Pacificare Review

Overall Rating

Can't think of any. SOMETIMES they pay?

This company nickel and dimes you. Even though you are PPO, you are stuck using only ONE lab - their pre approved lab. If your In-Network doctor sends your labs some place else without asking you, you're screwed. The customer service on the phone is dismal. The only reason I have this lousy insurance is because my employer provides it free of charge - but in this case, I'm definitely getting what I paid for! I'm actually considering paying for my own outside health insurance at cost to me, because I hate Pacificare so much. I have had nothing but problems with them, they don't provide proof of their policies when you ask.

Do NOT use Pacificare PPO insurance company. If you are choosing between taking a job and the company offers this horrible company as health insurance, consider it a very black mark against that company, as you will experience nothing but problem after problem with these people. I've had many different health insurance plans over the years: Blue Cross, Cigna, Aetna, you name it. I never had any problems at all with all the other insurance companies...except Pacificare. Even all of my doctors concur that they and their patients all have trouble with Pacificare paying claims. I'm pregnant right now, and there is a certain test done in California that is required by the state. The bloodwork is sent to the state of California's lab, no other lab - all OB's send the lab there for STATE testing. Well, apparently Pacificare doesn't like to pay for this in network, so they claimed it was out of network (i.e., my doctor didn't send the blood to their pre approved lab). I asked my doctor about this and she said NONE of her other patients have ever had a problem with their insurance companies paying for this state-run test. I just spend almost 2 hours on the phone with Pacificare trying to find out why, and asking for them to fax me their policy on the matter (which they repeatedly refused to do). You see the type of run around you'll get. I have been more stressed out by dealing with my INSURANCE COMPANY during my pregnancy than by any other cause. Isn't that ironic? Their favourite phrase is: "that's your benefit policy", yet when asked to provide proof of that, they hem and haw and never do, not even the supervisors. I feel sorry for the poor folk who have to work at this horrible company, as I'm sure they get irate patients every single day, wondering why Pacificare insists on not helping. In fact, I'd say that if your employer offers this health insurance, they are probably too cheap to afford decent healthcare, and that's a sign of the health of that company, in my opinion. You will pay for their cheapness every time you deal with a doctor or with Pacificare. So you may as well tack on extra hours to your normal work week, as time you have to spend dealing with these people, sorting out incorrect EOBs, faulty policies, etc. (My EOB forms have been incorrectly showing that my deductible has been paid since February - turns out those EOBs were wrong, and Pacificare was printing the WRONG current deductible ($0) for many many weeks. I can only guess why.