Amerihealth Insurance Company of New Jersey

Terrible Insurance company! I carefully researched on our wonderful gov’t site the Health Insurance Marketplace, picked what I thought was a good higher level pain «AmeriHealth NJ
Gold EPO AH Advantage $ 10/​$ 20. WELL FORGET IT, SO FAR they have refused to cover 3 of the medicines I’ve been on for years (and previously cheerfully paid by Aetna, United Healthcare and Oxford), but NO… they won’t cover as medically necessary, 3 drugs which I am doing well on and my doctor wants me on. On their «alternative» was a totally different type of product ex: nose spray to an inhaler! Mind you, it’s suppose to be a superior plan
with a superior monthly premium. I went on the the US Gov’t marketplace to see if I can
complain, but there’s is no provisions to leave any comments, which is dead wrong as if that was the care, a consumer could be warned as with this site on Unilocal with all the other terrible reviews! I will be changing coverage shortly, but please take heed, they are a terrible
corrupt insurance company misrepresenting themselves as very good coverage.

Online bill payment doesn’t work, customers are expected to wait on call hold for 1 – 2 hours to talk to a representative (sometimes the phone gets disconnected as soon as a customer rep takes the call), multiple policy terminations, refusal to reinstate after taking payment on phone for the months where online bill pay failed etc etc etc. They don’t understand that customers have jobs and can’t ake off for hours just to make a phone call during weekdays from 9 – 5.
Luckily my doctors offices were very good and offered to reduce the bills (since Amerihealth cancelled by policy) and it ended up being cheaper than insurance premiums. You need a lot of luck to deal with this company if you are dealing with them. I advice proactive measures to search on
or other private agents before Amerihealth messes up with your healthcare and finances. Can I give them ZERO stars?

Really BAD company at it’s core! I concur with everything Perry B. shared. Unfortunately, we are now out of the open enrollment period and there is nothing I can do to switch. BEWARE, they do not accept credit card payments. It’s bad enough my job of 17 years ended last year and I now have to pay for health insurance without having a paycheck, but I cannot afford to have insurance without being able to finance it through my credit card. Amerihealth NJ is so deceptive that they accept a credit card when you are signing up but now I have learned the hard way they do not accept credit cards for my monthly payments. This was never disclosed and the acceptance of it the first time implied they accepted credit cards on a regular basis. Clearly they have the capability to accept them, but they don’t want to pay the 2% the credit card companies charge them. Shameful practice and just another example of an insurance company that is only in it for the money and not because they care whatsoever about helping people.

I live in New Jersey. I chose the most expensive plan available from
. I ended up with AmeriHealth POS+ Platinum National. Amerihealth may be one of the worst companies I have ever dealt with, not just in Insurance, but in any field. They have phone coverage only from 9 – 5 Eastern time Monday through Friday. They recently changed everyone’s ID number and distributed cards that say «regional plan» even if you are part of the PHCS Multiplan national plan. Their plan covers very few doctors, and you have to leave their site to go to a different site to find doctors. It took six months to find this out from them. When you get a letter from them it is often just to deny a claim. They not only deny it, but they refuse to put the doctor’s name on the claim, and only use internal numbers. They also do not apply the denied amount to your our-​of-​network deductible. They simply mark it denied, say the total amount is your responsibility, but do not apply the of the out of network amount to your out-​of-​network deductible. You can only reach them from 9 – 5 week-​days. Their voice response system does not understand anything; often even if you enter the numbers on your keypad. If you are put on hold, expect to be cut off and have to start over again. Even if they say they will call you back, they do not. It seems they will say anything but they do nothing. Your card does not have the Group ID printed on it, something doctors ask for. They also share your information with WebMD, and recently listed an illness that I do not have. They allowed me to delete it, but not before telling me that I am only preventing it from being displayed; that they are not allowed to change information they received from a provider. This was a disease one can only contract in Sub-​Saharan countries. I have no way to actually correct the error. Their website is an abortion; the ability to look for doctors is virtually impossible to use I still cannot find a doctor I was referred to to perform a diagnostic. They simply do not have a category for it. The company uses every trick in the book to avoid paying for coverage, and they make it extremely difficult to even know which medical even they are denying.

You are an awful company. I have been dropped off my policy 3 times. Every time I call you guys have no idea why and you do nothing to fix it? I have spent days of my life on the phone with customer service who just says they can’t do anything to help me. You haven’t billed me the correct amount in the past 6 months. The fact that you can’t unfreeze my account immediately after you froze it for no reason, is just stupid. I can’t get my prescription that i need every day and neither can my wife. I really hope I end up in the hospital so I can Sue the hell out of you!!! Just another big company that doesn’t have any reason to care for their customers because you get your money no matter what. I will be posting this all over the web making sure to get the word out.

Our first policy was decent enough and everything was as expected. The usual number of claims were lost or rejected for odd reasons. They did not notify us when we hit our max out of pocket and we spent a year getting money back from doctors.
Our second policy was very different. All the rules changed and we were hit by surprise charges, and we are still disputing the max out of pocket. They consistently forget to add in the pharmaceutical expenses. It took over two weeks to send a summary of our expenses for me to reconcile with my records to point out what they missed when they changed computer systems mid-​year and lost $ 1,700 of claims.
They also started paying some claims from February in October.
Better than Oxford and they do usually pay eventually but it’s a nightmare to deal with them since nobody seems to have any information, their computer systems stink internally and externally, and sometimes you get weird EOBs listing a doctor as being in-​network and then rejecting them for being out of network.