This insurance is not for the faint-hearted, meaning you need to be persistent, consistent, and keep communication going. It's a lot of work. My son had a surgery and the claim was denied, but after a few calls and conversations the claim was eventually reprocessed and paid. I was happy. I don't know if it's because I was patient and nice enough? Or just luck? Not sure. The deductible was fulfilled and they are paying for all his PT visits which is also very helpful. I'll see how it goes for another half a year before making a decision. read more

The absolute worst excuse of an insurance company. Basically they take your money and deny all claims. I can't believe they're able to be allowed to continue doings business. Run, go to someone more reputable. Complete garbage! Zero stars, be prepared to spend hours on the phone for every single thing. read more

This company is awful. The didn't cover anything for the past 8 months because suddenly they think I have other insurance. Nevermind the fact that they have always been primary. Nevermind the fact I haven't had any other insurance for three years. Now I have to figure out how to tell them I don't have other insurance....it would be nice to know IN ADVANCE if this is an annual requirement... And then I will probably manually have to resend all the claims. They never pay for anything. I avoid going to the doctor at all costs because every time I try to use this insurance something isn't right. They don't advertise what preventative care they cover, so I could probably be getting age/gender appropriate screenings, but then again they would probably try to charge me anyway. To top it off the monthly amount I pay for two healthy individuals is a thousand dollars. 12,000 a year for health insurance I can't afford to use. Can't get rid of it either, because the company chips in half of that...and they won't transfer it to any other insurance so I'd be paying everything out of pocket. It is so ridiculous. Hands down the worst insurance I have ever had. read more

WORST HEALTH INSURANCE I'VE EVER HAD IN MY LIFE! I just started a new job and went and saw a PCP to establish care and do a preventative health visit. I went in healthy, with no complaints or concerns. My new PCP ordered some tests, labs, and otherwise sent me on my way. I was sent a bill for over $200 just to establish care! I called twice and my appeal was denied. Soooo.... being healthy and proactively establishing care is VERY EXPENSIVE. I tried scheduling an ultrasound of my thyroid (my PCP ordered it) and they wanted me to pay $540 before the imaging! I ended up cancelling the appointment. Whatever you do, if your employer opts in for the worst insurance company out there... don't get sick!!! read more

Terrible customer service. They are rude, evade questions, provide opposing information when I am told to refer to the claim portal.

Terrible insurance company! My so called free yearly physical cost me $200! Don't even try to get an approval for a procedure. They will just deny it or say it's out of network when a patient only sees the doctors that they tell you are in network! Don try to contact customer service about explanations on why procedure is denied. C/S doesn't speak enough English to understand what they are being asked to explain! read more

As a dental provider attempting to gather basic in-network benefit information for our patients, my experience with Meritain Health has been extremely disappointing. This was after already attempting to obtain the information through their provider portal and faxback, neither of which provided the necessary details. Even then, it took over an hour on the phone just to gather minimal, incomplete information. Simple questions--such as frequency limits or age limits for a specific dental code--should be readily available to in-network providers, yet the representatives struggled to locate or explain this information. The customer service representatives did not seem to understand what was being asked, nor were they able to clearly relay accurate benefit details. When I requested a supervisor, I was told they were "busy," instructed to call back, and then refused the option to wait on hold. This is unacceptable, especially for providers trying to deliver timely and accurate care to patients. Ironically, I receive clearer and more efficient benefit information from insurance companies that utilize AI-based systems. With Meritain, you're honestly better off waiting the four weeks for a preauthorization, and even then the information provided is vague and basic at best. For an in-network insurance company, this level of inefficiency and lack of provider support is frustrating and unacceptable. read more

Not even joking, this insurance coverage is more expensive yet worse coverage than my pet insurance

Meritain has been terrible to work with on the phone and very difficult to figure out if providers are in and out of network and they do not have a good network of providers. When working with customer service about a billing claim for a mammogram they will not cover it. Will not! Their representatives are difficult to understand and my providers have tried working with them and Meritain is non responsive. read more

Absolutely useless customer service in getting a pre-authorization for an MRI for surgery. Having to wait over 48 hours to get a STAT MRI back is absolutely disgusting. If the conditions worsens, I bet they'll be fast action on a law suit! read more

They manage my Retiree Health Savings account, which is money I put aside from my paychecks to cover out of pocket medical expenses. Getting them to actually pay out those funds is a HORRIBLE process. They find all kinds of reasons to deny claims. I had no choice in who would manage this or I would move it somewhere else. For anyone considering using Mission Square for retirement plans (which uses Meritain Health to manage the RHS, STAY AWAY!!! read more

Merit aint finally approved the RFA for my thyroid an I had that done. Today I had a migraine that my home meds were not sufficient to take care of. Went to their website to find an urgent care as my doctors office is not open. After signing in to get information they want to email a code to verify it's you accessing the site. I understand this, but after putting in the code, it says it's not able to assist and to call a Meritain phone number for assistance. Call the number and THEY ARE NOT OPEN ON WEEKENDS. By this time I'm in so much pain and now frustrated and crying. Finally just googled urgent care facilities in my area and called them to see if they take my insurance. My next step was the emergency room if I couldn't find one. Was able to find an urgent care. Why is there not an open site just to find care that doesn't take a damn hour?! I hate this insurance! I miss Kaiser! read more

If you want live, don't get this insurance. They enjoy denying life saving methods. They delayed approval for medicine etc

If I could give negative stars, I would. My sons had their wisdom teeth removed in May 2024. The claims were submitted in June 2024. I had to call in September 2024 to find out why they hadn't been processed. I was told "They hadn't been looked at yet by a human." Meritain has denied the claims and wants a letter of denial or an EOB stating the reason for denial before they process anything. Our medical insurance classifies this as a dental claim, and even though I've submitted it numerous times, they see "dental" and automatically reject it. However, in this case, it's against their policy to provide any written documentation explaining the denial. Their own customer service rep was on the phone with our medical insurance rep, who clearly, verbally stated that this would never be covered under our medical plan. This is even in Meritain's notes! But Meritain insists on a written denial they know we can't get. It's a bureaucratic loop designed to wear you down. I was told the claim was sent to adjusters on 6/21 and to wait 60 days. I finally called back today, only to find out it was denied on 6/22, one day later. No call. No email. No notification. Just silence. One kind rep said I could ask for her directly and she'd call me back. Turns out Meritain gives their reps 30 minutes a week to follow up with customers. That's not a typo. Thirty minutes. A week. And when you do reach someone, half the time the connection is terrible, the rep is incomprehensible, or they sound like computerized. This isn't just poor service, it's deliberate obstruction. Meritain's system is built to frustrate, delay, and deny. If you're considering them for coverage, run the other way. Fast. I will forever tell anyone I speak to how horrible this company is. read more

0 stars. Worst Insurance company ever. claims are always denied. I have used several companies over the years and never had this many issues. read more

I was on the phone today with a rep by the name of Deanna after putting me on hold several times. She could not assist me. She couldn't answer any of my questions about my insurance coverage. she could not answer questions about their website. I found her to be very inexperience and when I asked her to transfer me to someone who could help, she said there was nobody else and no manager. How could that be ,was she working from home? It is my second time calling about the same issue and no help as of yet. Last rep I called,which was about a week ago the same thing. I am finding no customer service and reps are inexperience and are not being trained probably..very frustrating. read more

The ABSOLUTE WORST INSURANCE TPA. Member services are incapable of giving necessary information, eligibility give inaccurate benefit information often saying things are not covered when they are, claims are often denied in error, account managers are not there when you need them. read more

Horrible service. Can't even get a password reset in under 2 hours. Agents don't seem to be trained at all and have no idea what customer screens look like. 80% of the information they provide is 100% incorrect. Employers, please consider a more reputable company for your associates. read more

If I could give negative stars, I WOULD. Meritain Health is TERRIBLE. They claim that they cover infertility treatments and are in network with a previous clinic I used. WHAT A LIE. The clinic informed me that Meritain has NOT PAID ANY OF THEIR CLAIMS IN THE PAST YEAR. As if the process of getting pregnant isn't stressful enough, now patients who thought they had coverage ARE FORCED TO PAY OUT OF POCKET SINCE MERITAIN IS UNCOOPERATIVE. DO. NOT. GET. THIS. INSURANCE. I have attached a screen shot of an email we received from our clinic regarding this TERRIBLE INSURANCE. read more

Meritain Health - Insurance Near Me - Minneapolis, Minnesota

0 stars DO NOT RECOMMEND! They are incompetent, will avoid helping you, will hang up on you, or blind transfer you on purpose! Worst insurance ever! read more

The worst employer sponsored insurance plan ever. They pay for absolutely nothing. They deny your claims they wouldn't even pay for a simple blood test to rule out rheumatoid arthritis. Seriously? And now want me to pay $150 to the diagnostic lab not going to happen. It is now in collections and I refuse to pay I'm spending almost $200 a month on this horrible insurance company and they won't even pay for a simple blood test. Two more months to Medicare and I can say goodbye. Please do not get this health insurance For your family. read more

They will screw you not telling accurate information. Because of an employees mistake I now owe hundreds of dollars due to them telling me the incorrect date when my insurance was up. Fought tooth and nail with phone calls and appeals for months!!!! Worst insurance I ever had!!! read more

The absolute worst experience I've ever had with insurance. I have an autoimmune disorder that requires monthly infusions - every other provider approves them for a year at a time. My infusions have now been delayed twice because of Meritain, which only just informed the pharmacy that they will only approve it for two months at a time, and refuse to expedite the process of authorization despite the health risk a delay poses to me. My company switched to Meritain to save month, they're literally the scum of insurance. read more

This is a horrible company!! Like Aetna the parent company, they don't have enough in-network providers and they deny everything! Why do we pay insurance when it won't pay any claims? I have had to fight tooth and nail with every claim and then when they get a claim they sit on it without updating the system so you still show a deductible to be paid! It's horrible!! read more

I had to be transferred from a ER to a hospital so I could be treated properly and was taken by ambulance. They will only pay the ambulance company the contracted rate and I'm stuff with the balance because they are out of network. Like I'm supposed to get on the computer while laying in pain to see if they are in Network or not. Horrible company! read more

they will deny your claims while still getting paid. Their customer service is horrible and very rude. Then when you ask to speak to their boss, they tell you they don't have a boss and hang up. I'm assuming they don't record these calls because nobody ever helps you. read more

Exceptional health insurance company. Have had them for several years and have paid next to nothing from Urgent care to semiannual Dr. visits to major surgery. Can't believe the problems some reviewers have complained about. read more

All the one star reviews are correct. My company moved to Meritain from full Aetna, unfortunately. "They try their best to deny claims then you have to jump through hoops to appeal and get it rectified." - Indeed. Worst health insurance experience I have ever had. My wife is in a lot of pain from rheumatoid arthritis - it's gut wrenching: should she get the treatment the doctors recommend? Knowing that we may end up with large medical debt because Meritain will refuse to pay? read more

Deserves NO Star! I'm a Biller for 50+ Out of Network Providers. WHY am I not allowed to talk to agent in the USA? This type of nonsense makes me want to never your company. I had a very rude agent on Friday, I called back today to chat to a supervisor about it & was advised we don't have any supervisors available. How do agents work w/o a supervisor...SMH!! Terrible Customer Service!!! Stay Away! read more

Zero stars! They don't deserve anything. NONSTOP ISSUES. I want to pull my hair out. Denied a surgery I really need and no one else can do. Took 5 MONTHS to deny my SCA. What a joke. Take forever to process claims. Almost every business I speak with about Aetna absolutely HATES THEM. I do too. I've dealt with lots of insurances in my life but Meritain is the absolute worst! I hate that we are stuck with them. Will be complaining to employer/Facebook. They need to change insurances bc F Meritain. --100 stars. Awful terrible company. read more

This company is the worst. Stuck with them by my husband's company. They send preapproval letters for surgeries and after you get the surgery they refuse to pay. What the heck? read more

NEGATIVE STARS! I wish this wasn't the only option through my company! Worst experience I've ever had with insurance! I had medically necessary bloodwork done, they denied the claim and I was billed $2,905.82. It took forever to get ahold of someone to figure out next steps to dispute the denied claim. I got a letter from my doctor, completed their outdated forms and then I had to fax it to 2 different departments because no one knew who was getting the faxes. I got a letter back in the mail that they denied the dispute because it's a genetics test, when my doctors letter clearly states it was not a genetics test! In their letter they include that they did not rely on documents, professionals, doctors, basically any kind of common sense to come to this decision.... and there's nothing I can do about it.... read more

Meritain Health - Denial from Meritain - Insurance Near Me - Minneapolis, Minnesota

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Just spoke with Angela out of Arizona. I wish I had asked her last name so she would get credit for this awesome review. I have called multiple times, unable to get in touch with a live person. Today I got to speak with Angela and she was a multitude of amazing things: She was super friendly She pulled out all the stops to help me with my request She said on the line long enough to confirm that I had received my email information She was overall extremely helpful Thank you for making today's experience a great one! -Diana Grosch Liberty National Life Insurance Provider Missouri read more

If I could give this a "negative" rating I would! The 1-star rating is too good for them! They use tactics not to pay claims, resulting in the patient receiving bills over and over! If I didn't work in the field I work in and know the ins and outs of insurance and claims processing, nothing would get paid or processed correctly. I feel sorry for patients who don't have my experience and simply pay things that they should not. Of course they always turn around and do the right thing, but only after I call them out on it. Shame you your Meritain! Shame on the employers who use them! You need to do better by your employees! read more

As a healthcare provider, this insurance company has been the worst to deal with relative to any other private insurance company I've accepted. Many hours have been spent trying to get claims to go through and when they finally do, they charge the patient for out of network fees half of the time, even though I'm in network. Their payment system of Visa cards through Echo is also problematic because the Visa numbers don't work half of the time. Unfortunately, due to the incredible administrative burden of this insurance, I may have to stop seeing patients with this insurance in my practice. I know one other healthcare provider who has had to stop seeing patients for the same reason. Oh, and they're rude when you contact them, on top of everything else. A giant thumbs down to whoever manages this excuse for an insurance company. read more

This horrible insurance company should not be in business. My husband had an accident that broke 5 ribs back in June of 2024 and they still have yet to pay any of his bill. Citizen Memorial Hospital chose this insurance company for their employee. Citizens Memorial hospital turned the bill into collections because Meritain won't pay because, "we called to get a statement but you couldn't talk." no he couldn't talk because he had asthma AND 5 broken ribs! He called them back gave the statement. Still no payment. Now they need a written statement. My husband sends the written statement. Still, no payment. Now they said it should get pushed through? Shame on Meritain and shame on the facilities like CMH that hire them to take care of their employees! No one does the right thing anymore. my husband has documented times he has had to call to find out why they still have yet to pay! Very disgusting. read more

The worst problems are the number of doctors they have in their network. Very few and not very good. It really depends on the specialty. Very hit and miss. Worst is any kind of mental health. Also I can't make appointments with many doctors that actually take Aetna because they hate Meritain since they pay very slowly. It's not really fair because I have Aetna Meritain and I should be able to see Aetna doctors but as soon as they hear the word Meritan they tell me I can't make an appointment read more

Before reading this update, I recommend reading my first (original) review. In the first review you'll find helpful tips and info about how Meritain *really* operates. Here's the update... 1) A Meritain rep (mentioned in my first review) violated HIPAA privacy rules when corresponding with me -- she cc'd my employer on an email that I thought would be private. It contained private health details like names of providers and the type of services I got. It sure seemed like retaliation when she did it. She said she cc'd my employer because she saw herself mentioned in my first Yelp review. Yup, like she was tattling on me to my employer, to get back at me. Well, I just got word back from the feds. The U.S. government agrees with me, Meritain did indeed violate my privacy. The Office of Health and Human Services has ordered an internal investigation and that Meritain "train" their employees how to do better. By better, do they mean Meritain is going to train their employees how *not* to write to a member's employer with their private health information in the email? Seems like that would've been a no-brainer, but I guess not. 2) Watch out folks. This is a real warning to everyone who's covered by Meritain. I just found a $900 error in my deductible "accumulator" that no one at Meritain caught. I had to catch it. (Once again, I'm having to spend hours, unpaid, to fix Meritain's mistakes. I should be on payroll...) Our out of network deductible at my company is $1,500 but I accrued $2,400 out of network before Meritain considered it "met". How the f*** does that happen? Between the gross financial errors and Meritain staff tattling on you to your employer (divulging your medical activities to them), Meritain really should be put out of business. I've never seen such a royal f*** up in all my dealings with insurance companies and I used to work in HR. Truly mind-blowing how inept this organization is. Watch everything like a hawk and expect to spend hours of your own valuable time correcting their mistakes and forcing them to comply with privacy laws. read more

Meritain Health - Letter from U.S. Dept of Health. Meritain violated my privacy. - Insurance Near Me - Minneapolis, Minnesota

Wish that I could give a "no star' rating. We all know that insurance is a joke as the working class pay in endless amounts of money only to be nickel and dimed whenever we are hoping to have procedures covered for what we pay into the system. I had an office hand and elbow surgery (Carpal Tunnel and Cubital Tunnel) and paid roughly $3K cash. I submitted my bills which of course covered the deductible first. I will be getting $232 back from Meritain Health after being told before I did the procedure that I should expect a much larger portion of the money that I spent over my deductible. When I asked why this was the case, I was told other in office surgeries cost "x", and this is what you get. 99% of people have my surgery type in the surgery center or operating room which would have cost Meritain 5-10 times more. Unfortunately, the joke and expense is on me. Unacceptable. read more

Meritain took over when I moved from NC to FL with the same employer. They decided to start my deductible at zero again in July when we joined even though I met my deductible in March for individual and family. This has caused a lot of delays in my families care. The worst health insurance I have ever had. It's now mid August and they still aren't smart enough to figure out why my deductible didn't populate properly. read more