Piedmont Community Health Plan

Be prepared to make constant appeals for your medical bills, especially after you meet your out of pocket deductible. I have met it several years in a row and each time, they try not to cover essentials that were even covered earlier in the year. Incredibly dissatisfied with this insurance company. I've been with a new one since January of this year and I am STILL dealing with medically necessary items not covered. Print out appeal sheets like they're free money, you'll need them. I'd like to edit this review. It's still very true that appeals are made often, however, the nurses working in that department are kind and clear when speaking with them. I've had every appeal so far be approved, which is a good sign.

Retired from centra in December..enrolled in COBRA to be effective 1/1/2022. Still as of February 28th claims being denied for medical and phsrmacy even though I have received my ID card clearly showing coverage effective 1/1, and I have paid $ 2000.00 worth of premiums thru March and still cannot access my benefits! I have already made numerous calls to PCHP but problems still persist. They continue to deny my claims stating coverage terminated 12/31..My advice..dont enroll in PCHP..the left hand clearly does not know what the right hand is doing. Total frustration....its a centra owned company..should have expected this...

My experience was wonderful. I tried every month to receive a check for over payment on my 2018 insurance. CSR Erma listened, asked questions, and was professional in her contact with me. She was willing to go back to January 2019 and follow the trail of the credit. She got it, I mean really got it. She understood that the check which I had received was for over payment on my 2019 payments. She assured me she would follow thru and contact me to advise of the progress of the credit. She did and I received a check for the full credit within 5 days. She is GREAT!!!!! I believe she should receive a raise or promotion. If I was still working I would steal her to work for me. She followed through, great customer service, professional, polite, listened, and told the truth. She is a great Piedmont representative.She should receive a raise and a promotion.

This is the worst insurance carrier that I have had the opportunity to deal with. There customer service employees are the most incompetent I have had the privilege of speaking with. It has taken 6 months to resolve claims. My wife has been in the insurance business for over 20 years and states she has never delt with such incompetentenci. Do not pay bills and hope to be reimbursed you will never get payed. this company makes Obama care look great. They continue to decline bills. Every Dr visit will require a reiteration of insurance paperwork verifying coverage. Still they will continue to decline. And the paper work will start over.

Review is 0/5. One of the worst companies I've ever had to deal with. I got this coverage since it was the only choice for me as part of the "affordable" care act. I enrolled in auto pay and the double drafted my account. It took months to get them to send me a check for my money. NOONE at piedmont has any idea how their system even works. I had to call Centra and get some answers because they kept telling me Centra wrote the refund checks. When you call them expect to be on the line for at least an hour just to get to talk to someone. To top off this year they charged me $100 more for my premium in December with no explanation or invoice detail for the increase in cost for the last month. I am so glad I got a job with health insurance provided. I have no idea how this business is still operating and would recommend getting any other insurance you can find.

Please just let me say the Bedside Manner of this Health Insurance is 110%..was in the hospital last week in ICU..and a lovely nurse for medical management just called to check in on me.....Never happened ever with Blue Cross Blue Shield......Thank you !!!!..

I haven't had much interaction with Piedmont Community Health, but I've never had any trouble. After seeing the few reviews on Google, I was not anticipating an easy phone call. I was pleasantly surprised by a woman named Renee who was very thorough, polite, and went the extra mile to ensure my needs were met. People are always quick to leave a bad review, while pleasant experiences are unnoted and unappreciated. Quality customer service is a rarity these days, so we should express gratitude when we experience it. Thanks again, Renee!

If you can possibly choose another health plan, I strongly advise you to do so. To make a long story short, when my 24 year old wife had chemotherapy after her double mastectomy after finding breast cancer, this insurance company declined her nausea medicine, only allowing her to fill the prescription for 16 pills instead of 60. Apparently to them, after chemo you don't really need nausea medicine. To add, I am currently in the process of trying to get my insulin back. I am a Type 1 insulin dependent diabetic. Two weeks ago, they decided I no longer needed my insulin and declined my prescription. It has been over two weeks and the prior authorization process still hasn't been approved, even though my doctor did his part. Yes, these claims have to do with Catamaran, PCHP's prescription provider, but they are who PCHP chose to provide this service. What I write to you is true. I strongly urge to you to never join PCHP.