Health Line One/ Opticaa Health
Complaint 161329 Details

My husband and I have been trying to get pregnant for years now and have found out through testing that IVF is our best bet. However that is quite expensive. I started researching into what insurances help with fertility, if any at all. After I filled out one form online saying they could find insurance companies to help with this, I ended up finding an article saying that there were only few states that offerd coverage or assistance and my state was not one of them. That day I received a call from Opticaa Health. I explained to them that they could not assist me and why- but they assured me they could. They asked for the fertility center we had been using and found them on their database and assured me that they were in network. They gave me the name and number of who to call if I decided I did want to sign up, because I said I wanted to discuss it over with my husband. I called the next day and talked to someone else who looked everything up about my fertility center and again said yes they did have my fertility center in their network. So that day I signed up. They told me that the plan offers 40%-70% assistance, but most of their clients had reported a 50% assistance rate.
This told me that I needed to save 50% of the rest of the cost on my own...being $10,000. Five months later, I had my side of the money ready to start treatment. I called my doctor to get everything straightened out before I came in, and found out that no, they were not in network with Opticaa Health. So then I called Opticaa Health. First they were very rude because I used the word "coverage". I said helped with coverage- but you aparantly cannot say "coverage". Whatever- they help with the cost. The woman said that no my doctor was not in network. I then was very upset but not ugly and said that we then had a problem, because I had been paying around $200 a month for the past 5 months for a service that was never even an option for me. Then basically the woman said it was my fault that I did not research to see that my provider was not in network. So this means to me that I am in the wrong for not seeing that they were going to rip me off. Well, I'm not in the wrong, but have learned a lesson. Longer story made shorter...I ended up talking to a manager; Robert. He went from decent to talk to to completely rude and unprofessional in about two seconds twisting everything I said, interupting me and not letting me finish anything I needed to say. Saying that they said that they would help pay for fertility but never guaranteed it would be my provider...um yes you did. Not to mention when he asked who I originally talked to and told him, he told me that "he liked the guy, but obviously he was not employeed with them any more for a reason. So this also says to me that they messed up, but aren't going to do anything about it and put it all on me. I said that I deserved some type of reinbursement, and he said no I didn't, they delivered their part and it was my fault I didn't try to use them before 5 months. Even though I had explained why- I didn't have the $10,000 ready to "use" them. Then I said I wanted to cancel and he said he couldn't. Basically he was only the insurance agent not the insurance itself. So I then called the "insurance" itself and told them I wanted to cancel and they then found that my fertility center was in nework.

I have been back and forth for 6 weeks now trying to get this thing worked out or me cancelled. I want my money back or someone to cover something! I talked to a very nice girl who also said that my provider was in network and sent me the page where her computer says that my provider is in network but still when I call my fertility center they say no. I called Opticaa Health again today to talk to this girl whom said I could request her, but instead they forwarded me to "Robert"...wait a minute...the same guy that had nothing to do with the actual insurance company and couldn't cancel my membership...???
I think my next stop will be the BBB.
If that doesn't work, I guess a lawyer will be hired. This is rediculous. I need assistance with a fertility treatment that is very important to me and my husband. If I had money to throw around, I wouldn't of needed their assistance. To top that off, I could have put all of these payments towards the treatment itself. But now I am over $1,000 in damages due to the monthly payments and stress due to dealing with these people. Rediculous. Beware and run from these people!!!!!