- Report: #141236
Complaint Review: Unicare - Plano Texas
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Unicare
3820 American Drive PL-104 Plano, 75075 Texas, U.S.A.
Phone:
800-718-9355
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Unicare Denied a $280 claim because the doctor said She has large adnoids Ripoff Plano Texas
I paid Unicare almost $200 per month. There is a six month waiting period on certain conditions (which I was not made aware of by the rep.) that are not covered. One of these conditions is adnoids. It was not a pre-existing condition. I took my daughter to the doctor 2 weeks before the six month waiting period was up. The doctor said, "she has enlarged adnoids and we may need to remove them." That statement is the only reason that Unicare can give me that they have denied the claim. This is absolutely ridiculous. They don't even offer to cover the part where he looked at her ears and said, "we need to put tubes in her ears." I have to pay $280 dollars to have someone tell me something I already knew. I would not recommend Unicare to anyone. The doctor's office even told me that Unicare is ridiculous about everything.
Jenny
Waxahachie, Texas
U.S.A.
Jenny
Waxahachie, Texas
U.S.A.
1 Updates & Rebuttals
Ruth
Houston,Texas,
U.S.A.
READ your literature before you buy anything!
#2Consumer Comment
Fri, May 20, 2005
Don't JUST believe "sales" agents. Read literature before buying anything! There are LOTS of con-artists out there on the streets, who'll tell you anything to make a sale! UniCare's sales literature SPECIFICALLY states that there is a 6-month waiting period for coverage that involves: - most hernias - sterilization - varicose veins - hemorrhoids - disorder of tonsils or adenoids MOST insurance companies have this SAME 6-month waiting period. You have a contract with UniCare. You had a 10-day right to review your contract & refuse the policy (and get your money back if not satisfied with the policy). Insurance policies do NOT pay for everything. If they did, they'd be out-of-business! UniCare tries to keep your monthly premiums LOW. In order to keep the pricing LOW, they MUST have limitations & exclusions in the policy. They also expect doctors & hospitals to give them substantial discounts....to keep YOUR prices lower. Doctors & hospitals in PPO networks have agreed to give discounts to the insurance company...for the EXTRA business that the insurance company is sending to them. Many doctors & hospitals complain about UniCare BECAUSE UniCare expects SUBSTANTIAL discounts from them. UniCare pays legitimate claims VERY quickly! I OFTEN see their claims paid electronically within 24 hours! I represent MANY companies. I admire UniCare for MANY reasons! Bottom line: -Read the literature before you buy anything! -Don't expect the insurance company to pay for EVERYTHING! -We DO have to be responsible for our OWN situations....No one owes us something for almost nothing. -Insurance is NOT cheap any more! Why? Because they have to pay for SO many doctor & hospital bills for un-healthy Americans! These are my opinions, after working as an Independent Health Insurance Agent in Texas for about 20 years now. Thank you for the opportunity to express my opinion.
