Meritain Health
Reviews and Complaints

I have never in my life been treated so poorly by an insurance agent. To the point where I even had to ask her why she was being so rude, and speaking to me the way she was when I wasn't being rude or disrespectful to her.

She continued being rude after that and basically said to have the hospital call her instead because they would actually understand what was happening. Everytime I asked a question or tried to understand something, she would huff and sigh really loud and say "hold on" in a very rude voice. I know everyone has bad days but this was completely unacceptable! Especially after I even asked why she was being so short with me and she continued to do it!

I called back and had someone else help me after that.

He was super helpful and polite. No issues at all with him!

Im convinced this company will do anything to get out of paying their claims. Ive had nothing but issues since my husbands company switched from highmark to meritain health 2 years ago.

Claims processing wrong CONSTANTLY. Its an actual scam company and I feel bad for employees who get screwed with this insurance as their only option. They should be shut down and Aetna should be absolutely ashamed of themselves for creating this nonsense just to save a dime.

You are saving money by making hardworking Americans foot the bill for things they shouldnt have to. If you plan to use your health insurance at all DO NOT go with meritain.

In working with Meritain on mutual client (a Plan Sponsor of Group Medical Plan) for whom Meritain is the claims administrator, the service representatives have taken months to respond to each audit requests for claims data and supporting documents. This has occurred in both years I've worked with them.

This resulted in delaying the plan's audit and Form 5500 beyond the extended regulatory deadline, so now the plan is noncompliant with DOL reporting requirements. It's absolutely the worst I've seen as an auditor working with numerous service providers over 8+ years.

Their and their claims support (e.g. explanation of benefits and how out of pocket was determined) lacks in clarity in comparison to other claims administrators.

Meritain a subsidiary of Aetnaallows its members to see Aetna providers.

But, on the other end of this, they have paid me perhaps 10% of bills submitted.

Calling them for assistance goes like this:

Me: Hi still you havent paid me, why?

Them: (long convoluted reasons)

Me: can you tell me what steps to take to be paid for my services?

Them: (nonsensical phrases that involve no actionable plan)

Me: I need to speak w a supervisor

Them: (puts me on hold 3 times. Total call time 40min) no one is available, theyll call you later.

Me: what is your supervisors name?

Them: I dont know

Me: youre telling that you dont know the name of your supervisor?

It goes on like this for awhile.

My company switched to Aetna Meritain last year. This review is for the RSV vaccine, which can only be reimbursed by Aetna Meritain if given by a medical provider, mine does not give it.

Cannot get it at a pharmacy. I spoke numerous times with Aetna Meritain staff. They suggested CVS minute clinics; however, CVS minute clinics have never had it in my area. They suggested a particular doctor; I called a few times; they have never given and do not give this vaccine.

I called Urgent Care which does not provide it. I suppose they prefer that someone get really sick and then they will have to pay a lot more than the $300 that it costs.

. It all started with signing up for Delta Dental in late June.

Our dentist only accepts Delta so I signed up for it and sent in my July payment coupon along with a check. A few weeks later I received a letter saying that Meritain had gotten the July payment but that I needed to send in an additional 64.43 for the added cost of Delta/ cost increases. They said for prompt attention so I sent in the check right away. That would have been July 24.

I even mailed it from Denver so it might get there earlier.

Today I went in to pick up my prescription and was told that my husband and I have no coverage! We both called Meritain and were told different stories but basically that until Meritain cashes the check, we have NO COVERAGE!

I have been sending in the coupons for Meritain/ Cobra for the past year on time each and every month. There is no reason to cancel our insurance based on 64 dollars I didn't know I needed to pay due to the increase. What if we had an accident or heart attack?

Nowhere in the letter informing me that I owed additional monies did they say we would be completely without insurance until they got the check!

Nowhere do they allow you to pay online or by phone! I understand "Old School" but this is highly unfair to deny coverage based on a decidedly archaic system with no flexibility nor kindness. Cobra is rather like the Wizard of Oz, no one has their number and the only way to communicate with them is through 48 hour turn-around emails.

Don't even get me started on Delta Dental because they are another entity from Meritain but Meritain signs you up for Delta. My husband made the fatal mistake of attempting to go to the dentist this month.

We had no way of knowing we weren't signed up but it turns out that it was more than the dental... until today.

Meritain, Cobra, and Delta all need to coordinate so that each company isn't blaming the other for mistakes.

I have dutifully paid each and every month. If Meritain wants to paid the correct amount when you make changes, then why don't they tell you to call instead of sending new coupons weeks later?