EMI Health

Won't pay based off diagnosis? Better not do the test then! Had the same conversation and trying to sort out why they will pay for one child and not the other. Their answer? I don't know. Been calling since September and they still don't know how to fix the bill or coding(spoiler alert it's none of those things). And don't worry, procedure codes are the same. The employees are bottom of the barrel, incompetent, time wasting, unhelpful. They don't know their own policies. Just keep calling until you talk to someone who will tell you what you want to hear- information won't be accurate BUT you got your answer.

This company used to be okay, but now they're one of the worst. They are dishonest and abusive to their providers and their insured members. The low cost plans are not worth the hassle they will create. Save yourself a major headache and look elsewhere for an insurance plan.

I was with EMI for approximately 14 years. Most of the time their service was good. I have a particular blood test that I have to get 4 times per year. At times, EMI seemed to have concerns about paying for the tests. One particular incident EMI refused to pay for one of my blood tests even though they had covered the cost previously numerous times. After contacting EMI's customer service numerous times over a 6 month period and getting nowhere, I was put in touch with Christy Castillo. I explained the situation to her and she was able to get EMI to pay the claim after all. I am not sure what kind of magic she performed but she was able to get the claim paid after all. Christy did an excellent job of advocating for me and understanding the frustration I was going through. Christy is the model customer service rep. She is an outstanding customer service rep. Scott

I got this insurance for dental because it was cheap. It wasn't worth it. Their website is so crappy and confusing. Some of the most important links don't work. The list of dental providers is small and the majority of the dentists they cover are the crappiest dentists in my area who just try to scam you. I found one that had good reviews but turns out it was wrongly listed and they don't even take my insurance.

I paid over $450 for a crown they didn't cover (because of the waiting period, which I expected. Then got a cleaning 2 months later, and they charged me the annual deductible because they said that the claim for the crown (from 2 months earlier) came in after the claim for the cleaning! Why can they just see that the first service was two months earlier (in the same year) and apply the deductible to that large amount that I paid instead of the cleaning? I called customer service and they said they can do nothing to correct it. TERRIBLE CUSTOMER SERVICE!

I see all of these one-star reviews and it is mindboggling to me. I am on the 'Select" plan and in five years I have never had one single issue with claims being paid. On the contrary, my husband has Anthem BCBS and his plan is a joke. We took him to his in-network hospital for what we thought was a heart attack, but it turned out to be a sinus infection. They did two CT scans while he was in the emergency room. Several months later, we received an invoice for $750 because the radiologist who is AT THE IN-NETWORK HOSPITAL is apparently NOT in-network. That should be illegal! If someone is in there for something they suspect is life-threatening, or any reason at all, if it's an in-network hospital, radiology should sure as h*ll be in-network, as well. I made several hours' worth of calls and had no results, so we've just been making payments.

These one-star reviews are a joke. I think they are taking their worst-case scenario and writing a review, but the tens of thousands of satisfied insured people are not writing reviews. So, here's mine in hopes that it may truly help someone. Also, mine is used on a regular basis. I see a doctor once per month and a specialist about four times per year, and am on seven different medications and I have NEVER had one single issue with my EMI Health Care plan.

worst dental plan ever. Needed a retreatment on a root canal and would not cover said it was a specialty and there for not covered.

Great organization, that has found a niche in the 10-150 employee medical insurance market in Arizona. The performance of the industry pools they write has been well below market trend. For 1-1-2020 their construction Pool had a 1.9% increase.

We have had nothing but issues with this provider. The biggest issue for us was the lack of education regarding the customer service reps. I waited a year to be able to use the insurance since there was a waiting period. They told me it was 12 months, but then when it hit 12 months they said 15 months. They literally just tell you whatever they want to tell you. A year later & we have paid all this money into a plan that we couldn’t even use! Pretty sure this is the definition of “scam”.

My surgeon's office called for a pre-authorization on a hernia surgery and was told "hernia's do not require pre-authorization, you are in network, the surgery is good to go. I have documentation from EMI Health that this conversation took place and stated "no pa needed." Two weeks later I had my surgery and ten days later EMI Health asked for my doctor records. It turns out the policy states that hernias DO require pre-authorization and mine wasn't covered because of a surgery I'd had 15 years earlier. The policy also stated the procedure for requesting pre-authorization -- which my surgeon and I followed to the letter. They denied the surgery ... like I could return the surgery ... and denied all appeals. I am now stuck paying a $22,000 bill due to a mistake THEY made. DO NOT TRUST THEM! If they make a mistake they will make you pay for it.