Freedom Life Insurance Company of America / US Health and advisor, Angel (Alexis) Rivera review: Payments not tendered to providers

I purchased what I thought was an insurance plan with premium coverage from advisor/ licensed agent Angel (Alexis) Rivera. Prior to purchase I went over every doctor I saw to confirm they were in network. Was told of my 8 first doctor visits at no cost, and more than likely I would get $75 checks for staying in network. I was purchasing a solid premium plan. The cost was $521 per month which to date has been always timely paid.

As I began my journey to use my coverage for routine wellness, I was noticing nothing being covered and paid for, but rather costs were negotiated and I would receive an explanation of benefits. I have requested my written policy 4x and to date have not received same. I have texted and emailed my agent and I am getting no responses since I began filing disputes over my claims. Prior to that he was working on it, it was an insurance wording mistake, the office was closed, he was still waiting on a response, the excuses go on and on and I have them all via text. I checked with him on every provider I would see. I would request lists of covered specialists, as he told me from day one, he would be my point of contact. Nothing was a problem with the plan, labs, diagnostics, I was covered.

Well let me tell you how covered I am:

9/23/21 standard lab work total 126.04, they pay only 30.00 so I now owe 70.83 when labs 2x per year were covered

9/30/21 see my PCP in network for annual exam and flu shot total 381, they paid the doctor but declined pay for an immunization that is costing me 166.70, I was never told immunizations were not covered, and during most annual exams a majority of patients do get flu/ pneumonia shots etc

2/10/22 procedural colonoscopy so now we have the surgical center charge 1250; the anesthesiologist charge of 750; surgeons charge of 645, only to find out they cap colonoscopies at 650; never was I told that preventive screening were capped, so now I owe nearly 2000

2/19/21 go to an in network facility for mammogram cost 344.95; well guess what they paid 250 and left me with 51.46; so I guess a diagnostic for my breasts is worthy of payment unlike a colonoscopy as perhaps if they did those without anesthesia it would much more economical

2/25/22 my pcp referred me to a neurologist for nerve pain, to an in network provider cost 627.00; was told it was coded as dental, dispute the bill as the nerve is the trigeminal nerve, 13 nerves that run from the brain through various places behind the eyes in the mouth, it’s not covered it’s dental. It’s not dental, it’s a nerve issue. Had to dispute that weigh no resolve today just like all of the above have not been resolved

3/27/22 Care Spot Urgent Center, supposed to cost me 75; the bill is 395.80 and I am responsible for 127.06

4/6/22 office visit with pcp, and get shingles vaccination total 819.00, they paid the doctor 100.00, the remainder is on me, so vaccinations again not covered

4/14/21 womens wellnesss exam with in network provider, I even provide them with the labs that are on the policy for the Pap smear, doctor charges 458.00 they paid nothing to an in network provider

As you can see I have touched on the highlights I have paid 521 a month and I could have virtually used that money to negotiate my own self pay rates. I don’t need to spend 521 for a negotiator plus all of these out of pocket bills.

None of these items declined were ever mentioned by the agent, the last time we communicated he even responded “ I see this plan is not working for you”, so don’t you have the integrity to do something. I ask about the billing issues and he wants me to explain to the facilities how to prove s same! I am the patient paying your company you work for me. This company is a compete joke, with agents who have no integrity or morals. Mr. Rivera and his girlfriend just had a baby, I bet she has another policy and can get her injections. So you can gladly send all my outstanding invoices to him for payment.

I wrote to him only last time last week again requesting a hard copy of my policy and an explanation as to the above, I asked that he please respond by May 6 in writing. I could not even get him to initially respond to me to get his email address, I had to ask corporate. This agent needs his licensed suspended as his ethics and oaths are all below standard. Additionally, he discussed the policy he got for me with a friend of mine who had also been attempting to get a policy with him. Although not grounds for HIPAA, but a breach in confidentiality.

How dare he discuss the policies he attempted to get for besides the fact this is not a policy of insurance, it is negotiated costs of expenses. This is basic negotiations. I have filed disputes on every claim described above, and have yet to hear back from corporate and of course have heard nothing from Mr. Rivera. Not even an apology, he knows he put me in a crap program that was never insurance, so how he sleeps at night is beyond me.

My sincere thanks for allowing me to present my complaint.

Janet Garmont

[protected]@aol.com