QualChoice health Plan Reviews

If you need the ER, then you are screwed. Qualchoice covers basically nothing there. Go elsewhere if at all possible.

Stupid! They do not inform their customers about mandatory mail order prescriptions and they give you no choice. They didn't inform me and I went into pick up my prescriptions from the pharmacy and my pharmacy informed me that my insurance wouldn't allow it to be picked up in store and that I wouldn't have my prescriptions... The insurance company is forcing me to mail order them and they gave me no notice and I was "notified" by my pharmacy! That's NOT their job it's YOUR job you stupid insurance company!!

Was not happy with the coverage. However the customer service representatives are extremely helpful and professional.

I've called several times over the past week and still can't get a simple and clear answer to a question: How do RETIRED ARKANSAS SCHOOL TEACHERS get the supplementary policy for gym access? Either the connecting person is in the wrong division or out of the office or honestly tells me they don't know the answer. Seriously? No one in QualChoice knows the answer to a simple question like "How do I buy this policy?"

My daughter has this ins and it covers nothing. Have to fight with every claim. They need to shut their door.

Words cannot describe how terrible this "insurance " company is. They do absolutely nothing for you.. if you purchase the highest plan possible through them it does you no good. It took a month trying to get them to approve the (prior authorization form). After a month calling every other day, getting told we just had to wait a few more days each time, finally a letter comes in the mail saying they will not approved the medication until two different types have been tried and failed... so we got a script for one of the medications they said had to be tried first... guess what. They wouldn't approve that one either..!!! Insurance canceled and our company insurance 30+ employees and their family's will be canceled as soon as Possible. This place is a disgrace.

These people are very unprofessional and I do not see how they are in business. & They literally do not cover anything. Having them is almost the same as not having insurance at all. Now, I have to pay a $150 fee for not having a PCP listed, when I DID give them a PCP. I got charged $150 and the doctor did not even do anything to help me. & QualChoice is acting like they won't cooperate. I deserve better. Are there any suggestions for better, more professional health insurance companies.

My sons medicine is being held up for no less then 4 days. The reason is because this stupid company is waiting on his Dr to give authorization to fill the prescription he wrote? They want to make sure there is not a cheaper alternative. The pharmacy has already said there is no generic form offered. I was warned qualchoice was a terrible insurance company before my work switched. Looks like it s true. To anyone companies or individuals shopping for insurance BEWARE OF QUALCHOICE.

Can't seem to get any home health aid for a quad who must be assisted with all personal needs, from toiletry, bathing.dressing, eating. Wife has had spinal fusion, but must still do all physical functions for husband. We have paid for this insurance since the day he became 100% disabled.
Maybe i should become indigent and get free care.

Horrible. I foolishly allowed them to draft my bank account for our premium every month....which was already close to $600 each month....but then, they took it upon themselves to almost triple our premium, and when I called them about it, said "We sent a letter asking you to call us." Anyway, nobody could give me a direct answer as to why our premium went from $600/month with a $10,000 deductible PER PERSON, to almost $1700/month, and a $15,000 deductible per person. Why even have insurance at that point?? One person told me it was because my husband worked a commission-only job, and therefore there was no guarantee that we would qualify for a subsidy the next month (even though we qualified the entire time he worked there)....one person told me it was because of inflation....one person could find zero reason, but refused to give us the previous pricing....it was an absolute disaster, and the only excuse they could all 3 give was "Well, we're within our rights under the ACA to do this." No thank you.

This place is a joke. My Dad was diagnosed with a rare heart disease and we've done nothing but fight and fight with them to cover his doctor's needs. You pay insurance for 15 years or more and they tell the doctor's what they will and won't cover. This is the piss poorest insurance I have EVER heard of, stay away from them.

They are benefitting from being outdated. They're technology is circa 1999.

Unfortunately QualChoice has fallen from grace so to say. I can remember a time when the quality of care provided by QualChoice was top notch. Now they employee rude nasty people who think it is funny that there clients suffer while they stall out review process for procedures and surgery's. This company makes getting tests, and procedures done borderline impossible. Such a shame to see QualChoice change from a good insurance company to one of the worst in the world.

As an employee of QualChoice for 25 years I have enjoyed my time here. As anywhere you make your job what you want whether good or bad. There is always bad days due to tight schedules and high inventory but the good far out way the bad. My co-workers are also friends we spend as much time at work together as we do at home with family. Through the years I have always heard rumors we wouldn t last, we were closing our doors, etc. all the negative, but my years show we have grown and are a stable company. Now with our partnership with Centene we will move on to bigger and better with a bright future.

I know your benefits for an insurance plan can be complicated and hard to understand but everyone at QualChoice is always willing to help in any way they can. I can attest to our great employees and each and every one go the extra mile to take care of your insurance needs.

I have experience of many years in working with the regional manager and staff in the QC Northwest AR office. The manager is extremely knowledgeable of the industry, and proactive in all my dealings with her. She always goes the extra mile. The entire team there responds promptly whenever assistance is needed. Great team work!

A bunch of incompetents.
Update--after continued mis-billings I have no recourse other than filing a complaint with the Arkansas Department of Insurance.

They will cover 100% cost for an opiod prescription, but when I called to ask why the suppliments I need isn't covered they told me to call Awesome RX. They say they can't answer me and we play hang up on the client and call back and hold, for 4 hours. Then I'm given the number to Opsum who says they don't know why I'm calling them, because Qualchoice makes those decisions. 7 hours, 10 people and still no answer. Awesome RX isn't even a listed company. How shady is Qualchoice? Bet your pain pills are covered, but nothing else. THIS is what is causing the opiod epedemic, people just following orders and passing the buck while they rake in the big bucks.

Your people hung up on me twice when I asked about your local location I'm appalled at this customer service you should be ashamed of yourselves letting people like that trained by you represent your business utterly disgraceful. SHAME!!!

If I could add 0 stars, I would. I'm over $2,100 in debt because of this "insurance". Won't cover anything I need like chiropractor or the ambulance bills. I was suicidal and I guess using the ambulance wasn't an "emergency ". I moved to another state and now after 3 months after my two hospitalizations , they tell me that they cant cover any of the ambulances I used . Now I am struggling to find a job and to pay this off with my mother . Worst insurance ever.

If I could give a zero star rating, I would. They made me pay a $200 co pay, when my summary of benefits says $40. I have been over all of this with them, they won't listen! The lady who does the insurance stuff at the dr office even said that the $200 wasn't correct. I've had someone with this company tell me the same thing. It wasn't an outpatient procedure done at the hospital, it was done in the dr office! I have yet to hear back from the supervisor that I left a voicemail for. We will not be using Qualchoice next year!

Funny how there's a running theme of them denying claims. When I go to a chiropractor they literally pay him whatever they feel like. That literally includes paying him nothing so all he gets is the $50 specialist copay I pay. I also recently had an MRI and it found arthritis in my neck. The hospital said they got a PA and my copay was about $40. They denied the claim, saying they approved the PA, not payment, and had to apply it toward my deductible, resulting in a bill of almost $700. I currently have a case with the Arkansas Insurance Department over these issues. I have the policy with the higher premium, but it doesn't matter unless you meet that deductible of $2,000.

I have had, and provided to my company's employees, QualChoice health insurance for over 20 years. They are responsive and friendly to deal with and have always worked hard to not just quickly pay claims, but to provide many extra services that help our entire staff and their families improve their health. They are the perfect size - big enough to have what we need but small enough to provide personal service. Can't say enough good things about QualChoice.

your company sucks , i have been trying to get my insurance card for over two years now , every time i call , i get the same BS that your company can't help, that i need to go to the department of human services and change my address, and i have EIGHT!!!!! different times and when i tell the person on the phone i get the same irritating response "well i'm sorry there's nothing i can do." really!!!!! i cant go to the doctor because i don't have a insurance card, i haven't been able to login to my account to print a temp card and i have tried resetting my password but every time i request the link to do so it never sends! seriously what the hell is wrong/going on.

QualChoice is the worse insurance company I've ever been with. After changing to blue cross at the first of the year, qualchoice decided not to pay my last two months of services in December and November. So I'm looking at thousands of dollars that I'm supposed to pay I have contacted a lawyer!!!!!!!!!!! Its It's truly that bad

If you can find any other kind of insurance, I would recommend using it. I had two doctors, who have actually examined me, tell me I needed an MRI. After waiting several days, my insurance denied it after recommending physical therapy for 6 weeks by someone who hasn't even seen me. I'm just grateful it's open enrollment so I'll be changing insurance carrier today.

My experience as a QualChoice member has been exceptional. I don't have frequent medical expenses, but when I do, QualChoice has provided the service I expect. I particularly like their member portal that provides me an easy way to access information about my claims when I need it.

I recently filed two separate reimbursement claims and they only paid out one of them. Somehow managed to screw that up by claiming they paid both amounts in the first claims check. Has taken FIVE calls so far to try and get my second claims reimbursement with no luck so far. No one ever calls back when they say they will. Horribly managed company. Can't seem to understand how a company can still be in business with all these shady maneuvers.

My friend is in the hospital right now as I post this. He has this insurance and they are refusing to cover his heart transplant in his home state. They are also refusing for him to remain inpatient throughout his procedure which actually bumps him down in priority for his transplant. Therefore, he could die before he ever even has a chance to have this life saving procedure. The hospital he is currently in performs several transplants per day and has the best transplant team in the state. My opinion as a nurse is to forgo this terrible and unreliable company.

They provide one statement to the member and another statement to the provider to put each other at odds. Would not recommend them for insurance.

I called the provider's office three times and the member service twice. The providers office was willing to dig a little deeper to research the problem. The Qualchoice Member office just wanted to brush it off.