Complaints

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.

• Initial Complaint

  Date:02/24/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  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 filed a claim for vision reimbursement, as is covered under my Wellfleet plan when I have a referral for an eye exam--I met this requirement to the letter. The claim was denied because of a need for tax information ("Services not covered without an authorized tax id#"). Their own email says "If additional information is needed [to process your claim], we will reach out to you via e-mail to request this information." This communication never happened--through which I could have provided the information. Now I have to go through the hurdles of formally disputing it because they could not be bothered to do this correctly according to their own procedures.

  Business Response

  Date: 02/27/2025

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and were able to resolve the claim issue described in the complaint favorably for our member. Wellfleet strives to deliver insurance solutions with accessible,quality customer service, and is therefore pleased to advise that this matter was resolved to the members satisfaction.
  
  Wellfleet members are always welcome to reach out to our team at
  ************ or ************************************************* to discuss specific issues.
  
  Sincerely,
  
  ****
  Consumer Affairs

• Initial Complaint

  Date:10/15/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  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.

  My right wrist was injured in February, 2023. I went to an urgent care (************************ Group ******************) in *******, **. At that time, I had a PPO plan with Wellfleet health insurance. When I visited the urgent care, I showed them my insurance information, and they told me that they are in-network. I never received any medical bill related to this doctor visit until in June, 2024, which is more than one year after the doctor visit. And the amount due is $345 with my insurance (Wellfleet) paying $0. I called my health provider and insurance company but couldnt solve the problem. The health provider said the insurance company accepted the bill that the provider sent them on March 13, 2023, but the insurance company didnt respond or give the provider an *** (explanation of benefit) until March 22nd, 2024. The provider then sent my insurance the medical records that they requested on May 2, 2024. On May 14, 2024 they sent them the cover letter they requested. After everything, they still refused to pay anything of the bill, stating that its over a year since the date of doctor visit so that they wont pay. But actually, it is their responsibility that they didnt respond to the provider until March 22, 2024. The health insurance company is being irresponsible and refuses to cover what they should cover. I am hoping that BBB can help me to protect my benefits and rights. I'll upload the insurance information and medical bill in the attachments. Thank you very much!

  Business Response

  Date: 10/22/2024

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and were able to resolve the claim issue described in the complaint favorably for our member. Wellfleet strives to deliver insurance solutions with accessible,quality customer service, and is therefore pleased to advise that this matter was resolved to the members satisfaction.
  
  Wellfleet members are always welcome to reach out to our team at
  ************ or ************************************************* to discuss specific issues.
  
  Sincerely,
  
  ****
  Consumer Affairs

• Initial Complaint

  Date:02/22/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  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.

  About 3 months ago I had trouble using my insurance to purchase my medication from the pharmacy because they were saying I had more than one insurance on my account. The only other insurance I could think of was the student insurance Wellfleet, I called the company to figure out if it was active because I had waived this insurance and deactivated it last semester. The customer service woman informed me that the insurance was inactive. Two months later I received my student refund check which had $597.00 taken out for insurance that I was told was not active. After seeing this, I tried to go wave the insurance because I already have ********* I was told that it was too late to waive Wellfleet insurance. If I wasn't told that it was inactive I would have waived it in time but being told this allowed me to think that I didn't need to take further actions to get it waived.

  Business Response

  Date: 03/06/2024

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and have connected directly with the member to provide guidance on how they should proceed. Wellfleet strives to deliver insurance solutions with accessible, quality customer service, and is therefore pleased to assist this member with this matter.
  
  Sincerely,
  
  *****
  Consumer Affairs

• Initial Complaint

  Date:08/22/2022

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  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.

  Despite multiple applications to waive the Wellfleet insurance policy for our son, Wellfleet continues to deny our request to waive the policy. We have applied multiple times for a waiver, each time providing the necessary documentation that Wellfleet requested. This has been going on for over a month. The first time the waiver was submitted, we got no response at all. The second time, we received a denial notification a week later, but no explanation for the denial, and no phone number was provided to contact someone. Once we were able to speak to someone by phone, we were told that the waiver was denied due to a date of birth discrepancy, and all we needed to do was to email a copy of my son's driver's license to prove the DOB which we did (Monday, August 20th). We also sent in a third application to waive the insurance and included the front / back copy as well. I called back today and spoke with a lead verifier named *******, who assured me that the application would be reviewed today. At approximately 4:50 pm (E.T.) we received another email denying our application. I contacted them again and this time I was told two conflicting reasons: at first, I was told that front / back copies of the insurance card (which they request on their application), is not sufficient proof that our son is currently insured and that we would need to also submit certificate of insurance as well, and that we had to reapply, AGAIN. Then I was told (in the same conversation), that they didn't have his insurance cards on file and THAT was the reason for denial. Because of this remaining balance on my son's account, I was REQUIRED to pay a $20 fee to Lindenwood and set up a payment plan so our son could move into his dorm tomorrow. In my opinion Wellfleet is purposely making this process difficult in an attempt to discourage parents from cancelling and forcing them into an unnecessary and expensive policy. This is a SCAM and it is costing families thousands of dollars a year.

  Business Response

  Date: 09/02/2022

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and have connected directly with the member with resolution to the issue described in the complaint. Wellfleet strives to deliver insurance solutions with accessible, quality customer service, and is therefore pleased to advise that this matter has been resolved to the members satisfaction.
  
  Sincerely,
  
  ****
  Consumer Affairs

• Initial Complaint

  Date:08/01/2022

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  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.

  Hi Wellfleet (who runs the Berkeley Student Health Insurance Plan (SHIP)),I submitted two adverse claims for this and another charge, and after 6 months, still haven't heard back from you via email, phone, or letters. I shouldn't be paying this charge and it's unacceptable for you to not respond to my adverse claim for this.You billed me full price for standard care incurred 10/8/21 for Claim #***********. This was routine preventative care bloodwork that my primary care practitioner recommended (and is customary with any doctor I've ever seen as regular preventative care).Being preventative care, SHIP should cover this expense ($284) at full cost and not charge me for that amount (see your guidelines page 12 and the screenshot attached). I would have never approved doing this work if I was expecting this unexpected $300 cost. This should NOT be coming out of my deductible, according to your advertised policies. The BBB complaint against Sutter Health (which I filed first) came back with the conclusion that it's Wellfleet / Berkeley SHIP's issue, as they did bill it as preventative (and rarely see patients billed by their insurance for it).On the SHIP Insurance plan, you say patient responsibility is 0% for "Preventive Services mandated by the Patient Protection and Affordable Care Act" (pg. 13 of the booklet) for in-network, which is what I had done.I hope you can resolve this internally and with the provider as I vouch that this is an adverse charge that is not fair to me and I should not be paying out of pocket for. This is a horrible way to treat students & their partners, for what already is a VERY expensive insurance plan ($500 per month). Needless to say, I've switched to Covered CA after this fiasco as I can trust it more and it's way cheaper with better coverage, and have been advising other students against the poor service and inappropriate charging (with horrid customer support). Berkeley Ship / Wellfleet ID - *********

  Business Response

  Date: 08/11/2022

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and have reached out to the member for follow up with resolution to the issue described in the complaint. Wellfleet strives to deliver insurance solutions with accessible, quality customer service, and is therefore pleased to advise that this matter was resolved to the members satisfaction.
  
  UC Berkeley plan members are always welcome to reach out to our team at
  ************ or ************************************************* to discuss specific issues.
  
  Sincerely,
  
  ****
  Consumer Affairs

  Customer Answer

  Date: 08/30/2022

  
  Complaint: 17647515
  
  I am rejecting this response because:
  

  This was never resolved by Wellfleet (their response that they settled this to my satisfaction is a lie.

  Sincerely,
  
  ***************************************

  Business Response

  Date: 09/06/2022

  Wellfleet takes healthcare privacy laws and protecting member privacy seriously, so the details we can share in response to this complaint are limited. We have extensively researched this matter and spoke directly with the member on 8/31/2022 with resolution to the issue described in the complaint. Wellfleet strives to deliver insurance solutions with accessible, quality customer service, and is therefore pleased to advise that this matter was resolved to the members satisfaction.
  
  UC Berkeley plan members are always welcome to reach out to our team at
  ************ or ************************************************* to discuss specific issues.
  
  Sincerely,
  
  ****
  Consumer Affairs