SCAMDiscount plan misrepresented as health insurance Reports & Reviews (1)
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Reported details
3521 West Broward Blvd
Suite 207
Fort Lauderdale, FL 33312
(888) 799-0190 / (888) 811-0364
Sales Agent: Leah Marie Fey - License: 1317302
Re: Complete Care Max from Horizon Health Solutions (effective date of January 1, 2025)
On December 3rd, 2024, I contacted Horizon Health Solutions at (888) 799-0190 to get information regarding supplemental prescription insurance. I spoke with the customer service representative, Marie at extension 104, regarding my specific medication and if it would be covered as my company has decided to drop it in 2025. I provided the medication name and dosage. Marie assured me that it was covered at a $25 co-pay. The price of their plan would be $139 per month with a one-time $50 enrollment fee plus the applicable co-pays for my prescriptions. I was told I was purchasing a supplemental prescription plan through Aetna insurance. It could be cancelled at any time without cancellation fees. Once I purchased the “insurance’ I would receive a physical card in the mail in approximately 10 to 14 business days but I could obtain a digital id card online. I agreed and purchased the “insurance” plan and received a Welcome email that same day. I never received a physical card in December 2024. On January 3rd 2025 I contacted Horizon Health Solutions at (888) 799-0190 as I needed to get my prescription filled by Thursday, January 9th 2025. They re-sent the Welcome email along with a username and password email so I can download the digital id card. At this time I was told that they do not send out physical cards for their plans. I thought that to be a bit odd since that was not what had been communicated to me on December 3rd, 2024. I logged in to the website and downloaded the fulfillment document. I went through the 7 page document and scrolled down to page 6 where the Compass Discount Program id card could be found with my name and member id number. It stated that it was NOT insurance but a discount card. I immediately called back and asked to speak with Marie at extension 104 as she was the one who had sold me what I thought was a supplemental prescription insurance policy. They would not let me speak to her. I asked to speak with Leah Fey who is listed as the Sales Agent on the Welcome email. They would not let me speak to her either. I asked who can I speak to, to get some clarity so I could get my prescription filled. They said no one was available to speak to me because it was outside of business hours although it was 4:30pm EST which is indeed during the business hours of Monday – Friday 10:00am to 5:30pm EST as posted on the Welcome email. I was asked to call back on Monday January 6th, 2025. I called on Monday as directed. At that time, I was told my medication is name brand and is not covered. If that was the case I would not have purchase this “discount” program. That was not what I was told on December 3rd, 2024. After being passed around from person to person I was eventually transferred to Lisa at extension 340. She explained I would need preauthorization for my medication. I asked for the form to be sent to me so I can have my physician fill out the necessary paperwork. She could not send me the form without speaking to the pharmacy department. She said she would call me back. I have not been able to connect with Lisa again regarding the preauthorization form. I have called repeatedly since Tuesday January 7th, 2025 and have been meet with all of the following: 1. the customer service representative tells me they could not help me because it is not their department, 2. they would tell that they will put in a request to have Lisa at extension 340 or Marie at extension 104 return my call, 3. I have been forced to leave a messages because I have reached the maximum hold time, 4. I have been hung up on after providing my member id number, 5. I have been on hold for as long as two hours without any one answering my call then I am disconnected. In my numerous calls I have asked to speak to Marie, Leah, Lisa, a manager, a supervisor or someone, anyone in charge who can assist me. I had to pay $553.51 out of pocket for my medication because I have not been able to get Horizon Health Solutions to honor this discount plan. I have also tried to communicate with them via email. On January 16th, 2025 I sent emails to [email protected] as well as [email protected]. I received a Support Request Received email immediately with request number 841081 and 841080 respectively. First Enroll called me by the following business day. I spoke with a supervisor, Juan, who explained that First Enroll provides billing services only for Horizon Health Solutions. He transferred me to member services in which again I was placed on a long hold without resolve. Today, January 24th, 2025 was my last attempt to speak with someone at Horizon Health Solutions to hopefully get my prescription covered through their “discount program.” As expected, I was left on hold. The representative would not even confirm the name of the company or provide a physical address where I can send correspondence in writing. I immediately contacted Frist Enroll and requested cancellation of my membership and a full refund of $189 for the month of January 2025. They were very cooperative and processed my request immediately. Although I have received a refund I am still in the same position where my prescription is not covered in 2025 and expensive. I am filing a complaint with the agencies below in hopes this does not happen to another consumer. I was clearly given false information from their sales agent. Their customer service department is horrendous. Their business practices are fraudulent or questionable to say the least. They should be held accountable for their actions or lack thereof.
CC: Better Business Bureau
CC: New Jersey Division of Consumer Affairs
CC: State of New Jersey Department of Banking and Insurance and Real Estate Commission
CC: Federal Trade Commission
CC: Florida Attorney General's Office, the Division of Consumer Services