Jeanie J.
Beware of Medi-Share
Beware of Medi-Share! We have been members for a few years and things had been going fine. Some things weren’t “shareable” but seemed minor u til my daughter with terrible migraines couldn’t find a medication that helped. She was having 2-3 migraines a week and it was debilitating. The neurologist finally recommended trying Botox injections (and it has been one of the only things that have truly helped). The drs office called for their pre-approval process (they may call it something else) and they said Botox for migraines could be shareable. So we made our decision based off of that information. They always say final determination will be made at the time the billing is submitted (as a way to not guarantee anything and cover their butts to deny your claim). They knew she was a pediatric patient but never said they wouldn’t approve it for pediatric patients. They denied the procedure stating that they wouldn’t cover because she’s a pediatric patient and it’s not formulary. When i asked why they have a process for the drs office to call and verify beforehand i was told that I should have personally called and that’s the only true way to verify if a procedure would be covered (because it would trigger some sort of actual review - so why don’t they do this when the drs office calls???? Or tell the drs office that the patient should call in to actually find out if it is shareable? They had no answer to their broken system). I asked how i could have known that and she read some guideline to me that didn’t even say that. I asked how anyone can have confidence having a major medical procedure and not being stuck with massive bills and was told that final determination could only be made after the bill was submitted. I no longer have any confidence in this company and am now stuck with a bill for $8,700. To truly help this procedure needs to happen every 4 months. How can anyone afford this??? They thought continuing to say “I hear you” would just magically fix the problem. Do yourself a favor and choose a different company. I am now looking elsewhere for a new company and let them know they were losing a member. They don’t care. They’re happy to take your monthly premiums and not pay for procedures, even if you call in beforehand. Also, nothing at a chiropractors office is shareable - even in office PT. I knew adjustments wouldn’t be, but that’s kind of lame…

