Pehp Reviews

always having issues with this company. they never want to cover my birth control on time, i always have to wait 20+ min at the pharmacy while they call and beg pehp to please cover this for me. i have endometriosis, birth control is necessary for me. they also do not cover my inhaler enough, for $50 i could actually go in to the doctor and get a breathing treatment. they want me to pay this every month for my life saving inhaler. lastly, they have been refusing to cover an antibiotic that my doctor says is necessary. making me call them, then my doctor, then the pharmacy, then them again, i do not have time to spend hours on the phone doing this, and i am also sick. i should be resting in bed, not battling with insurance. i have had to do their job for them, over and over with these phone calls and getting paperwork. THIS IS NOT MY JOB. i've been told by both the pharmacy and my doctor, this is PEHP's job and that they should be calling, not me. but since they won't do it, i have to, because i am sick and need treatment. i don't understand why it's so hard to get treatment. it's just an antibiotic, it shouldn't be so difficult. i feel like i am getting sicker because of all this stress PEHP is causing.

Always helpful when I call for questions and they do their best to resolve any issues.

I love how PEHP takes care of me, not just physically but mentally too. Thanks PEHP for making sure we have free wellness resources accessible. Whenever I am at a medical office and mention PEHP, the staff always says good things too.

PEHP is hands down the most corrupt and fraudulent organization I have dealt with in my entire life. I pay for the most premium dental insurance they offer. I have submitted in excess $6000 in dental claims all of which the are contactually obligated to pay. PEHP has paid The state of Utah should be ashamed. What a disgraceful organization. Just outright fraud!

My businesses done with great timing and good work on my business thank you all for the service !..

My experience with PEHP has been ok, there was some confusion with a cash back payment after my surgery. After three phone calls I (hopefully) received correct information. I am due to receive a small check this month. My family has not had any insurance until the last three years due to employment. I am switching companies so we will see if this is a smooth transition from on company to another. Both have PEHP as their provider. Here's hoping to a smooth transition. Have had no problems with payments.

I have dealt with so many other health insurance companies and PEHP is the best to work with. My husband is a Type 1 diabetic and we always seem to have question after question. Any time I have a question they are super helpful especially when it comes to billing! I like how they walked me through the billing process on their website which is very user friendly. We have been pleased with PEHP!

I wish there was a 0 star rating because PEHP would get a 0 star rating from me. I dealt with two employees with PEHP (manager and director level) today and they did not show any signs of having common sense in resolving issues. Glad my employer is no longer associated with PEHP and if in the future there is any chance that my employer considered PEHP I will do what I can to road block that from moving forward. Forewarning, if your employer is contemplating using PEHP, try to persuade them to go a with a different provider. If you are stuck with PEHP I wish you luck because you will need it.

My rating is an amalgam of two experiences with PEHP that were two years apart. In the first instance a family member had major surgery (that had to be done without delay) that was successful in every way possible. The PEHP representative found a surgeon within network over the holidays (not easy because of the rarity of the illness) and covered the expenses as indicated in the policy. Five stars for that.
More recently the same family member had a recommended surgery (distantly related to the first) which required PEHP approval. Got the CPT codes which were both approved. Level 2 OR expenses were quite high, leading to PEHP denying payment for about 50%. Nor did we receive a doctor s bill for 15 months. When it arrived (with the approved/stated CPT codes) it showed that PEHP had rejected nearly 70% of the charges. Multiple calls to the doctor s office (as well as what I remember the doctor saying when he came out of surgery) indicate the surgery was routine and according to the CPT codes.
PEHP said differently, that the surgeon had deviated from the stated CPT procedure. They didn t have any further detail, and the great frustration over these 15 months (!) is the lack of information that has been shared, either by PEHP especially, or by IHC.
IHC at least has provided an advocate that has been helpful to me understanding more about their decision-making process.
By contrast, I ve spent probably 500% more time on the phone with PEHP going around in circles. The representatives are generally sympathetic and always willing to listen. However, I think their ability is sharply proscribed because they never offer much in the way of specifics in terms of what should happen next. Once they suggested an advocate would work through my situation with me, but within a few days (last summer) I received a phone call from their office saying there would be no advocate forthcoming that audits were completed, proper, and the case was closed (even though at that point the doctor s bill sat somewhere between them and IHC, and would not be issued to me for another half-year or so).
Another PEHP rep, months later, said I could file a written protest, the first employee to say so among a half-dozen or more I had spoken to, but then indicated that since the case was beyond the six month deadline that the protest would be rejected out of hand.
Finally, calls to the Utah Insurance Department, though helpful in terms of information, suggested that the state has no power to regulate or sanction PEHP because of the way they are funded. It seems they do not have to answer to anyone, and in my most recent experience, I will vouch for that. One star.