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Business Profile

HMOs

Harvard Pilgrim Healthcare, Inc.

Headquarters

This business is NOT BBB Accredited.

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Complaints

This profile includes complaints for Harvard Pilgrim Healthcare, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

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Harvard Pilgrim Healthcare, Inc. has 8 locations, listed below.

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    Customer Complaints Summary

    • 40 total complaints in the last 3 years.
    • 13 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

    Sort by

    Complaint status

    Complaint type

    • Initial Complaint

      Date:04/05/2023

      Type:Billing Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      Someone else is using my social security number and has an insurance account at harvard pilgrim. I was unable to obtain insurance due to the identity fraud

      Business Response

      Date: 04/07/2023

      Your complaint has been received. Harvard Pilgrim will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrims ************************* at ************ if you need assistance in the meantime. Thank you

    • Initial Complaint

      Date:03/27/2023

      Type:Service or Repair Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I submitted a claim on Harvard Pilgrim website for reimbursement for at-home covid tests purchased on Dec 5th, for $42.46. I never received a check. I have called multiple times about this and every time I get a different answer. Once they said it has been sent, so wait for 3 weeks. Then when i called again they said there is no record of a claim in their system. So I was asked to resubmit. I resubmitted, still didn't get a check back. I called they said a check was issued on March2, so i have to give it 3 weeks for the check to arrive. It still didn't arrive, so I called again on 3/27 and they said the check was sent and cashed on March 2nd. then they transferred me and rep said that information is not correct so she will have to transfer me again. after two more transfers, i gave up and hung up after spending 45 minutes on the phone today. I am filing this complaint because there needs to be an easy way for me to get my reimbursement, and I should not be given a runaround for such a simple thing. The lack of consistency in theiir responses is appalling!! I just need my check and a apology.

      Business Response

      Date: 03/29/2023

      Your complaint has been received. Harvard Pilgrim will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrims ************************* at ************ if you need assistance in the meantime.  Thank you

    • Initial Complaint

      Date:01/15/2023

      Type:Service or Repair Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      After a year and a half of purchasing their insurance and using it maybe twice in that time frame Harvard pilgrim cancelled my insurance in may of 2022 for lack of payment! Yet they still charged my account for two more months June and July for the monthly premium cost. I had to physically go to my bank and block Harvard pilgrim from my bank account to get them to stop taking funds for a service they had already canceled on me! I accessed my bank statements and could see where they took two months payment more than once and only applied one month payment credit to my account meaning my account was actually current at the time they cancelled actually I believe they owed me money for over payment! I contacted them several times and they just sent me their incorrect record of payment history that clearly contradicted my bank account statements its been a half a year now and they still owe me money for overpayment and I no longer carry insurance due to there inability to credit my account for payments I did pay and have record of paying! Would like a refund at the very least but very unethical of them to take my money and give me nothing for it and then cancel my insurance that I carried really just in case anything ever happened and I needed it! Now Im without my money and without my insurance with no communication from Harvard pilgrim!

      Business Response

      Date: 01/19/2023

      Your complaint has been received. Harvard Pilgrim will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrims ************************* at ************ if you need assistance in the meantime.  Thank you

    • Initial Complaint

      Date:10/28/2022

      Type:Billing Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      HP told me my payment didn't go through then charged me for it and charged me for the next payment i made because I thought the first payment didn't go through. They will not refund me. I was double charged. This is fraud. HP processed two payments for my monthly premium. Yesterday, I attempted to make a payment to my monthly premium on HP's website. I put all of my information in and paused to find my card before processing. When I processed it the website sent me back to billing main page, without any confirmation and said i was "timed out" or something to that effect. I waited 20 mins or so to make sure I didn't receive a confirmation email. I didn't received a confirmation on that first attempt until 20 hours after my attempts. On my second attempt it went through and I immediately received a confirmation. Great! I paid my healthcare for the month. Then I wake up and my account is overdrawn and it's showing a "preauthorization" for the attempt I first made. I called HP and explained to them that their system kicked me out and never sent me a confirmation number and that I NEED that money back because my account was overdrawn. They told me tough luck, I can't get a refund. It's Friday. I don't get paid until Next Thursday. I have NO money. I can't feed my family. They stole my money. This is fraud. I

      Business Response

      Date: 10/31/2022

      Your complaint has been received. Harvard Pilgrim will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrims ************************* at ************ if you need assistance in the meantime.  Thank you

    • Initial Complaint

      Date:09/17/2022

      Type:Billing Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I had a payment to pay my market place based health insurance on the 19th, which is around the time i usually pay it, but my old bank had been in the process of being acquired and transferring account and had an unreport to customer problem honoring payments on various days depending on the account. This I was informed of in September. My payment didn't go through and I had missed the sole email from HPHC telling me it wasn't processed because I was away with my family on vacation and didn't see the line email. Come to find out my service was cancelled when I went to pick up expensive medication for my son. I called HPHC and asked to be reinstated and that I would pay them every due plus an additional month if we could just be reinstated. The financial department told me that they only reinstate insurance if it was HPHC's mistake. Since it was the banks mistake HPHC told me reinstatement was impossible due to some sort of regulation through the exchange and that I could definitely qualify for getting insurance again through the market place. But when I talked to the market place representative they told me I needed an offer of reinstatement offer from HPHC to even attempt to get insurance back before 2023 ( 4 months without insurance). I have children and a wife who all have chronic illnesses requiring expensive medication we can't afford without insurance. We make ok decent money so we don't qualify for state based insurance. Because HPHC refuse to reinstated my insurance, I can't qualify for any for of insurance for 4 months in less I quite my job or get seriously injured. This is insane. I have money to cover insurance but not the services my insurance covers. We've had to cancel medical appointments, personal therapy for me, my wife and my son. My wife has medical that helps her work. I'm struggling already a week without my mood stabilizers which is effecting my ability to work. I just want me medical coverage back, please help, I'm scared as h*** about my kids

      Business Response

      Date: 09/19/2022

      Good morning,

      Your complaint has been received. Harvard Pilgrim will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrims ************************* at ************ if you need assistance in the meantime.

      Thank you

    • Initial Complaint

      Date:08/23/2022

      Type:Service or Repair Issues
      Status:
      Answered
      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      Answered:
      The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      March 31st of 2022 I postmarked a fitness reimbursement form and mailed it to Harvard Pilgrim as I have done for the last ten years fitness contracts ect . Two days later I got a rejection letter saying it was late. I called member service it was postmarked. The rep never heard of something being postmarked. She claimed it was being reviewed. I called again member service relayed the information that the check for reimbursement would be mailed within **** business days. To date, I have called eight times and continue to have member service tell me they will get back to me. It is almost Sept 22 can not believe a health care plan operates in this manner.

      Business Response

      Date: 08/24/2022


      Your complaint has been received. Harvard Pilgrim Healthcare will investigate and provide a response with the findings directly to you in writing within 30 days at the address on file. Thank you for bringing this matter to our attention. Please contact Harvard Pilgrim Healthcare ************************* if you need assistance in the meantime.

    Harvard Pilgrim Healthcare, Inc. is NOT a BBB Accredited Business.

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