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Business Profile

Medical Plans

Keystone First VIP Choice

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Medical Plans.

Complaints

Customer Complaints Summary

  • 5 total complaints in the last 3 years.
  • 0 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.

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Complaint status

Complaint type

  • Initial Complaint

    Date:07/13/2023

    Type:Service or Repair Issues
    Status:
    Unanswered
    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.
    Testosterone has been prescribed to treat my diagnosis of ************* Syndrome since the age of 12. Initially treated with Testosterone injections, then patches and now currently with gel. My current prescription for Testosterone gel was sent to CVS Pharmacy by my Endocrinologist *********************** MD, June 2, 2023, during my last office visit. Keystone First, my current insurance carrier, has repeatedly refused to approve this life altering medication. After multiple unsuccessful calls to the pharmacy to obtain the medication, my mother and I have made multiple calls to Keystone First to obtain an explanation. Saturday 7/1/23 during 2 separate calls, ****** a KF Members Rep told us that the medication was not approved because Keystone First's system stated that I still had Personal Choice **/***** a primary under my father's employer. Explained that this was incorrect, and that the proper paperwork had been sent regarding this matter on 5/4/22, informing Keystone First via fax that my Personal Choice insurance was discontinued on 4/1/23, eight days after my 26th birthday. ****** therefore sent an email to the pharmacy and stated that the issue was resolved, and that the adjustment and the approval would be obtained by Monday 7/3/23. However, on Monday 7/3/23, CVS continued to state that my medication remained unapproved by Keystone First. My mother then spoke to **** and ******, 2 KF Reps, who once again assured me that the insurance issue had been resolved and that the medication would be approved by Wednesday 7/5/23 after the holiday. Of course, on Wednesday 7/5/23, the medication remained in a state of denial by Keystone First. Spoke to ******, Pharmacist who stated that Keystone First now was seeking "additional information" which consisted of two additional labs, *** and ** from the Endocrinologist. Labs have been sent twice. Currently, despite complying with every request, the Testosterone remains unapproved, and my health is suffering. Please help.

  • Initial Complaint

    Date:06/12/2023

    Type:Billing Issues
    Status:
    Unanswered
    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.
    On May 10, 2023 I sent them some medical bills that I had to pay for out of pocket, totaling $5233.76. I realize the providers I went to are out of network so I am looking for partial reimbursement.

    Business Response

    Date: 08/10/2023

    July 19, 2023 

    Dear *** *******: 
    I am in receipt of your July 9, 2023, letter. 
    I apologize if you have been reaching out to us without any success, but we are certainly interested in assisting you with this matter. 
    We are requesting at this time that you re-open this complaint. Please send confirmation of my request to me. 

    Thank you. 
                      , Esquire Senior Legal Counsel 
    Amerihealth Caritas 

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