I was diagnosed with "chronic Systolic Heart Failure" by a spectrum health facility (Spectrum Heart in Grand Rapids). I was told I needed open heart surgery to repair my aortic valve at a cost of $165,000 (estimated). Spectrum refused to do a minimal invasive less expensive procedure called TAVR that would fix the issue and avoid open heart surgery. My Drs at Holland hospital (spectrum also) were in agreement with Spectrum Heart. They said I had Partial Valve dehiscence and TAVR procedure would not work. Only .3 - 1.2 % of people get this so I had doubts. I received a third opinion from Cleveland Clinic. (out of network) Their exact words "we don't like to be 100% opposite and in disagreement of other hospitals but your diagnosis is 100% wrong. I proceeded to get the TAVR procedure done which would save PRIORITY HEALTH Approx. $100,000. 6 months later I am doing great, priority wealth refused to cover it! What it comes down to is that SPECTRUM HEALTH/HOSPITAL OWNS 93.9% of PRIORITY HEALTH. Therefore they want to force you to go to their facility even if it means you have to have open heart surgery instead of a procedure that Cleveland Clinic performed as out patient surgery in a 40 minute procedure without ripping my chest open and a 7 day hospital stay and lots of recovery time. This should be ILLEGAL, for a healthcare company to be owned by a hospital. They would rather tell me every year that my premiums are going up and make me pay more. As to have some sort of common sense to realize they could pay Cleveland Clinic $65,000 instead of paying Spectrum $165,000 and save themselves 100K. But I guess they find it in their best interest to try to force PH members into a procedure not needed so they can pay themselves even if it is not remotely in the patient/members best interest. Because then when you actually do what is best for you they get your premiums and they can then deny to pay anything. Their appeals process is a joke! Keep in mind their BBB review rating is 1.14 currently and 1 is really the bottom as you can not give them a 0. read more

Working as a nurse, I deal with this awful insurance more than I care to. They refuse to cover needed supplies and services that patients need. Sadly, my company elected this insurance and I'm now a cancer patient myself and this company has denied my CT scan and my PET scan. This company is the most unethical company I have EVER had the misfortune to deal with. Warning to the elderly, do NOT pick this as a supplemental insurance. read more

Trying to get the help that a person needs is awful. Talking to health care providers cemented our dismay with this company. They do not care about their clients health or safety as long as they can squeeze out a couple more dollars. read more

IME, PH uses disreputable third parties to deny claims as fast as a bot. For radiology reviews they use EviCore, which their insureds have eviscerated in hundreds of horrible google reviews. read more

1. They never had to pay a dime in the many years I had them, until I got a kidney stone (about $5K bill) and they would not pay, just kept giving me the run around for 9 months, with collection agency after me etc. The doctor across told me to write the president of priority a letter and told me what to say. All the bills were then paid within 10 days. 2. When I turned 65, went on Medicare with BCBS (they are great) Advantage, dropped Priority 10/31/23. Lab and doc submitted a bill for service on 10/23/23. Priority said our policy expired 10/2/23 and I was not covered. Had to show them the the prem had been deducted from my wife's payroll stub, etc. Still waiting to hear. Priotity is the worst by far, go with ANYONE else!!! read more

They want to control how women take their birth control. I was told by my pharmacist that Priority Health doesn't want women to skip the placebo week (both my doctors want me to,) so the 3-pack prescription will leave a woman without birth control pills for 5 days until Priority Health will refill the prescription. I had to pay $30 out-of-pocket for an entire pack to cover the 5 days. They like to allow a refill only a day before you run out of your prescription, so you'll never know if the pharmacy will have what you need for the next day. It's a very anxious time not knowing if you'll have the daily medication you need for the next day. They also negotiate co-pays for some reason, which leaves a very strange amount to be paid. read more

As a medical biller, I would warn you to RUN as fast as you can from this insurance company. It takes forever to reach anyone on the phone, and when you do, they are unfriendly and sometimes just downright condescending and rude. I would NEVER advise anyone to choose a plan with this company. read more

if i could give zero stars i would this company is just a big scam find a better one . I signed up for an extra year just because I had surgery planned, I used th exact same plan as before ( confirmed by the government) they changed the plan all the doctors and the hospitals that were on the plan that they told me to use were off the plan and they denied all the claims trying to stick me with 7 k of bills after paying thousands in deductable and premiums I'd be better off with no insurance read more

The customer service is terrible. I have been trying find out why they are not paying foe a covered service. The responses are from clueless people and I never get an answer. I have asked to speak to someone higher up. They say someone will call me but they never do. I have tried many times. read more

Horrible insurance company to work with. Anytime I have needed to communicate with them I am on hold at least 30 minutes. Recently after 360 days they recinded payment for a provider's appointment for my daughter with severe disabilities. Thus far I have spent over 2 1/2 hours of time trying to resolve an issue for a benefit that is certainly covered by the health insurance we pay for. read more

Priority Health is getting worse and worse every year. They will drag their feet with approving medications, prior authorizations and appeals. They do not care what the Doctors Office says and will change the medication on a whim with little to no notice in the middle of treatment. They do not care how much pain you are in or how much your quality of life is deteriorating. GREED AND APATHY are their company motto! read more

Worst insurance company I've ever encountered in my existence. They take low quality of care to a new level refusing to pay for anything. Hundreds upon hundreds of dollars for the worst type of care. This company along with others puts profits above everything else. Honestly, this company is incredibly unethical and should not be an option for insurance. read more

I am at my wit's end today as another appeal for coverage was denied. I've exhausted my peer to peer, and self appeal. Now I'm appealing at the state level. I'm trying raise awareness for how awful insurance can be and how they can drastically impact your quality of life. This is not the end of this with Priority Health. At this time, I am not allowed to work or drive according to my PCP. I also had to take my last semester off to finish my RN. I feel like they're forcing me into disability as an only option at this point. I was directly admitted to the hospital by my GI and ended up with a week stay to get my NJ placed and to tolerate nutrition again. I was discharged home without any supplies. I told them they may as well sign me up for hospice since they're letting me starve and I was told I have to go through hospice to set that up. So awful of them. I was a previously healthy 27 year old before severe gastroparesis. With a mission stating: "improve health, inspire hope, and save lives", and a vision of "personalized health made simple, affordable, and exceptional", I expect more. read more

I came here to give them a one star and see lots of people have already. They don't call you for your transportation most times, their phone system is doesn't work right, and the transportation told them they called me when they did not. Their customer service is good until there is an actual issue. read more

Never had so much trouble paying a company. Refused to give me an invoice or way to pay when I signed up. I had to wait for the mail when I had plans to be out of town out. Ended up mailing in the payment late. Tried to sign up to pay by credit card, like I do with my gas bill, car insurance, electric, cable and internet, cell phone. But they don't take them Signed up for electronic withdraw by bank account, the screwed that up, and I mailing in a payment late again. I'm trying to give you money, why do you make it so hard. read more

Please keep in mind EVERY Heath care decision Priority Health makes regarding your health is based upon $$$$. Absolutely the worst Heath Care experience of a Lifetime. Selected Priority /PH because upon application they covered my Doctors and Medications. However two months into care they fought me on both fronts and refused to cover medications . I believe they are not a Health Insurance Company, they are however a Health Company that negotiate simple discounts with Health Care providers. Please be advised ! read more

Do not fill out info online... Priority Health will spam you forever! I wanted to get pricing for a policy and received no less than 50 spam calls in 24 hours! I've asked to be removed from their list and the calls keep coming. I can't make them stop. Talked to Operator, Customer Service, and Sales. Everyone said "not my department" Beware before you provide them with your contact info. read more

Priority Health only worries about their bottom line. They don't pay for your COVID tests unless, apparently they are free! I have a serious case of breathing problems but, thanks to P.H. I only use 3 of the 5 meds prescribed. I can only afford 2, one I get using a discount by CVS, ty CVS! You see, they say they try to keep costs down, but to protect their bottom line, not for the insureds benefit that's for sure! Look somewhere else, Humana is a great alternative. It costs more but a lot less tier 3-4 drugs! Priority likes to put well needed meds on tier 3-4, protect s their bottom line better! read more

when I say worst insurance you can have I mean it 2 months before I can use the insurance but they took thier payment but I can't use the insurance. like how does that work. you guys don't pick up the phone and reps have attitude and can't even help you like why are y'all directing me to my HR at the Job when you handle the insurance that's all the reps kept telling me you would have to talk to hr about my medicine I need and to get a provider near me ok. low budget insurance read more

Worst experience ever. Before I signed up I verified that my medication was covered. After getting on board, they told me that my medication would only be available if I tried a medication that they (the insurance company, not my physician) wanted me to try, and fail first. This is based on their kickbacks and deals with the medication manufacturer (and yes, they admitted that on the phone during the appeal). So beware. Your medication is NOT actually decided by your physician when you are with Priority Health, your medication is decided by the insurance company. I have spent untold hours dealing with this and running out of my medication (which can indeed have fatal consequences), asked my doctor to waste time sending in everything they asked for, only to be told it doesn't matter, Priority Health as an insurance company is the ultimate authority on what medication you should have. Now filing an appeal with the state. read more

Horrible insurance. They do not live up to their name "Priority Health", health is not their priority, money is. Their unethical tiered policies is forcing me to have to switch to a new PCP from my PCP who knows me and my complicated medical history all because she is not an approved tier 1 doctor. Refuse to cover anyone out of network even if care is medically necessary. They say they like member feedback but when I provide feedback and medical proof of my needs, they continue to deny care. I believe they are unethical and if I could switch insurances I absolutely would, sadly I am forced to stay with them and it is having physical and mental health consequences. read more

Went online to pay monthly invoice. Unfortunately online web payment did Not work totally. Tried twice. Had to pay by phone using a checking account. Would be nice if Priority Health accepted credit cards. read more

I Agree with most of the negative reviews here. This is the worst insurance provider I have come across. They pretend that they care but actually it's all just a show. It took my parents 5 months to just get their insurance card. They make it sound so caring when they want to send a Physician and nurse team to home to check on 65+ years old patients. In the end they actually sent a doctor that retired from regular practice (73 years) and was barely able to move around to do anything. He was more interested in documenting history than actually checking the patient. The only check he did was using a wrist cuff to measure his BP and we all know that wrist cuffs are not reliable. He was the only person visiting instead of the team they so hyped about. My father has been taking Novolog for 5 years and this is the first time he gets denied. Physician already requested for it and Pharmacy never got approval. So, I called Priorioty and they said that the Physician made standard request and it takes 21 days to review! Really? Someone dependent on Insulin can wait 21days? So, the Physican requested again stating "urgent" and this time, they rejected today. When I called, Priority agent stated that the Physican had to mention if he had any visual impairments or other causes to why he needed that Novolog. Really? They sent home Physican, they have records from the regular physican and we spent so much time to send all his previous info to the designated Priority nurse manager and they did not have that info available? Why waste our time? My father runs out of his Insulin tomorrow and I am panicking what will happen. I just want the world to know that it was Priority that is liable for everything. Last year he had Physician Healthcare Network insurance and we never had to wait for approval even when Trulicity was prescribed along with Novolog. This year, he has a more expensive plan with the worst coverage? Please never ever buy Priority Insurance. I myself am a health professional and I know how much of a struggle they are for patients to get coverage from. read more

I've had Priority Health through work for 17 year. Do to my health, had to go on disability. so I called to see if I could get individual insurance on my own. I talked to Omaira. She was very helpful, and found me an affordable option that I signed up for today. Thank you very much Omaira! You did a great job. read more

I have been with Priority Health almost 12 years. They just denied me the help I need from the Cleveland Clinic, even after talking to my Cardiologist EP. they strung me along for 3 months my ablation was scheduled for May 22 (5 days from now), I had to call and cancel it today. #PriorityHealth does not care about their customers just their profits. Also their customer service lines are terrible. You will be on hold fo an hour and when you get someone they know nothing and say they will transfer you to a supervisor or manger but what they do is transfer you to a fax line or customer service line, then you have to call back and go on hold 40 more minutes. Stay away if you have a choice. read more

I've had Priority for two years now. Last year 2020 they allowed $2,000 hearing aid allowance and $300.00 for eye glasses. You chose any provider. I bought both from Costco as they offer superior products at a reasonable price and loads of service. This year the still offer the same limits, but now there is a deductible. For the cheapest pair of hearing aids purchased for their company store only. They admit that Costco is probably cheaper. The deductible starts at $495.00. Such a deal? Is Priority getting a kick back? Stay away from Priority. If I could give them zero stars I would. Now I will wait for the 2021 Medicare plans and chose a different company. I have filed two grievances with Priority....all they do is listen. read more

The worst health insurance company you can have. Avoid them at all costs. They will do anything to get your money, even more so than a normal health insurance company. Including help cover up malpractice. Anything to make a dollar with these guys. Last year, I was informed due to changes in Priority Health's coverage plan, I would have to get a new doctor. The doctor they chose for me required that I take a physical before he took me on as a client. So, though i go to college in Missouri, I flew up here in order to see this new doctor. (**THE ONLY THING MY INSURANCE COVERS IS A PHYSICAL) So I went in for the physical. During my physical, the dr. noticed in my chart that I had been diagnosed with borderline asthma as a kid and asked if it was something that still bothered me. I assured him that it was not and that if I did have an inhaler, I had no idea where it would be. He insisted he write me a new prescription for an inhailer. I went home, the "physical" lasted maybe 6 minutes, and didnt think about it for a month or so. Then the bill came. I wasnt billed for my phsyical, but I was billed for an "asthma chekup". I dropped the Doctor. After 6 months of being ignored and constantly told that "someone will be in contact with you shortly" by an insurance company that obviously didnt care I was being taken advantage of, I was fed up and filed several complaints against the dr. and the company. They launched an "investigation" or so they said, and never asked me a question, never looked into the matter beyond reading MY FILE. MY MEDICAL FILE. After a week of the "investigation", they called me and69ing informed me that nothing wrong had been done and I would need to pay them. Bunch of crooks. Ill never pay those blood sucking leaches a cent. Ill raught in a cell in the basement of the Kremlin before I pay anthying to those liberal bastards. read more

Don't get insurance here..I was paying the amount my online account told me too and they canceled my insurance for 7 dollars they said I didn't pay..I always paid what amount my account stated...They then claimed they are unable to see the amount I was asked to pay..Look else where unless u want to end up with no insurance like me...If u do go with them record every call and save all bills,screen shots any contact you have read more

I am posting this poor review because Priority Health because I was in the hospital for a few days, and a specialist told me to get a specific test for diagnostic purposes, and I left the hospital with a signed order. The order, however, needed to come from a primary care doctor, so my primary care doctor placed the same order again, and they rejected it and wanted me to pay to repeat all of the tests that I got in the hospital (about two weeks ago) again (out of my own pocket of course because of deductibles) before they would consider approving the test. They offered no medical reason, and this was just punitive to try to force me to spend money in hopes of not getting the test. I have started priorityhealthsucks.com for people to add their reviews. read more

We have been working with priority health since February on a preventative care claim that is supposed to be covered according the medical office where we were serviced and according to people at Priority Health. However, they would never pay the bill. We paid over 900 in premiums per month with a high deductible and yet they refuse to pay a 94.00 bill that is supposed to be covered under preventative care. We have now gone on Medicare and will not use Priority's supplement plan due to their response on this small bill. I know their procedures for claims has changed and they initially deny almost everything, but how foolish from a business sense to lose longtime customers over a small item like this. In addition to this, we tell others our experience and encourage them not to use priority health. Doug G. read more

Customer service is horrible, whether calling them or sending them emails. My email has gone unanswered for ten days now. Calling them is a joke. You can be anywhere from 30, 40, or even 50 placed in line. Once I was #2 in line for a Rep and it took 38 minutes to get to my call. My advice is to look elsewhere for insurance. read more

Doesn't fully cover all components of basic laboratory bloodwork because they're not "preventative", even though they're what every single doctor orders during an annual physical. They covered my cholesterol and blood sugar labs but not my CBC, metabolic panel, and thyroid hormone panel. I only went to my physician in the first place because of the free annual exam thanks to the ACA! Greedy and shameful company. read more

CANCELLED INS. AFTER I HAD MY SON BEWARE! I asked to take my son off of my insurance because they put him on mine even tho his dads insurance covered him 100% they cancelled my insurance instead and must've completely took me out of the system bacause they couldn't figure anything out. DO NOT GO TO THEM THRU THE MARKET PLACE THEY SUCK. read more

Worst health insurance I have ever had. It's atrocious. Only giving one star because I have to in order to fill out a review. They "authorized" a service for me with a provider, I have the letter of authorization. So I went and had the service done. Oh yeah, they authorized that for my out of network deductible. The letter doesn't say that . . . and why would I call in to get authorization towards my out of network deductible ($18,000)? When I called about this, they said they had done me a solid authorizing the service for out of network, instead of it not applying to any deductible amounts. Wow! Thank you! Now if I can just spend another $14,200 in out of network medical expenses I can start to get some coverage. This is after countless denials of coverage that I had to call in to get fixed because the provider was just coded wrong or they didn't realize they were in THEIR OWN NETWORK!!! The provider came right up on their web site, and Priority Health's employees are telling me, "sorry, they are out of network". This insurance is a joke. Run away. You will be calling EVERY time you see a doctor. In fact, they want you to call every time. Says so on their website: you have to call them AND the provider the day of service to be sure they are in network and it will be covered. Of course, beware; "authorized" doesn't mean you will have anything paid for. They continue to say on their site you must call every time the day of service, because providers and doctors go in and out of network all the time. Great. So currently I live exactly 1 mile from a hospital with an ER. I can go there as long as I am willing to pay for everything myself. I may, in the event of an emergency, drive past another hospital on my 6 mile drive to an ER that is in network. I sure hope nobody gets hurt at my house before I win the lottery. read more

My plan is through my employer. I have had nothing but good service with them. Even help with insurance outside of the US while traveling.