal of the Food & Home Card benefit effective January 1, 2025.

We understand that benefit changes can be unexpected, especially taken into account your enrollment date being so close to the yearly benefit changes. We apologize for any confusion or inconvenience this may have caused as it was not our intention for you to feel misguided.

Sincerely,
***** *.
Grievances, Manager
Devoted Health

Customer response
02/10/2025
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

**** *****
Initial Complaint
12/20/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
For my ******** Advantage plan # H7147-004 with Devoted Health, I have $400 coverage for eyeglasses, lenses and frames combined. This $400 coverage is listed on page 121 of my EOC and page 9 of the plan's Summary of Benefits. On October 3rd, I purchased glasses from an in-network eyecare provider and the Devoted *** lists this as claim # AJX5EK6SZU. The total cost for the glasses (amount the plan has approved) is listed as $455.20 on page 6 of the **** On that same line, the *** incorrectly lists the Plan's share as $240. The correct Plan's share is $400 and the correct amount of My Share is $55.20 and NOT the $215.20 listed on the ****I was incorrectly overcharged $160.00. Please correct the *** and refund the $160.00 either to me or the eyecare provider.
Business response
12/30/2024
First, thank you for contacting us regarding your concern with the payment for your eyewear benefit. We sincerely apologize for the frustration you experienced, especially with the difficulty in reaching a resolution over the phone.
After reviewing your concern, we would like to provide the following explanation:
You are correct, your plan provides up to $400 per year for eyeglasses, lenses, replacement frames, or contact lenses. On October 12, 2024, Devoted Health received a claim (AJX5EK6SZU) for your visit to *************** Health Center on October 3, 2024. The provider billed $669.00.
On December 27, 2024, we received your member reimbursement request (AJXCA7876W) for $254.98 for the same eyewear benefit. The plan processed this request and approved an additional payment of $160.00, which will be mailed to you as a reimbursement check.
We hope this resolves your concern and clarifies how your eyewear benefit has been applied. If you have further questions or require assistance, please do not hesitate to contact us at 1-800-DEVOTED ***************). TTY users can dial 711.
Once again, we apologize for any inconvenience. Thank you for being a valued member of the Devoted family. We appreciate the trust you place in us to support your health and wellness.
Sincerely,

***** *.
Appeals and Grievances
Devoted Health

Customer response
01/10/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.

According to Devoted's response letter on 30 Dec:

"The plan processed this request and approved an additional payment of $160.00,
which will be mailed to you as a reimbursement check."

As of today, Jan 10, I have not received a check.

Please keep this complaint open for until I receive the promised reimbursement check.

Thank you, ****** ******
Business response
01/23/2025
Good Morning ******,
I wanted to follow up regarding your recent complaint. Our team spoke with you on January 16, 2024, and confirmed that you have received and cashed the check for $160.
Thank you for your understanding and patience throughout this process.
Best regards,
**** *.
Sr. Complaint Manager
Devoted Health
Initial Complaint
12/04/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On Nov. 15, 2024, I needed a list of in-network partial hospitalization facilities (psych), so I called Magellan, who is supposed to handle my inquiry, as they did last April. This time, however, the agent at ******** informed me that as of Nov. 2024, Devoted now handles all of their own member inquiries about who's in-network, so I was transferred to an agent with Devoted. I requested a list of partial hospitalization facilities. ***** appeared confused by the task of needing to find this information for me, as heard on the recorded call, but he said he emailed it to me. ***** emailed me a list of inpatient psychiatric hospitals, not partial hospitalization facilities. At the time, I didn't press the issue, I wanted the information just in case I needed it. On Dec 2nd, I really needed the services of a partial hospitalization program, so I called Devoted to ask for the list of in-network partial hospitalization facilities, and they refused to provide it to me. I spent 2 hours on the phone, spoke to a supervisor, and got nowhere. The supervisor said she'd forward my case to the new behavioral health team, and someone would reach out to me with the list. I told her this is urgent and I desperately need care. I've called Devoted back again on Dec. 3rd and Dec. 4th. I still have no idea as to where I can go for treatment. On Dec. 4th, I received a call from a Devoted agent, with what I thought was a list of facilities, but it WASN'T. She said she'd escalate my case to the social worker, who can then give me the list of covered facilities. Why all the games???My therapist is looking for places for me, but the places she calls are not in network. I called ******** and filed a complaint against Devoted for deliberately preventing me from seeking care at an in-network covered entity. This list is not accessible to me anywhere on their member portal or website. I am literally at their mercy. I want an explanation and an up-to-date, accurate list.
Business response
12/11/2024
Dear *******,

Thank you for taking the time to share your experience with us. We want to begin by sincerely apologizing for the frustration and difficulty youve faced in trying to obtain a list of in-network partial hospitalization facilities. Your health and well-being are our highest priorities, and we are sorry for any delays or confusion that have added to your stress during this urgent time.

We understand the urgency of your situation, and I am glad to see that one of our complaint specialists recently connected with you on December 11, 2024, to address this issue. Our specialist will be contacting ************** directly to discuss coverage and ensure they feel confident in working with Devoted. This step is meant to help make the process as seamless as possible for you.

Additionally, we will proactively send you an additional list of other in-network partial hospitalization facilities in your area. This is to ensure you have alternatives available should ************** not meet your needs.

We deeply regret any confusion or miscommunication during your previous calls, as well as the time and effort you have had to spend seeking care.
Please dont hesitate to reach out to us if you have any further questions or concerns. Thank you for giving us the opportunity to address this.Our team is always looking for ways to improve the member experience and will review this case further to figure out how we can prevent situations like this in the future.
If you have questions or need anything, you can call us at 1-800-DEVOTED ***************).

Sincerely,
***** *.
Complaints Manager
Devoted Health

Customer response
12/11/2024
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
I have an evaluation scheduled at the ************** scheduled on Friday, Dec. 13th at 8:30am. They are waiting to hear from Devoted Health about whether they will cover my care at the partial program if I miss a day due to a dental appointment. The coordinator at the Horsham Partial Program wasn't confident that my insurance would pay if I missed a day, and she stated this in an email.
The ************** is the only one available to me. The other 2 are NOT. The *************** in ************ has a waiting list for their partial program, and the Lenape Valley Partial Program in ********** is only open to those living in ***** and ****************************** I live in *************
I am respectfully asking for a prompt resolution of:
1. Either Devoted covers my entire partial stay through end of 2024, even if I need to miss days, and/or
2. Provide other in network partial program alternatives

Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.

FAQ

Regards,
*******

Business response
12/18/2024
Weve reviewed the concerns raised in your rejection comments and would like to provide further clarity and reassurance regarding your coverage and the steps weve taken to resolve your case.

Per ******** guidelines, PHPs require members to meet a minimum of 20 hours of participation per week to qualify for coverage. ************** has confirmed that their program operates 6 hours per day, 5 days per week, for a total of 30 hours. Therefore, if you need to miss a day due to an appointment or other reasons, you would still meet the required hours for coverage. Both our claims team and ******** have confirmed that missing a day in the program should not result in any issues with claim payments.
************** confirmed your evaluation appointment was scheduled for December 13, 2024, on December 14, 2024 ************** submitted Prior Authorization request # OP0140251782 which was approved by Devoted on that same day.

We have confirmed that your appointment with an out-of-network behavioral health provider at ****** Community on December 11, 2024, is covered under the 90-day Continuity of Care (COC) window, which applies until your disenrollment from Devoted Health effective December 31, 2024.

We understand that ************** is currently your only available option, and we are doing everything possible to ensure there are no barriers to your participation in their program. We appreciate your understanding and patience as weve worked to resolve your issue.

If you have questions or need anything, you can call us at 1-800-DEVOTED ***************).

Sincerely,
***** *.
Complaints Manager
Devoted Health
Initial Complaint
11/13/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
My complaint has to do with customer service. ********************** gave me a Lifestation alert device last year. Now they are discontinuing the service and want the device back. I never used it and want to send it back. The problem is that I can't get anyone in customer service to help me obtain a return address label. Can you please help me resolve this issue. ***** *****
Business response
11/14/2024
Dear *****,
Thank you for reaching out regarding the return of your Lifestation device. We appreciate how proactive you are in sending the device back.

Weve confirmed with Lifestation that, due to the 2025 benefit changes, they will be mailing you a prepaid return label in December, which will include instructions for sending the device back. Youll only need to drop it off at your local post office.

When I called Lifestation to confirm your address, I noticed that the address they had on file differed slightly from what we have here at Devoted. This may explain why you didnt receive the label you requested in October. I have since updated your address with them to reflect:

********************************>*************************

With this updated address, you should receive the label without any issues.

If you dont receive it by mid-December or need any further assistance, please dont hesitate to reach out to us at 1-800-DEVOTED *************** or you can contact Lifestation directly at ************.

Thank you for your patience, ****** and we apologize for any inconvenience this may have caused you.

Sincerely,

***** *.
Appeals and Grievances
Devoted Health

Customer response
11/19/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

***** *****
Initial Complaint
10/07/2024
Complaint Type:
Order Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I sent an appeal in on 08/30/2023 for a patient that had chemo and we had authorization from Devoted stating no auth was required and when it was time for the claim to be paid, It was denied for no referral and did not pay any of the claim. The referral is only good for administration which we are fine not getting paid for that however the treatment was at great cost and should be reimbursed based on us trying to get authorization for the drugs and it stating no authorization was required-I do have proof of this however has a person's name on it so can not upload.
Business response
10/11/2024
Dear *******,
Thank you for bringing this to our attention. We apologize for any confusion or inconvenience caused by the denied appeal. I have sent an email to ************************** for further follow-up. Kindly send the member information, claim details, and any supporting documentation to **************************************** and we will be happy to research the issue further and provide a detailed response.
We appreciate your patience and look forward to assisting you.
Best regards,
**** **********
Sr ******** Complaint Manager
Devoted Health
Initial Complaint
09/23/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I filed reimbursement form with Devoted ******** to get back my $404 what I spent as an absolutely essential for my dental exam what my dentist requires on October24, 2023. I spoke to Devoted representatives at least 3 times. My case fir reimbursement was " pending " almost for a year!!! Nobody knew what is going on? I need my mo ey back. I as APPROVED by Devoted, but never received my $ 404 back for reimbursement. Shame! My case us pending. Really? For almost 1 year?
Business response
10/01/2024
Dear Galina,
Thank you for reaching out, and I sincerely apologize for the frustration and inconvenience you've experienced regarding your reimbursement. On 11/08/2023, we received your receipt in the amount of $404, paid to Elite Dental Dentistry. In order to be eligible for reimbursement, our dental vendor (Delta) requires a reimbursement form which includes records of services provided. I emailed a copy of the form to gbgb1593@aol.com. If you have any questions, please reply to my email and I’m happy to assist. You are eligible for reimbursement up to 365 days from the original date of service (10/24/2023). You can return the completed form directly to me via email or you can mail it to Delta Dental.
Sincerely,
Matt Hollifield
Sr Medicare Complaint Manager
Devoted Health
Initial Complaint
09/18/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I am now with my third PCP since joining Devoted in Oct 2022. Really difficult getting to know a doctor and then losing them for unkown reasons. I LOST MY *************** DOCTOR AS WELL AND HAVE BEEN UNABLE TO FIND ANOTHER THAT OFFERED THE SAME TREATMENT AS THE ORIGINAL DOCTOR HAD. MY PAIN HAD BEEN CONTROLLED TO A LEVEL 5 FROM 9.5 AND IS NOW BACK TO A 9.5. AFRAID I WILL HAVE TO CHANGE MY ADVANTAGE HEALTH SELECTION.
Business response
09/27/2024
Dear *******,
Thank you for speaking with me on September 25th. I apologize for your experience with plan PCP's. Unfortunately, the provider network can change at any time for various reasons. We notify members impacted by a network change at least 30 days in advance. I understand that you would like to receive service from an out of network specialist that offers specialized treatment. We contacted your PCP and instructed him to send the plan an out of network authorization request. Both you and your PCP will receive a written response once a decision is made, please contact us at 1-800-Devoted if you have any questions or if we can further assist.
Thank you for your feedback,
**** **********
Sr Complaint Mgr
Devoted Health
Customer response
09/27/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

******* *******
Initial Complaint
08/16/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Devoted food and home card is a joke.You cannot use it for anything.Everything I need is excluded.No pet food, no gasoline.Went to the grocery store the other day and it didn't pay for anything.I was so humiliated
Business response
08/23/2024
Hi *****,

I apologize our Food & Home card is not meeting your needs. The Food & Home Card is a monthly allowance that allows you to purchase groceries, pay for utility costs, and/or pay for rent or mortgage costs.
You can use your card at a participating grocery store or shop online with a participating retailer. Visit *********************************************** to search for stores near you.
You can only use your card at participating stores not at convenience stores, restaurants (including fast food), or gas stations. You can buy any food you choose, but certain items arent included like alcohol, baby formula, pet food, or household goods like paper towels.
On your Devoted Choice Plus Pennsylvania PPO plan, you have a $100 monthly allowance. You can spend your allowance all at once or use it throughout the month but you can't roll over any unused allowance to the next month. Devoted Health will automatically add more money on the first of each month.
I see that youve been able to utilize the Food & Home card on a monthly basis. Please reach out to me at **************************************** if you have any questions or if I can help with locating additional participating stores.
Thank you for your feedback,
*****************************
Sr. Complaint Mgr
Devoted Health
Initial Complaint
08/13/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
On 5/9/24 we received a check from Devoted Health for one of our practice members of $9.00.The bank said Devoted needs to " release the check to us", I have called multiple times to get a new check issued. Every time I call, i speak to a different *** that has no idea what they are doing or how to help. The response ends up being the same each time " a new check will be issued to you in 30 days" The last time I called, I was told that we were denied a new check . This insurance company is breaking the law by not paying providers in network with them
Business response
08/22/2024
Hi ******,
I apologize for the delay and time spent.
On 08/19/2024, I let you know via email that a new check was sent on 08/16/2024 in the amount of $9.00. Please keep in touch with me at **************************************** until you are able to successfully deposit the check.
Best,
************************;
Sr Complaint Manager
Devoted Health

Customer response
08/22/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

*************************
Initial Complaint
07/31/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I was notified with a letter on July 29 that I was now enrolled in devoted health care HMO starting August 1. This meant that my current Aetna policy would get cancelled. I did not enroll in this plan. I called them on 7/29 and complained and told the to cancel this policy. They called back on the 30th to ask if I really wanted to cancel. I told them yes and asked them how this happened. The lady couldn't answer and couldn't find an application for me on file. On 7/31, I am still fighting with them to cancel. I did notify ******** concerning this issue.
Business response
08/03/2024
Thank you for bringing this to our attention **************, I sincerely apologize that you were enrolled without your consent and I'm sorry the inconvenience. You were cancelled from Devoted and returned your previous plan with Aetna with no lapse in coverage. We are investigating the agent that enrolled you with Devoted and will provide corrective action if appropriate. If you have additional questions or would like to discuss the matter further, please contact me directly at **************************************************.
Best,
*****************************
Sr Complaint Manager
Devoted Health

Customer response
08/03/2024
[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

Better Business Bureau:

I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved.

Regards,

*************************

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