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Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
12/27/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I would like to file a complaint against Fidelis Care. I received an invoice from ************************** in ************* for the services of ******** 2022 and I contacted ***** from **************************, and she informed me that Fidelis Care and Denta Quest never notified the group that I had an annual dental cap and therefore they billed me $770.00. Every time I call Denta Quest a customer service a Denta Quest worker checked all the claims they said it shows every claim shows Patient Responsibility is $0 and they tell me to reach out to ************************** and They will not return my phone calls. When I file a complaint with Fidelis Care Grievance and Denta Quest Grievance they will me I do owe money to ************* Dental. I went to another ************ last year as well they also were told by Fidelis Care and Denta Quest that I had unlimited Annual Cap. If two ************ offices in town being told that I have no annual dental cap and then I get a bill in the mail Fidelis Care and Denta Quest should be under Investigation. I am not paying $770.00 and Fidelis Care and Denta Quest should pay for it not me. I want Fidelis Care to contact **************************. I had to include this bill in ********************. Please contact ************* Dental **** State ******************************************* *************Business response
01/09/2024
January 9, 2024
Better Business Bureau
******************************************************************************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated December 27, 2023 regarding a complaint filed by consumer ***************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Initial Complaint
12/01/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
First issue: I visited my dentist either at 11/23/21 or 6/23/22 for a cleaning. The dentist told me that I needed treatment consisting of four visits a year instead of two. They submitted it for pre-approval to Fidelis. When Fidelis denied it, it was because I was over the age of 18. This was odd, because I chose a Family Dental plan through the marketplace and never before had a problem with it. Calling Fidelis, they asked me to call either ******** State of Health or DentaQuest. When I did so, those other entities told me to call Fidelis. Speaking to a supervisor didn't help. I tried to make those calls dozens of times over the past year and half, and have done so again today. My latest calll with NY State of Health today concluded with me needing to file a complaint, so I am. Fidelis Care has done nothing to look into this issue for me and fix it, which resulted in me being denied care for something that I should have been approved for.Second issue: The plan through NY State of Health clearly states that Telemedicine appointments are supposed to be free. However, I have been charged for these appointments time and time again to the point that I stopped wanting to even take the risk. I fought it one time with Fidelis, but when I realized that this will continue on happening, I gave up and just paid. This is either a technical mistake, in the good case scenario, or blatant false and misleading information. Third issue: Fidelis have continuously denied me prescription medications that were prescribed by my doctors, even those that have been previously approved. They have denied me coverage for daily medications I needed to get. When I called them today to inquire about that, they said it was because they have a refill cap amount, which means that they'd like me to get 4 times of a 90 day supply vs 12 times of a 30 day supply. At no point was that communicated to me, and so I had to pay for these medications out of pocket multiple times.Business response
12/15/2023
Fidelis is in receipt of your letter dated December 1, 2023 regarding a complaint filed by consumer *********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Customer response
12/20/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:[Your Answer Here] The businesses is stating in their response that they cannot disclose medical information with the BBB, which I appreciate - but I cannot **** this issue resolved until it is resolved. I would advise Fidelis to respond to this case once we indeed reach a resolution, and then I will gladly close this case.
In order for the BBB to appropriately process your response, you MUST answer the question above.
Sincerely,
*** *****
Business response
05/03/2024
May 3, 2024
Better Business Bureau
****************************************************************************************************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated April 24, 2024 regarding a complaint filed by consumer *********. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Customer response
05/08/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
*** *****
Initial Complaint
11/20/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
UGh!!!!!!! That fidelis care they were reported and complaint about a lot like ALOT MANY times they continue to harass via phone calls and sending mails to someone by ********************* they DO NOT live at ***************************************************************** continue to write on their mails unknown sent back to sender this problem been going now for many years they that fedelis care for some reason they dont understand nor they dont comprehend THAT PERSON ********************* DOES NOT LIVE THERE AND TO STOP AND DO NOT HARASS TO QUIT IT THEY that fedelis careContinue to sent mails and call they harassing that person and btw thats how fraud happens they dont take it seriously and they still think that that person by name ******************** at that address again ***************************************************************** they wont stop!!!!!!! They need to quit it already !!!!! Geez!!!!! Ive reported them to department of health, attorney general, department of education ********* I dont know how many times they that fidelis care has been reported a lot and they fidelis dont care!!!! Ugh!!!!!! I dont understand and dont get and what they dont understand what is that they dont comprehend? They that fidelis care also were notified that THERE ARE NO MEMEBERS THERE IS NO MEMBERS and by ********************* NO members!!!!!! Geez!!!!!!! Simple to comprehend and understand that!!!!! Ffs!!!!!! Idiots they are that fidelis care and their BS!!!!!! Tired and sick of it !!!!!!!!Business response
12/01/2023
November 29, 2023
Better Business Bureau
******************************************************************************
Review ***********
To Whom It May Concern:
Fidelis is in receipt of your letter dated November 20, 2023 regarding a complaint filed by consumer ************************ Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Customer response
12/13/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:[Your Answer Here] THERE IS ARE NO MEMBERS BY THE NAME OF ********************* PERSON OKAY THEY WERE CONTACTED SO MANY TIMES TO STOP HARASSING BY CALLING THEY USE DIFFERENT NUMBERS AS WELL AS NO CALLER ID NUMBER(s) AND TO STO AND SENDING MAILS HARASSING FILED COMPLAINTS AND REPORTED FIDELIS CARE TO AS WELL TO Department of health and attorney general so many times by that fidelis care CONTINUES TO DO SO THEY WERE ASKED TO STOP AND THEY WERE TOLD THAT THERE IS NOT NO MEMBERS BY THE NAME OF ********************* AND THEY DO NOT PERSON ******************* DONT NOT LIVE AT *****************************************************************!!!!!!!! How many times do have to report and file complaints against them fidelis care!!!!!!! THEY DO NOT COMPREHEND THAT THERE ARE NO IS NOBODY THAT DOES NOT HAVE ANY KIND OF INSURANCES They are ARE NO MEMBERs THEY DONT COMPREHEND THAT THEY WONT STOP HARASSING CALLING and SENDING MAILS WAS TOLD TO WRITE ON THEIR MAILS RETURN TO SENDER UNKNOWN THEY FIDELIS CARE TEHY WONT QUIT IT!!!!!!!!
In order for the BBB to appropriately process your response, you MUST answer the question above.
Sincerely,
***********************
Business response
01/10/2024
Fidelis is in receipt of your letter dated January 3, **** regarding a complaint filed by consumer ************************ Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Customer response
01/23/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:[Your Answer Here] THEY CONTINUE TO HARASS SOMEONE NAME PEROSN ********************* THERE IS NOT PERSON NAMEALEX ****** *** NOBODY AND BY THAT NAMES DOES NOT HAVE ANY KIMD OF INSURANCES THEY CONTINUE TO HARSSING BY CALLING AND SEND ***** TO ********************* ***************************************************************** THEY WERE CONTACTED SND WERE TOLD PLENTY OF TIMES TO STOP AND DO NOT HARASS BY CALLING AND SENDING ***** AND THAT NOBODY IS NOT MEMEBERS AND THERE IS NOBODY BY NAME ********************* DOESNT HAVE NO INSURANCES THEY STILL CONTINUE TO CALLS AND SEMD ***** AFTER ALOT TIMES THEY WERE TOLD TO STO AND THERR IS NOT NO ONE BY *************** DOES NOT RESIDE AT ***************************************************************span style="-webkit-text-size-adjust: 100%;">!!!!!! THEY DO DUMB THEY DONT UNDERSTAND NOR THEY CANT COMPREHEND DEALRTMENT OF HEALTH WERE CONTACTED AND BBB BUT THEY DISREGARD THAT THEY COMTINUE TO HARASSING CALLING AND SENDING JUNK ***** THE ***** CONTINUE TO WRITTEN ON THEIR **** JUNK BS ***** THAT UNKNOWN. REFUSED. SENT BACK TO SENDER AND THEY WONT LEAVE ALONE!!!!!!!!
In order for the BBB to appropriately process your response, you MUST answer the question above.
Sincerely,
***********************
Initial Complaint
10/20/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
im a retired and very sick man. I receive Social Security Im on ******** and Im a low income individual. I get $2000 a month and have **** rent 400 child support cable canned water. I have a service animal I have to take care of and ******** now wants me to pay them $323 a month to continue getting my services. I had a home health nurse Who worked 40 hours a week Monday through Friday 6 AM to 2 PM that is also now cut off. I cannot access my medications. I have to pay over-the-counter since my child support was lowered. They say I made too much money now they said I can be in the program and fax them bills. They keep not accepting them. Im not on welfare I dont even receive food stamps. I am without insurance. They just cut my ******** transportation Cab to my outpatient program. Theyre not getting paid. My psychiatrist and doctors are not getting paid. Im going without Care and my mental medication Im schizophrenic I have PTSD I was in an explosion in the oil field, Im burnt, I have depressive tendencies, bipolar and bad panic, attacks, insomnia, and a brain bleed. I have no use of my hands at all. I walk with a cane. Im on a lot of medications then Im now being denied over $300. My payments have never changed from Social Security. They have always been the same. They just lowered my child support because I couldnt afford to pay and my daughter is about to be 18 in a few months. Ive been to the ******** office many times. Ive been on the phone every day for six hours for two months trying to figure this out and you hear a different story from everyone theyre giving me the runaround and theyre extremely rude and do not care due to my mental disabilities. Its very hard to understand the insurance and what Im supposed to do and they do not care. I spoke to my lawyer about it and I want to *** them.Business response
11/03/2023
To Whom It May Concern:
Fidelis is in receipt of your letter dated October 20, 2023 regarding a complaint filed by consumer ********************************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Initial Complaint
10/16/2023
- Complaint Type:
- Sales and Advertising Issues
- Status:
- Answered
3 different people in the sales department lied to me, or gave me incorrect information, that any Telehealth appointment was free even if it was with my regular pcp, and that I didn't have to go through the Fidelis app.Then they started billing me for all my Telehealth appointments. When I called them to find out why, they said I had to use their app or teledoc. Basically there is a discrepancy between what they tell you before you sign up, and what the reality is. Because of this ****************** I shouldn't owe.Business response
10/26/2023
Fidelis is in receipt of your letter dated October 16, 2023 regarding a complaint filed by consumer ************************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.Initial Complaint
10/12/2023
- Complaint Type:
- Order Issues
- Status:
- Answered
I created an insurance policy through *** of health for my daughter. Fidelis care is the provider. I paid the first their month initial premium. Through no fault of my own, this money was credited to my sons account. By the time this was resolved I had employee based insurance for my family. I was told that I have to pay septembers premium to make the account active for the months that I already paid for. Then told I needed to contact *** of health to change the insurance end date. I have done everything in my power to resolve this issue for the last month and a half. All I want is coverage for the months I paid so *************** and hospital can send out bills for my daughter. I have contacted Fidelis care and *** of health consistently 3-4 times a week ****h phone calls with no resolution in sight.Business response
10/25/2023
October 25, 2023
Better Business Bureau
******************************************************************************
Review ID: ********
To Whom It May Concern:
Fidelis is in receipt of your letter dated October 12, 2023 regarding a complaint filed by consumer *******************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will continue to address the concerns directly with the complainant.Initial Complaint
09/28/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have been with this health insurance for the past 2 years now, I have several health issues as well as a history of trip and fall due to my imbalance from my arthritis. I have home health aids with a particular agency that I've been using for several years now. I am constantly having to request Fair hearings regarding denial of several types of services from this health insurance provider I want to change my health care provider but it will delay my services that I received now, this complaint is in regards to request for additional hours for my home health aids so that I may receive adequate home care services we have had several Fair hearings regarding the last request and they are still giving inadequate information as well as the incorrect amount of hours requested. I originally had 70 hours we made a request with documentation provided from my doctors from 70 hours to 120, which I now have however that amount of hours is only based on the previous Fair hearing which was still waiting to be resolved we requested another Fair hearing because we requested the amount to be change from 120 to 168, however they had not corrected this request and it was denied twice the last Fair hearing was for the incorrect amount of hours requested. Requesting the raise in hours from 120 to 168 in order to receive adequate home health **** services. We will start a lawsuit if it is denied again based off of medical neglect.Business response
10/12/2023
Fidelis is in receipt of your letter dated September 28, 2023 regarding a complaint filed by consumer ********************************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan has addressed the concerns directly with the complainant.Initial Complaint
08/10/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
My covered medication the pharmacy is telling me ******** and my insurance doesnt want to cover pay for the medication when its always been covered this is not fairBusiness response
08/18/2023
Fidelis is in receipt of your letter dated August 10, 2023 regarding a complaint filed by consumer **************************** Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility,claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.Initial Complaint
07/18/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
Applied for FidelisCare a couple of weeks ago and got my plan approved. I already received my member ID, however, I am not able to access the member portal, nor any other health insurance information I urgently need. I've contacted FidelisCare via ************ several times but the responses are not fixing the problem in any way. I am currently enrolled in FidelisCare plan, but I can not use any of its benefits because of the missing member portal access.Customer response
07/21/2023
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me and the matter has been resolved.
Sincerely,
****** *********************************
Initial Complaint
03/24/2023
- Complaint Type:
- Billing Issues
- Status:
- Answered
My coverage with Fidelis began on May 1, 2022 with their **************** care program.I have used the plan for to visits to doctors at AdvantageCare Physicians. The first visit was a routine appointment, the second visit was to get the doctors to write a prescription so that I could get a Drug Screen Lab for employment purposes.These two visits resulted me getting a bill for over $300 and $400 each. I received those bills because Fidelis states that I have a Coordination of Benefits issue. Fidelis states that I have insurance with Aetna, when in fact the period of coverage for the *************** was 04-01-2921 to 11-26-2021. The Termination Date was 11-26-2021, however, Fidelis will not update my profile within their system. Instead, Fidelis states that they require a Termination Letter from Aetna. ***** refuses to send a Termination Letter to Fidelis or **** have stared to receive annoying calls from collection agencies because of this error and I would like to Aetna and Fidelis to resolve this issue between themselves. I want to know that I have only ONE health insurance policy and that I can go to the doctor when I need. At the moment if I go to the doctor I am afraid that the doctor **** will go unpaid and that I will have the account go into collection.Aetna ********** Effective Date 04/01/2021 and Termination Date 11/26/2021 Telephone: ************** Aetna for InfoSysBusiness response
03/30/2023
To Whom It May Concern:
Fidelis is in receipt of your letter dated March 24, 2023 regarding a complaint filed by *******************************. Due to federal and state privacy and confidentiality regulations, we are unable to disclose any protected health information, including, but not limited to eligibility, claims, and billing information. Fidelis appreciates that the Better Business Bureau has brought this matter to the attention of the Plan however, the Plan will address the concerns directly with the complainant.
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Contact Information
2501 Jackson Ave
Long Island City, NY 11101-5095
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Get a QuoteCustomer Complaints Summary
66 total complaints in the last 3 years.
25 complaints closed in the last 12 months.