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I enrolled the end of January 2022. The process was a piece of cake. The representative was pleasant and assured me everything I wanted was covered. I believed him; after all, this is a Christian based organization. His name is Justin Silverstein with Christian Health Quotes and he is still employed.
I am a smoker. I told Justin that I am a smoker. Not once did he mention that any conditions related to smoking are NOT covered. Who in their right mind would choose this company if they're a smoker? He also failed to mention that Thyroid issues are listed on their list of pre-existing conditions. He was aware I have a thyroid issues because I had to provide a list of meds. It's obvious NP Thyroid is used to treat a thyroid condition.
Allegedly, an internal investigation is underway regarding my the deceptive enrollment by Mr. Silverstein but will not be shared with me because it's an internal investigation. In other words, nothing is being done to correct the deception and it will continue. I have filed a complaint with the BBB. Christian Health Quotes is a DBA so if you are looking for them to file a complaint, search from Ideal Health Benefits, LLC.
I have recently discovered (November 2022) OneShare Health changed their Guidelines. They can change them at any time, and they claim members are notified. Several other members and I, that I have reached out to, have not received any notification of the Guideline changes which went into effect on May 15, 2022. I'm still waiting for the flyer that was allegedly sent to members.
Another issue not mentioned during enrollment is that you have a 90-day waiting period. If you go to the doctor, labs, ER or Urgent Care within the first 90 days...you are NOT covered. This rule was just extended to 180-days effective May15, 2022 and is not mentioned during enrollment.
I feel during enrollment, the member should be advised the OneShare Health will look high and low for a pre-existing condition to avoid paying claims. It takes filing with the BBB to find out what your pre-existing condition is. Mine is MENOPAUSE!!! It is NOT listed in their pre-existing condition list; however, it fits their description of pre-existing, according to OneShare.
Several years ago, a law was passed so that health insurance companies could not refuse coverage for those with pre-existing conditions. OneShare Health is not an insurance company. They are a Christian Health Ministry and that is how they get away with breaking the law. They are only governed by the Attorney General and the IRS. How Christian-like is this practice?
My nightmare started March 22, 2022. They were denying claims stating pre-existing condition. They will ask for a specific form to be filled out for a 2 year look back. You are to list all the doctors that you have seen 2 years prior to becoming a member as well as any medications that you have taken 2 years prior. (I have yet to figure out why this form is required because they do not believe you and will continue searching for a pre-existing condition).
I listed one doctor and 3 medications. Shortly after, I went to a Dermatologist and had a suspicious mole removed. This doctor's appointment sent up a RED FLAG (according to OneShare) and they requested all records from the dermatologist while refusing claims due to another pre-existing condition review.
Same thing happened when I saw a Cardiologist. The point I am making is they did not TRUST that I had only been to one doctor for 2 years prior to enrolling. I thought this is a Christian based company. I have over 50 recordings of conversations with OneShare Health representatives. I have one in which a representative states that they do not trust the member when providing the 2-year look-back.
If you've made it this far, you are probably exhausted just reading the beginning issues I am having with this company. It is very exhausting; however, if I can help other members who are getting ripped off and perhaps deter people from becoming a member, all my efforts will be worth my time.
Supervisor KeKe Dorsey. She needs a raise...poor lady was in a meeting for over a month. I left many messages for this lady to call me back and it took over a month. She finally called me and left a voicemail. In the voicemail, she leaves me her direct line with her extension. The number she left is a non-working number. In a later conversation, I informed her it was not working, and she said she would investigate it. She also claims that other members were able to reach her.
Ashley Stolicny, with compliance, reached out to me (only because I left a complaint on the BBB). She called Ms. Dorsey's number and it was, in fact, a non-working number. It was over a month that Ms. Dorsey was giving out a non-working number. (and remember, she stated other members are able to reach her)
Once I finally reached Ms. Dorsey, we went through the EOS's (Explanation of Sharing), and I requested copies of letters OneShare claims were sent to 2 of my providers requesting additional records. (Again, they are still looking for a pre-existing condition.) I received the letters from Ms. Dorsey and there are no dates, so I have no way of knowing when they were sent. I firmly believe she fabricated these letters because she screwed up and used the same date of service for both providers. One was for Memorial Hermann Hospital and one for Houston Methodist. I am certain I was not in 2 different hospitals on the same day. Also, in the body of her email, she leaves another number for me to call.
GUESS WHAT....IT DOESN'T WORK!!
A few days later, I spoke to another representative and requested the same letters and amazingly, she sends me 2 totally different letters. This representative also stated that Loomis (3rd party claims processer) has a tendency to lose paperwork. Is this just another way to avoid paying claims?
Automated Labs
I still have not received a clear definition of automated labs; however, it is not listed in their guidelines as "not covered". I wonder why? If you look at a bill for CPL, Quest or Lab Corp, it's very expensive. I believe this is just another way they screw the member.
Pre-notification department
Fax number goes to a voice mail. Call the member number and press #2 for the Pre-notification department. If there is no answer, a recording comes on and says press 1 and your nine-digit phone number. Uh...a phone number is 10 digits. Still waiting for an excuse for this one too.
I emailed my pre-notification paperwork for sinus surgery. The next day I received an email stating they needed the records for DOS 6-21-22 for Urgent Care. Well, I didn't go to Urgent Care on 6-21. The only thing I did on 6-21 was a mammogram and what does that have to do with my sinuses? (Again, they are still looking for a pre-existing condition).
Note: I had to pay out of pocket, to the tune of, $20,000 because the ENT does not do business with OneShare Health any longer. Hmmm... I wonder why? And I am pretty certain that I will not see a dime of this money.
OneShare Health has agreed to pay on the denied claims for menopause and automated labs. The reason given to me is their guidelines do not specifically state that menopause and automated labs are not covered. When I asked Ashley, compliance supervisor, if the guidelines would be edited to reflect the change or will they just continue to rip people off...her response was "that's a good question". This conversation is recorded and I will post it soon.
More coming soon...
I am currently taking a 24 week digital marketing course
to learn how to promote my website on
ALL platforms to reach a much large audience.
I record every call to OneShare Health and will upload them soon.
It's amazing what I have recorded...example...I have a rep telling me that Loomis loses paperwork. Loomis is the third-party company who processes the claims.
AND THERE IS LOTS MORE!!!
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