Complaints

• Initial Complaint

  11/26/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I have about 1300+ in my HMA and been trying to use it (with no solutions from HMA/claim choice or the insurance agent that sold it to me).I tried to use my funds I have built up since October 19, 23. 20+ calls that have not lead to me using my funds.Mostly me leaving vmail & no return call. Initially we choose this as it had a debit card where I have not had to create an account as that is to much given disabled.I have a 713-850-**** and several other numbers. I found out from the insurance agent, Christine ****** 352-358-**** informed me that they are no longer using the debit card system. I eventually talked to at HMA or claims choice and told I had to fill out HMA provider claim reimbursement submission form for 3 practices but basically the HMA company wants them to bill, that is not required by law as my main dr office is only required by federal law. I asked 20+ times for a new debit card or a new card, weird new card says the effective date is 12/31/23 so seems like I can not access my funds. I am to create an account online so the info of the change was never disclosed to me, and the automated system still says we can use our HMA debit card. Asked for a new card which I never got, I just eventually got the card from the post office sent to my old address due to ME forwarding.I was told an agent would call but canceled my appt as I didn't have the money to prepay and this is holding up my treatment. I keep asking for the reimbursement form and mailing address as my mom agreed to bill for me. The automated system has directions but no URL THIS IS KEEPING ME FROM CONTINUING MY TREATMENT. NEED: 1. Ensure that my address has been changed in all systems NEW ADDRESS (given 5+ times) **** ***** ***** **** ***** **********, TX 75082 2. A PDF or paper copy of reimbursement form to mail in and address to mail to so can use funds (or give me an updated debit card) 3. URL for site and directions (but I am unable to do due to cognitive disabilities and Mom is to old)

  Business response

  03/06/2024

  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching medical benefit towards the medical balance, and we have tens of thousands of satisfied members. The matching benefit is designed on a graduated schedule, where the matching benefit starts in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that time. There is no cash value. Members can access their HMAS® medical benefits through the HMAS® Medical Benefits ID card. 
  Initially, Ms. ****** was issued our HMAS® Medical Reimbursement Visa® debit card to access her HMAS® medical benefits, but the claims process was changed on October 12, 2023 to the HMAS® Medical Benefits ID card. The reason for this change was to improve our members’ access to their HMAS® medical benefits for eligible medical services because our Visa® debit cards had necessary spending controls that would sometimes lead to declined transactions, resulting in our members having to pay out of pocket and submit claim reimbursements. To improve the claims process and eliminate these declined transactions, we issued our members the HMAS® Medical Benefits ID card. HMAS® members simply present this HMAS® Medical Benefits ID card to their providers, and that prompts their providers to submit claims to Health Matching Account Services for processing through our third-party administrator, resulting in no out-of-pocket claims for our members’. The HMAS® Program and Member Contract that Ms. ****** selected and agreed to specifically provides that HMAS® may amend or change the claim procedures as it may deem necessary and it does not permit refunds because there is no cash value. This is a critical requirement in the design of the HMAS® Program, which allows our members’ contributions to grow and multiply over time. Please see the excerpt below taken from the cover page of our HMAS® Member Contract:
  “This Contract explains in detail your obligations regarding your account as well as how and for what medical expenses your account can be used. The HMA® is not a financial product. It is your responsibility to read and review the provisions in this Contract. If we do not hear from you within 7 days of any objections to the provisions in this Contract your agreement with HMAS® will be in force under the terms and conditions in this Contract or any other amendments to this Contract that are subsequently put in place.”
  HMAS® is happy to state that we have been working with Ms. ****** since her complaint was filed on November 26, 2023. Her address has been updated, and we processed and paid Ms. ****** $1,535.50 in claim reimbursements in December 2023.
  In conclusion, we would again like to thank you for the opportunity to provide our response and we are hopeful that this apparent misunderstanding will now be clarified. If there is any additional information that you may need concerning this matter, please advise. 
  
  
  Thank you, 
  Geoff ****
  

  
  

• Initial Complaint

  11/09/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  When I signed up for this program through their agent, I was told that a debit card would be provided which I could use to draw from my balance for medical expenses including OTC purchases at a pharmacy. I have used that debit card for two plus years. As of October 2023, the debit card was replaced with an ID card, requiring a medical provider to call and confirm eligibility and availability of funds. This has caused confusion on my part and on the part of my medical providers. My regular pharmacy does not do phone in approvals. My chiropractic office was told by ClaimChoice, HMA's new partner that this is not Health Insurance and were left wondering how to get payment for my insurance copay! I have an MRI scheduled, and the hospital called today requesting a pre-registration co-pay of $50. As I no longer have a debit card, I had to pay by my personal debit card - HMA no longer accepts claims for out of pocket payments. HMA have moved the goal posts and changed their terms of service by removing access to my funds. I request a refund of all of my payments made over the last two plus years!

  Business response

  03/06/2024

  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching medical benefit towards the medical balance, and we have tens of thousands of satisfied members. The matching benefit is designed on a graduated schedule, where the matching benefit starts in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that time. There is no cash value. Members can access their HMAS® medical benefits through the HMAS® Medical Benefits ID card. 

  Initially, Mr. ****** was issued our HMAS® Medical Reimbursement Visa® debit card to access his HMAS® medical benefits, but the claims process was changed on October 12, 2023 to the HMAS® Medical Benefits ID card. The reason for this change was to improve our members’ access to their HMAS® medical benefits for eligible medical services because our Visa® debit cards had necessary spending controls that would sometimes lead to declined transactions, resulting in our members having to pay out of pocket and submit claim reimbursements. To improve the claims process and eliminate these declined transactions, we issued our members the HMAS® Medical Benefits ID card. HMAS® members simply present this HMAS® Medical Benefits ID card to their providers, and that prompts their providers to submit claims to Health Matching Account Services for processing through our third-party administrator, resulting in no out-of-pocket claims for our members’. The HMAS® Program and Member Contract that Mr. ****** selected and agreed to specifically provides that HMAS® may amend or change the claim procedures as it may deem necessary and it does not permit refunds because there is no cash value. This is a critical requirement in the design of the HMAS® Program, which allows our members’ contributions to grow and multiply over time. Please see the excerpt below taken from the cover page of our HMAS® Member Contract:

  “This Contract explains in detail your obligations regarding your account as well as how and for what medical expenses your account can be used. The HMA® is not a financial product. It is your responsibility to read and review the provisions in this Contract. If we do not hear from you within 7 days of any objections to the provisions in this Contract your agreement with HMAS® will be in force under the terms and conditions in this Contract or any other amendments to this Contract that are subsequently put in place.”

  What Mr. ****** referred to in his complaint regarding a refund is addressed in our HMAS® Member Contract under Section 4 on page 8, which states that members are able to cancel at any time, but there is no cash value and there are no refunds. Please see the excerpt below taken from page 8 and 9 of our HMAS® Member Contract:
  4.2   Termination.  This Agreement will be terminated, and medical benefits will be relinquished and no refunds will be processed as follows:
  4.4   Effect of Termination.  If this Agreement is terminated by either Party, the Primary acknowledges that the Primary and all Eligible Person(s) will NOT continue to have use of the Primary’s HMA® Contribution Account, for Eligible Services and the Primary’s HMA® Account Balance will be relinquished to HMA® SERVICES and no refunds will be processed.  Please note that once a Primary’s account has been terminated, should the Primary subsequently seek to reopen his/her account, a new account will have to be originated and no medical benefits previously relinquished will be reinstated.
   
  Mr. ****** was sent several notifications about the change from the HMAS® Medical Reimbursement debit card to the HMAS® Medical Benefits ID card, and how to continue to access his HMAS® medical benefits for eligible medical expenses. We have made every effort to ensure all of our members understand the claims process with the HMAS® Medical Benefits ID card. In addition, Mr. ****** has been successfully using his HMAS® Medical Benefits ID card as HMAS® has processed and paid $1,065.51 in claim payments for Mr. ****** between December 2023 and February 2024.
  In conclusion, we would again like to thank you for the opportunity to provide our response and we are hopeful that this apparent misunderstanding will now be clarified. If there is any additional information that you may need concerning this matter, please advise. 
  
  
  Thank you, 
  Geoff ****
  

  
  

• Initial Complaint

  11/09/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  09-16-23 $84.00 x 2 = $168 I am extremely frustrated with this company. I have called and asked for a break down of my monthly contributions and the lay out of THEIR contribution. They claim they don't have one. I asked what they are contributing and so far a $50 dll MONTHLY fee which is chipping away MY contribution. I sent them countless emails as well and called and I'm on hold for long periods of time. I have managed to speak w/ one representative but no real information was provided. Therefor I am requesting a refund of MY ENTIRE contributions. They claim I only have $30 dollars worth to use for services. I am demanding a full refund of my funds. This company is a scam. BE WARE

  Business response

  03/06/2024

  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching medical benefit towards the medical Balance, and we have tens of thousands of satisfied members. The matching benefit is designed on a graduated schedule, where the matching benefit starts in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that time. There is no cash value. Members can access their HMAS® medical benefits through the HMAS® Medical Benefits ID card. 
  Initially, Ms. ******** was issued our HMAS® Medical Reimbursement Visa® debit card to access her HMAS® medical benefits, but the claims process was changed on October 12, 2023 to the HMAS® Medical Benefits ID card. The reason for this change was to improve our members’ access to their HMAS® medical benefits for eligible medical services because our Visa® debit cards had necessary spending controls that would sometimes lead to declined transactions, resulting in our members having to pay out of pocket and submit claim reimbursements. To improve the claims process and eliminate these declined transactions, we issued our members the HMAS® Medical Benefits ID card. HMAS® members simply present this HMAS® Medical Benefits ID card to their providers, and that prompts their providers to submit claims to Health Matching Account Services for processing through our third-party administrator, resulting in no out-of-pocket claims for our members’.  The HMA® plan has not changed, just the way that eligible claims are processed and paid has changed. The HMAS® Program and Member Contract that Ms. ******** selected and agreed to specifically provides that HMAS® may amend or change the claim procedures as it may deem necessary and it does not permit refunds. This is a critical requirement in the design of the HMAS® Program, which allows our members’ contributions to grow and multiply over time.
  Ms. ******** was sent several notifications about the change from the HMAS® Medical Reimbursement debit card to the HMAS® Medical Benefits ID card, and how to continue to access her HMAS® medical benefits for eligible medical expenses. We have made every effort to ensure all of our members understand the claims process with the HMAS® Medical Benefits ID card. In addition, Ms. ******** only contributed for 2 months before requesting to cancel, which was processed. During the early months of the HMAS® plan (as stated above), the matching benefits start low and gradually increase over time. Ms. ******** did not give her HMAS® plan long enough time to build up to see the full value of the matching benefits.
  In conclusion, we would again like to thank you for the opportunity to provide our response and we are hopeful that this apparent misunderstanding will now be clarified. If there is any additional information that you may need concerning this matter, please advise. 
  
  -- 
  Thank you, 
  Geoff ****
  

  
  

• Initial Complaint

  11/08/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  This company introduce a health matching account debit card. They have deactivated the debit card. I have paid 5000 dollars into this fraudulent program they advertised as a health matching saving account! I would like my money returned!

  Business response

  03/06/2024

  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching medical benefit towards the medical Balance, and we have tens of thousands of satisfied members. The matching benefit is designed on a graduated schedule, where the matching benefit starts in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that time. There is no cash value. Members can access their HMAS® medical benefits through the HMAS® Medical Benefits ID card.

  Initially, Ms. ******* was issued our HMAS® Medical Reimbursement Visa® debit card to access her HMAS® medical benefits, but the claims process was changed on October 12, 2023 to the HMAS® Medical Benefits ID card. The reason for this change was to improve our members’ access to their HMAS® medical benefits for eligible medical services because our Visa® debit cards had necessary spending controls that would sometimes lead to declined transactions, resulting in our members having to pay out of pocket and submit claim reimbursements. To improve the claims process and eliminate these declined transactions, we issued our members the HMAS® Medical Benefits ID card. HMAS® members simply present this HMAS® Medical Benefits ID card to their providers, and that prompts their providers to submit claims to Health Matching Account Services for processing through our third-party administrator, resulting in no out-of-pocket claims for our members’ The HMAS® Program and Member Contract that Ms. ******* selected and agreed to specifically provides that HMAS® may amend or change the claim procedures as it may deem necessary and it does not permit refunds because there is no cash value. This is a critical requirement in the design of the HMAS® Program, which allows our members’ contributions to grow and multiply over time. Please see the excerpt below taken from the cover page of our HMAS® Member Contract:

  “This Contract explains in detail your obligations regarding your account as well as how and for what medical expenses your account can be used. The HMA^® is not a financial product. It is your responsibility to read and review the provisions in this Contract. If we do not hear from you within 7 days of any objections to the provisions in this Contract your agreement with HMAS^® will be in force under the terms and conditions in this Contract or any other amendments to this Contract that are subsequently put in place.”

  What Ms. ******* referred to in her complaint regarding a refund is addressed in our HMAS® Member Contract under Section 4 on page 8, which states that members are able to cancel at any time, but there is no cash value and there are no refunds. Please see the excerpt below taken from page 8 and 9 of our HMAS® Member Contract:

  4.2   Termination.  This Agreement will be terminated, and medical benefits will be relinquished and no refunds will be processed as follows:

  4.4   Effect of Termination.  If this Agreement is terminated by either Party, the Primary acknowledges that the Primary and all Eligible Person(s) will NOT continue to have use of the Primary’s HMA^® Contribution Account, for Eligible Services and the Primary’s HMA^® Account Balance will be relinquished to HMA^® SERVICES and no refunds will be processed.  Please note that once a Primary’s account has been terminated, should the Primary subsequently seek to reopen his/her account, a new account will have to be originated and no medical benefits previously relinquished will be reinstated.

   

  Ms. ******* was sent several notifications about the change from the HMAS® Medical Reimbursement debit card to the HMAS® Medical Benefits ID card, and how to continue to access her HMAS® medical benefits for eligible medical expenses. We have made every effort to ensure all of our members understand the claims process with the HMAS® Medical Benefits ID card.

  In conclusion, we would again like to thank you for the opportunity to provide our response and we are hopeful that this apparent misunderstanding will now be clarified. If there is any additional information that you may need concerning this matter, please advise. 

   

  --

  Thank you, 

  Geoff ****

• Initial Complaint

  07/05/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  The HMA card rarely works for authorized medical expenses. There are too many “rules” causing this. Prescriptions filled by the ******* Pharmacy are not eligible for card use. They also decline most medical provider charges blaming the doctor’s office for not using the correct medical coding on card processing. Due to this, I had to pay $760.03 out of pocket unexpectedly for my prescription and submitted all claim paperwork timely and correctly. They even asked for a prescription label which I submitted within 1 day. My claim then moved from “under review” to “processing” several weeks ago, but my money has yet to be released. This is MY money I have paid into this plan to cover medical expenses. Emails go unanswered and customer service tells me that the claims department does not speak to customers. I told the last rep I spoke to that this is definitely unlike my previous health maintenance account and asked about cancelling my membership. She informed me that I would forfeit all of the personal funds I have paid in if I chose that option, so I’m still having to pay into a plan that refuses to release my own money.

  Business response

  07/21/2023

  In response to Mrs. ********* complaint, I would like to start by making an introduction about Health Matching Account Services and the HMA® plan. We have been in business since 2016 and we have tens of thousands of satisfied customers. The HMA® is a patented and registered trademarked product that is exclusively offered by Health Matching Account Services, and has been featured in ******.
  
  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching medical benefit towards the medical balance. The matching benefit is designed on a graduated schedule, where the matching benefit starts in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that, which provides the member with an average of a $2 for $1 medical benefit that they can use towards eligible out of pocket medical expenses. There is no cash value. Members can access their HMA® medical benefits through the HMA® Medical Reimbursement Visa® Prepaid card or through the HMA® Claim Reimbursement process on the HMA® member portal.
  Mrs. ******* enrolled into the HMA® 7500 plan through an independent contracted broker on June 13, 2022. During the online enrollment, Mrs. ******* electronically accepted the terms and conditions of the HMA® Member Contract, which serves as your electronic signature. The HMA® 7500 plan for a family has a monthly contribution of $128.50 and is designed to reach the $7,500 target benefit cap after 35 months. Mrs. ******* received her HMA® Member Welcome email and HMA® Member Contract on June 18, 2022, which she agreed to receive by electronic communication during enrollment. The HMA® Member Contract clearly discloses all of the terms and conditions of the HMA® benefit plan. Please see the excerpt below from the cover page of the HMA® Member Contract:
  
  “This Contract explains in detail your obligations regarding your account as well as how and for
  what medical expenses your account can be used. It is your responsibility to read and review the provisions in this Contract. If we do not hear from you within 7 days of any objections to the provisions in this Contract your agreement with HMAS® will be in force under the terms and conditions in this Contract.”
  
  The HMA® Medical Reimbursement Visa® Prepaid card does have necessary restrictions on it to ensure that it is only used for eligible medical expenses under the HMA® Member Contract. For example, the HMA® Medical Reimbursement Visa® Prepaid card does not work at the ******* pharmacy or other grocery store pharmacies because those merchants are not medical providers. The HMA® Medical Reimbursement Visa® Prepaid card will work at stand alone pharmacies for prescription drug purchases. In the event that a member does have a prescription drug purchase from a grocery store pharmacy, the member can easily submit a claim reimbursement for that purchase through the HMA® member portal. This is clearly stated in the HMA® Member Contract under Section 1.1 “Eligible Medical Expense”:

  “Prescription Drugs with a prescription Rx number purchased at any grocery store pharmacies, ***** Club, ******, and other similar organizations can be covered on a mail-in reimbursement basis by completing the HMA® Reimbursement Form located in the Resources section of your HMA® member account portal and submitting an original, itemized receipt within 30 days of the purchase”

  Mrs. ******* did submit her prescription purchase from ******* as a claim reimbursement, and it was processed and paid to her on July 12, 2023. We also see that Mrs. ******* has used her HMA® Medical Reimbursement Visa® Prepaid card at doctor offices to pay her out of pocket medical expenses.

  
  We would like to thank Mrs. ******* for giving us a chance to serve her and her family and provide them with the benefits of the HMA® plan.  We regret that she is not satisfied in this situation, although she was satisfied in the other claim situations, but the HMA® plan has a defined list of eligible medical services and providers put in place to secure the superior matching benefits that HMAS® and the HMA® plan provide. We want to continue to work with Mrs. ******* in the future to ensure that she continues to access her HMA® benefits for eligible medical expenses, but we do request that Mrs. ******* read her Health Matching Account Services HMA® Member Contract to understand how to access her HMA® medical benefits according to the contract.

• Initial Complaint

  03/24/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I began paying $200 a month to this plan in April 2022 at the advice of Paris *****, my Medicare supplement salesperson, who was also working for HMA. It was supposed to be a matching plan that could be used for healthcare needs; however, when I tried to lower my monthly contribution in February 2023, I was told that I couldn't do that until after I had contributed 24 payments. I'm 77 years old and decided to end the plan. They then told me that it had "no cash value," and they were going to keep the approximately $1300 I had in it. I was able to use it for medical services, but when I tried to use the prepaid Visa they issued, it said it was over the limit, even though I had a little more than $200 still in the account. When I called, I was told that I could not have that money and that there always had to be one month's payment in the account. They showed me the fine print on the contract, something my insurance agent didn't tell me--because they didn't tell him. He then shared with me that he had tried to use his account for a surgical procedure, and they would release only so much money a month. I'm concerned that other seniors may fall for this ploy. I lost $200 plus all the "management fees" they took from my deposits; I could have lost a lot more if I had selected a higher amount to contribute. Thes people hide behind their initials. There are other stories about them out there. Seniors need to be warned.

  Business response

  04/10/2023

  The HMA® is a medical benefit plan in which members make a monthly contribution and Health Matching Account Services awards an increasing matching benefit towards the medical benefit balance. The matching benefit is designed on a graduated schedule, where the matching benefit starts out low in month 1 and then gradually increases each month the benefit is not used. The HMA® is designed to reach a target benefit cap over 35 months, assuming the benefits are not accessed prior to that, which provides the member with an average of a $2 for $1 medical benefit that they can use towards eligible out of pocket medical expenses. Members can access their HMA® medical benefits through the HMA® Medical Reimbursement Visa® Prepaid card or through the HMA® Claim Reimbursement process on the HMA® member portal.

  
  Mrs. **** enrolled into the HMA® 15000 plan with her spouse through an independent contracted broker, Paris Cluff, on April 25, 2022 with a start date of April 26, 2022. The HMA® 15000 plan with a spouse included has a monthly contribution of $203 and is designed to reach the $15,000 target benefit cap after 35 months. Mrs. **** received her HMA® Member Welcome email and HMA® Member Contract on April 28, 2022. The HMA® Member Contract clearly discloses all of the terms and conditions of the HMA® benefit plan.

  
  In regards to lowering the monthly contributions, it is stated in the HMA® Member Contract under Section 2.1 on pages 5 and 6 that a member is not eligible to reduce the HMA® plan level and monthly contribution until the member has been in the HMA® plan for 24 months. Mrs. **** had a start date of April 26, 2022 which means she would be eligible to reduce her HMA® plan level and monthly contribution on April 26, 2024.

  
  In regards to cancelling the HMA® plan and receiving a refund, the HMA® Member Contract states under Section 4 on page 8 that the termination of the HMA® plan will result in any remaining medical benefit being relinquished and no refunds will be given.

  
  In regards to leaving one month’s contribution in the HMA® plan, it is stated in the HMA® Member Contract under Section 1.4 on pages 4 that the current balance in a Primary’s HMA® Contribution Account for purposes of paying for and adjudicating Reimbursements pursuant to the Contract, less one month’s HMA® contribution (including Maintenance Fee) which must be maintained at all times as a floor in the Primary’s HMA® Contribution Account.

  
  Due to the terms and conditions stated in the HMA® Member Contract that are described above and that Mrs. **** accepted during the online enrollment, we were unable to process her request to lower her contributions or cancel the HMA® plan and receive a refund. However, as Mrs. **** stated, she was able to utilize all of her available HMA® medical benefits towards eligible medical services before cancelling her plan.

  
  We would like to thank Mrs. **** for giving us a chance to serve her and provide her with the benefits of the HMA® plan.  We regret that she was not satisfied with the necessary limitations of the HMA® plan put in place to secure the superior matching benefits that HMAS® and the HMA® plan provide, and has decided to discontinue her participation. 

• Initial Complaint

  06/08/2022

  Complaint Type:

  Billing Issues

  Status:

  Unresolved

  More info

  January 21, 2022 I sent in the request form to be reimbursed for a hospital payment. I have yet to receive the check. According to all their documents its a 30 day turn around. Also I am trying to use my HMA card to pay a hospital bill, and their new card (the old one worked fine) can only be used in person in a chip reader. How many hospitals do you know that you can pay in person at time of service! You can't! Nor can you go to the hospital to pay the bill. Today (6/8/22) I was able to get Advent Health Daytona Beach hospital billing on a 3 way call with a man from HMA Services, Inc. who proceeded to tell both of us that the card cannot be processed unless it is at the hospital. Corey from Advent Health stated that isn't possible, and asked if I send in the bill, if they would cut a check directly to the hospital as other HMA's have done and he said no. The only way I can pay my bill is if I pay it with MY personal credit card and then send it in for reimbursement. WELL that brings us back to January...I still don't have my check! This company is awful and should not be in business. Please help me get my $9k from them so I can pay my hospital bill and get other bills covered. They don't want to give up MY money!

  Business response

  06/27/2022

  The HMA® Claim Reimbursement Program works by reimbursing our clients for eligible medical expenses under our HMA® Member Contract. We provide our clients with an HMA® Claim Reimbursement Visa® card that can be used at the point of service to pay for eligible medical expenses, assuming that the provider is assigned a merchant category code (MCC) that the HMA® Claim Reimbursement Visa® card is programmed to accept. If the HMA® Claim Reimbursement Visa® card is unable to be used with an eligible medical provider, then the client can access their HMA® medical benefits through a reimbursement process. Our clients receive our HMA® Member Contract by email when they first enroll. This HMA® Member Contract explains in detail the eligible medical providers and services the HMA® covers and how the medical benefits can be accessed with through the HMA® Claim Reimbursement Visa® card or reimbursement process. The HMA® product is based on actuarial science and the medical benefits we award our clients are actuarially sound. The HMA® Member Contract is in place to make the program rules are followed.

  Denise ****** submitted a request for a claim reimbursement from a chiropractor on January 21, 2022 and the request did not have an itemized medical receipt so the reimbursement request could not be processed. We have informed the client of the outstanding issue of not providing an itemized medical receipt for the services, but we have yet to receive it. Therefore, we cannot process the reimbursement until we receive the itemized receipt.
  
  For the hospital bill on 6/8/22, our HMA® card was declined due to the online merchant category code from the provider. I explained to the client that she can use the card in person at the hospital or pay the bill out of pocket and request for a reimbursement, per our HMA® Member Contract under Section 2.3 on pages 6 and 7. After that initial call, I followed up with the client on 6/10/22 to try and resolve the issue on how she can pay her hospital bill. I asked her to send me a copy of the hospital bill so I could verify if it is an eligible medical expense under the HMA® Member Contract. Upon review of the hospital bill that the client sent me, we found that this was not an eligible medical expense under the HMA® Member Contract and would not be eligible for reimbursement because the client only made a partial payment on the original bill and then set up a monthly payment plan, which is not allowed under the HMA® Member Contract under Section 1.10 on page 5. The client is now trying to pay off the full bill but it is now over the 90-day window that we allow for hospital bills to be covered. The client then explained that there was a mix up on the billing that the hospital sent her and she would talk with them on getting it resolved. At this time, we have not received an updated hospital bill from the client. We will continue to work with the client and make any eligible claim reimbursements under the HMA® Member Contract.

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