ComplaintsforHealth Alliance Plan (HAP)

• Initial Complaint

  08/19/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  Hap has a reward program, that gives rewards for making certain visits to your doctors or certain tests. We have some new incentives this year which the amount is different for each one. I made my visit for my annual wellness visit, it occurred back in January this year, contacted customer service to find out why I didn't get it, I was told until they get a claim from the doctor then the reward would be sent. Well a few days ago I got a reward letter in the mail, but, it contained a subway reward card, I didn't fill out a form for a reward for the ***** reward yet, I was still waiting for it to come in the mail. When I spoke to customer service I told them the form came with a subway card in it for *****.I told them the subway card was not my choice, and i had not filled out a form yet.the way it works is you fill out the form and you have a choice of several companies to choose from, so i said i would like to choose for myself, they said they couldn't take it back.

  Business response

  08/20/2024

  Good afternoon,

  The plan has granted a one-time exception to allow for the member to choose a new voucher to replace the Subway $40 gift card. A voucher will be mailed today to the member at her current address. I hope this satisfactorily addresses the members issue. Please reach out should you require additional information or actions on behalf of the plan. 

  Thank you,

  ***********************

  Manager, Appeals & Grievances

  Health Alliance Plan of Michigan 

  Customer response

  08/28/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.

  Better Business Bureau:

  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.

  Regards,

  *******************

• Initial Complaint

  04/24/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  4/24/2024 Hap Denied treatment of the recommended dose by the *** as well as my Dr for the ongoing treatment I take for MOD. Dr as well as the *** recommend 84mg and Hap denied it and said they will approve the 56 mg. The 84 mg has been working and providing relief for MOD. Hap Should not be overriding my Drs recommendation as well as the recommendation of the *** just to save their bottom line. This is clearly a cost saving measure at the expense of my health. Looking to have my appeal approve and bumped back up to the dose recommended by my ***********

  Business response

  04/25/2024

  The Members Provider Dr. ******************* has initiated an internal appeal for this member on April 22, 2024 regarding this matter. The appeal is currently pending. HAP takes all complaints seriously as it helps determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns and help us to better provide the optimum health care to our members. All concerns received are investigated and are resolved directly with the member and or their provider. Please know that we strive to deliver excellent service to our members and if there are any additional questions regarding the pending appeal, please contact our *************************** at **************. We are open Monday through Friday from 8:00 a.m. to 8:00 p.m.We will be open on Saturdays, from 8:00 a.m. until 12:00 p.m., from February 15 through March 31 and have extended hours from October 1 through February 14 of the following year. At that time, customer service specialists will be available seven days a week, including holidays, from 8:00 a.m.to 8:00 p.m.
  

  Customer response

  04/26/2024

  [A default letter is provided here which indicates your rejection of the business's response. 
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of why I am rejecting this response appear below:
  
  [This is not a resolution to my issue.  It is just a standard statement they copy and paste to complaints. I have called their customer support number and sat on hold for over 30 minutes and then get disconnected. Feel free to give me a call if needed. You have my number. ]
  
  Regards,
  
  ******* Chappell

  Business response

  04/29/2024

  Appeal #********** was submitted by Dr. ******************* on April 22, 2024. This appeal is currently pending and under review. The outcome of the appeal will be communicated with the provider. We cannot open a duplicate appeal for the same denial when the current appeal is pending and under review. Please allow time for the investigation to be completed. 

  Customer response

  05/01/2024

  [A default letter is provided here which indicates your rejection of the business's response. 
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of why I am rejecting this response appear below:
  
  Once Hap approves the appeal , I will except this . Not until then. 
  
  Regards,
  
  ******* Chappell

• Initial Complaint

  03/31/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  I have been unable to get my prescriptions for a month now. I have called HAP 8 times. Spoken to a supervisor twice. Each time I am told the issue is resolved, I go to the pharmacy to pick up my medications & am told my insurance is denied. I need my health benefits that are paid by myself and my employer. I have had HAP health insurance for over 20 years with no issues. Now no one seems to be able to fix the issue. Nothing changed on my end.

  Business response

  04/02/2024

  HAP takes all complaints seriously as it helps determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns and help us to better provide the optimum health care to our members. All concerns received are investigated and are resolved directly with the member and or their provider. Please know that we strive to deliver excellent service to our members and if there are any additional questions, please contact our *************************** at **************. We are open Monday through Friday from 8:00 a.m. to 8:00 p.m.We will be open on Saturdays, from 8:00 a.m. until 12:00 p.m., from February 15 through March 31 and have extended hours from October 1 through February 14 of the following year. At that time, customer service specialists will be available seven days a week, including holidays, from 8:00 a.m.to 8:00 p.m.

  Customer response

  04/03/2024

  [A default letter is provided here which indicates your rejection of the business's response. 
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of why I am rejecting this response appear below:
  
  This is not a resolution to my issue.  It is just a standard statement they copy and paste to complaints.  I have called that number and talked with HAP representatives 8 times in the last month.  I called yesterday and finally someone said my prescription plan was not activated.  Very careless entry system on the part of HAP. Where is the quality control?  How can an issue with coverage keep happening for a month?  Why wouldn't representatives take the time to assure everything is entered correctly and functioning after the first call.   I went without prescriptions for a month because they have no checks and balances and can benefit from their members not receiving paid services.
  
  Regards,
  
  **** *******************

  Business response

  04/05/2024

  As a member of our plan, you are a valuable source to help determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns. Being aware of these important facts will help us to better provide the optimum health care to our members. After reviewing your complaint, the following was established. Due to a system error, your prescription drug coverage was reinstated in our system. The incident(s) you described are not typical for the level of service we strive to deliver to you. We apologize for any frustrations or inconveniences you have experienced. HAP values your membership and partnership for your health care needs. 

  Customer service has reached out to provide this information and you should expect a resolution letter via mail. Please reach out if we can further assist. 

  Customer response

  04/10/2024

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.

  Better Business Bureau:

  I have reviewed the response made by the business in reference to complaint ID ********, and find that my issue is resolved. Should never have taken 4 weeks.  I went 4 weeks without prescriptions because several people failed at their jobs.

  Regards,

  **** *******************

• Initial Complaint

  01/31/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  1-30-24 i went to the dr ****** sick, diagnosed with covid. my dr prescribed me paxlovid.pharmacy tells me and my dr that health alliance plan requires prior authorization for me to get the paxlovid. my ******* the prior authorization takes between 5 days and 2 weeks. I feel like this is a scam by ***** alliance plan to get out of paying for paxlovid, they know that there is a window of only a couple days to start taking the paxlovid, but they do this so that it will take longer than your window. i only go to the dr 1 or 2 times a year, seems like im not receiving the service im paying for, with them playing this game for a prescription, possibly life saving. Between my employer and myself, we are paying $24k a year for my health insurance, way to much to feel like my health care provider is playing games with my health. only 2 weeks before open enrollment too. hopefully you can help get this fixed so others can get the medication they need, obviously it will be too late for me.

  Business response

  02/07/2024

  HAP takes all complaints seriously as it helps determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns and help us to better provide the optimum health care to our members. All concerns received are investigated and are resolved directly with the member and or their provider. Please know that we strive to deliver excellent service to our members and if there are any additional questions, please contact our *************************** at **************. We are open Monday through Friday from 8:00 a.m. to 8:00 p.m. We will be open on Saturdays, from 8:00 a.m. until 12:00 p.m., from February 15 through March 31 and have extended hours from October 1 through February 14 of the following year. At that time, customer service specialists will be available seven days a week, including holidays, from 8:00 a.m.to 8:00 p.m.

• Initial Complaint

  12/01/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  This is an addition to a prior complaint. The prior complaint was against basic cobra. Basic Cobra now says theyve received my payments and should have coverage. HAP now says my coverage was terminated due to non payment. Ive called both Basic Cobra and HAP and spent much time on the phone. Theyre sending me in a circle, one blaming the other. I dont know where else to turn. Please help!

  Business response

  12/08/2023

  HAP takes all complaints seriously as it helps determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns and help us to better provide the optimum health care to our members. All concerns received are investigated and are resolved directly with the member and or their provider. Please know that we strive to deliver excellent service to our members and if there are any additional questions, please contact our *************************** at **************. We are open Monday through Friday from 8:00 a.m. to 8:00 p.m. We will be open on Saturdays, from 8:00 a.m. until 12:00 p.m., from February 15 through March 31 and have extended hours from October 1 through February 14 of the following year. At that time, customer service specialists will be available seven days a week, including holidays, from 8:00 a.m.to 8:00 p.m.

• Initial Complaint

  11/05/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I have repeatedly (5) times contacted this company and asked to be removed from their mailing list. 3 times in an email and twice in a phone call. The first time was someone that answered the phone and said I'd be removed. Second time I talked to a ********************* who said she was a manager. Insisted that she would expedite the issue and I'd be removed. Still has not happened. Got another ************* 11/5/22. I went thru this same c*** witih HAP 2 yrs ago and it took me 6 months to get it stopped. I don't understand what their problelm is. I don't want, never wanted and never will want their HAP plan. I am completely satisfied with BC/BS. WIll never change and want HAP to STOP the mailings. I now consider it harrassement. I told this ********************* that if I received one more mailing I would report it to the BBB and she insisted it would not happen again and I would not have to resort to that. Our mail system is bad with mail being stolen and put in the wrong boxes. I DON'T want my name like this out there for a chance of it being stolen.

  Business response

  11/14/2022

  HAP takes all complaints seriously as it helps determine when and where there may be a need to improve services. Member feedback is especially important as it helps us to better understand our members needs and concerns and help us to better provide the optimum health care to our members. All concerns received are investigated and are resolved directly with the member and or their provider.Please know that we strive to deliver excellent service to our members and if there are any additional questions, please contact our *************************** at **************. We are open Monday through Friday from 8:00 a.m.to 8:00 p.m. We will be open on Saturdays, from 8:00 a.m. until 12:00 p.m.,from February 15 through March 31 and have extended hours from October 1 through February 14 of the following year. At that time, customer service specialists will be available seven days a week, including holidays, from 8:00 a.m.to 8:00 p.m.

  Customer response

  11/14/2022

  [A default letter is provided here which indicates your rejection of the business's response. 
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of why I am rejecting this response appear below:
  
  [You must provide details of why you are not satisfied with this resolution. Please type details here:]
  
  Regards,
  
  ***********************

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩