Business Profile

Health Insurance

Healthfirst, Inc.

Headquarters

This business is NOT BBB Accredited.

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Complaints

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

Customer Complaints Summary

65 total complaints in the last 3 years.
22 complaints closed in the last 12 months.

If you've experienced an issue

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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:07/02/2024
Type:Billing Issues
Status:
ResolvedMore 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 keep receiving bills that Healthfirst should have paid out. I didn't start getting ******** until Sept 2022 so anything prior Healthfirst is responsible.I have no ** pays for either,never did.I'm tired of being harassed by bills I don't owe.
Business Response
Date: 07/05/2024
Dear BBB,
We have reached out to the member and all the claims that were previously unpaid due to a COB issue are reprocessing. We will continue to stay in communication with the member to assist in resolving all the bills.
Sincerely,
Member Services
Customer Answer
Date: 07/10/2024
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. If not all paid,I will be reporting until it's all paid.

Sincerely,

***********************
Initial Complaint
Date:05/10/2024
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.
This is my third complaint against my insurance carrier, HealthFirst, and this one is in regards to my attempts to correct false information in my records maintained by HealthFirst. According to said company's records my primary care doctor is *************************** and I assert herein that *************************** is not my primary care doctor and I has never been my doctor. In fact, I have never met the man, spoken to the man and have clue who he is. Yet, the dingbats in the customer service department at ********************** refuse to understand these facts.
Business Response
Date: 05/15/2024
Dear BBB,
We addressed this concern with the member on 5/13/24. After speaking to the member and attempting to assist with a doctor change, the member has declined to update the doctor at this time. Member was advised they may call *************** in the future to make the update.
Sincerely,
***************
Customer Answer
Date: 05/25/2024
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: The response of the business is an utter lie. I assert herein that the ****** in the customer service department at ********************** never asked me to select a new doctor. Moreover, the response of the business fails to address the main issue of my complaint, that HealthFirst had ******************************* listed as my primary care physician and I have no idea who that person is. HealthFirst needs to explain how and why they had that doctor listed as my primary care physician when I have no idea who he is and have never met him, spoke to him or had any contact with him. I am baffled at the unprofessionalism and incompetence displayed by HealthFirst staff. ****** WORK AT HEALTHFIRST

[Your Answer Here]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

*************************

Business Response
Date: 07/11/2024
Dear BBB,
A representative has spoken to the member earlier this week and explained that the assigned PCP, ****************, was listed since this provider was the referring provider on a PCA authorization. Member explained this is not the current provider he sees for his care which is **************. ************** was verified as an in-network specialist and member was informed he can continue seeing this provider without assigning as a PCP. Member confirmed he understood and had no further questions at the time.
Sincerely,
Member Services
Customer Answer
Date: 07/17/2024
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: Once again the staff at HealthFirst does not understand that ******************************* has never been my primary care physician. In fact, I have never met the man. And I did not contact **************** for any PCA authorization and I have no clue who contacted him. HealthFirst has for many years continually made errors in identifying my primary care physicians. The company had no right to go behind my back and assign him to be my PCP and or have him conduct a PCA authorization. On another note...when will the company hire some customer service employees that speak and understand English. I am tired of dealing with those who can not understand clear and concise English.

[Your Answer Here]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

*************************
Initial Complaint
Date:05/09/2024
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.
I am supposed to renew my insurance and have made several appointments where not only did I not receive a pre-call notification but the representative never showed. I have made several complaints. The rep is in ****** which is ******. I am in **************. For some reason, I am being told that she is the only rep who can renew me. She finally called me off hours with no apology or explanation. I was told before she called that the "membership team" and supervisor had an active ticket to find a new rep. I do not want to share private information with someone who is so negligent. I told her I was not confident in her taking my private information because I had made complaints about her being a no-show to which she said she had been "on location" and was unable to call. I want a new rep to handle my renewal. I did a deep dive and found out that insurance reps are overwhelmed because they are too busy handling new membership for ******** for migrants. This made sense because she, the rep, is in ****** "on location" and not handling her scheduled appointments. I have until the end of the month to renew. If I am not given a new rep, I am filing with HIPAA, NYS, and calling my local news outlet that does segments for consumers.
Business Response
Date: 05/16/2024
Dear BBB,
This complaint is resolved.

Member renewed directly via ************** of Health (NYSOH) and we have addressed the issue with the Retention Specialist that failed to assist timely with the renewal. Member will become effective with Healthfirst ******** effective June 1st.

Sincerely,

Member Services Department
Initial Complaint
Date:05/08/2024
Type:Sales and Advertising 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.
This is yet another complaint against HealthFirst and in regards to the horrible customer service and also in regards to staff at said company falsifying official records. On May7, 2024 I called the HealthFirst cutomer service phone number more than 7 times in hopes of locating my case manager and ascertaining the status of a previous complaint. Once again I had to deal with customer service agents who do not speak or understand English well and were unable to locate my case manager and or process my request for information. In addition, I was advised by one agent that someone names ********* from HealthFirst had been trying to reach me by calling me. This is an utter lie. I DO NOT UNDERSTAND WHY THE COMPANY FORCES SICK AND DISABLED PEOPLE LIKE MYSELF TO DEAL WITH IDIOTS IN THEIR CUSTOMER SERVICE DEPARTMENT WHO DO NOT SPEAK OR UNDERSTAND ENGLISH WELL THUS MAKING CLIENTS HAVE TO REPEAT THEMSELVES CONSTANTLY. AND SOMEONE NEEDS TO EXPLAIN WHY MY CASE MANAGER, *****, HAS NOT HAD THE DECENCY OR PROFESSIONALISM TO RETURN MY PHONE CALLS.
Business Response
Date: 05/08/2024
Dear BBB,
The complaint has been previously addressed with the member and the member does not have any additional concerns at this time.
We have spoken to the member and assisted with all inquiries. The member was informed of the rights to file an appeal regarding the denial of services/PCA hours. The member has declined to file the appeal over the phone at this time and will await for the letter in the mail instead. We have expressed our apologies for any inconvenience and will continue to communicate with the member directly to ensure all concerns are resolved.
Sincerely,
Member Services
Customer Answer
Date: 05/16/2024
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: The response of the business fails to address several issues raised in the complaint and fails to identify what action, if any, the business has taken to address the issues regarding poor customer service and how the company will improve the issue with customer service agents not speaking or understanding English and their failure to resolve issues. The response of the business also fails to address the issue of the repetitive and idiotic procedures a client must do to verify their identity.

[Your Answer Here]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

*************************

Business Response
Date: 06/24/2024
Dear BBB,
We contacted the member and addressed the concerns. One of our representatives has provided a direct contact number for any future inquiry. The member was also advised that we have reviewed all previous interactions and addressed them internally.
Sincerely,
Member Services
Initial Complaint
Date:05/06/2024
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.
This is a formal complaint against HealthFirst and in regards to the horrible customer service and overall service I have received from this company. 1) When you call the company's main number you are forced to navigate through numerous prompts and then verify your date of birth. You are then put on hold waiting for a live agent and then must verify all your personal information with the live agent sadly, many of the live agents do not speak or understand English well and you must continually repeat yourself. 2) Trying to get a customer service supervisor on the phone results in lengthy wait times and again you a forced to disclose all your personal information and most of these supervisors do not speak or understand English well and you must continually repeat yourself again resulting in lengthy delays. 3) Recently, I was assigned a case manager named *****, who called me and left me a voicemail message but did not leave a return number to reach her. When I called the number that she called me from it was the main number for the company and after having navigating the idiotic and repetitive security questions I spoke with a rep who was unable to locate my case manager and refused to give me a direct number for her. I have left messages for her but she has not had the decency or professionalism to return my call. 4) Due to several severe health problems I was recently assigned a Home Health Aide but Healthfirst only assigned my home health aide to work with me 9 hours a week. I requested additionally hours but was denied. Apparently, some idiot nurse at the company who failed to do a proper assessment of my case feels that my having HIV, Congestive Heart Failure (for which I will be getting heart surgery in upcoming weeks), my having had 3 severe stomach infections that destroyed my GI tract and cause severe throat spasms that close off my airway and having a spine deformities with bulging discs and muscle spasticity with antalgic lean that prevent me from bending, walking, showering or performing daily chores, does not warrant my having a home health aide for more than 9 hours a weeks. I do not understand how a nurse can assess a patient without speaking to the patient.. Moreover, the nurses and doctors from the *** Independent Assessor program, the agency the certifies a patient's health problems and grants a patient's request for a home health aide, has already verified my severe health problems and clearly stated that I need daily assistance from a home health aide. Yet, the idiots at Healthfirst seem to think they know more that my doctors and those from the *** Independent Assessor program. In closing, I have requested that I be allowed to appeal the decision to only give me a home health aide for 9 hours a weeks but the company has refused to send me the paperwork necessary to file such appeal and request a fair hearing with New York State.
Business Response
Date: 05/08/2024
Dear BBB,
We have spoken to the member and assisted with the concerns. The member was informed of the rights to file an appeal regarding the denial of services/PCA hours. The member has declined to file the appeal over the phone at this time and will await for the letter in the mail instead. At this time, the member did not have any other concerns.
Sincerely,
Member Services
Customer Answer
Date: 05/21/2024
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: Once again the company has failed to address all of the issues raised in the complaint and I assert that the company is attempting circumvent the BBB complaint. Furthermore, I have yet to hear from anyone in regards to the grievances and or appeals I have filed. I will have no choice but to take legal action.

[Your Answer Here]

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

*************************

Business Response
Date: 06/24/2024
Dear BBB,
We spoke to the member on 5/31/24 in regard to the appeal decision letter. The member was informed of the next step in the appeal process; to file a fair hearing. We followed up with the member and were informed that the fair hearing was already initiated. The member is working with the state on the next steps of the fair hearing process.
Sincerely,
Member Services
Initial Complaint
Date:04/22/2024
Type:Customer Service Issues
Status:
ResolvedMore 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 name is ************************* and I have an active Healthfirst plan Member ID *********. I have been unable to login to my Healthfirst online account since April 2024. When contacting Healthfirst customer service they acknowledged their is an error preventing me from logging into my online account, and advised I would get a call back to fix the issue. However, I have not received a call back. I am requesting contact to help me login to my Healthfirst account.
Customer Answer
Date: 05/03/2024
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
Date:03/13/2024
Type:Product Issues
Status:
ResolvedMore 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 have been trying to speak in regards to my aunt's health for a total of 6 days. I submitted a signed HIPAA form numerous times in order to ***** me the authorization to speak on my aunt's behalf. EVERY TIME THAT I HAVE CALLED HEALTH FIRST, I HAVE TO JUMP THROUGH HOOPS AS THEY INDICATE I AM NOT ON THE SYSTEM AS A RESPONSIBLE PARTY TO SPEAK IN MY AUNTS BEHALF. Regardless of the times I've called and an agent is able to verify the signed HIPAA form and that I am in deed a responsible party, the agents I have spoken to have told me 10x they will write in the NOTES that I am a responsible party. HOWEVER, every time that I call, THE AGENTS CANNOT SEE THE NOTES FROM THE PREVIOUS AGENT. This is extremely negligent and unprofessional!!!!!!!!!!!!
Business Response
Date: 03/14/2024
Dear BBB,
A form was validated today adding ********************************* as members responsible party. We outreached to ******** but her voicemail s full and we cannot leave the message. We outreached the member and let her know that ******** is the responsible party on file.
Sincerely,
Member Services Department
Customer Answer
Date: 03/14/2024
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
Date:03/01/2024
Type:Product 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.
Applied for ********************************* Leaf Plans during December enrollment period, I received a bill from them in the mail on 12/30/23. I tried paying the 1st payment online with the information they gave me on the bill. And it wouldn't accept the payment. So I mailed a check payment to Healthfirst Leaf plans LB 5645 PO Box ***** ************ ** **********, which they received and cashed on 01/03/24 the ****.# on the bill ******. I did not receive a health card, instead I received a letter dated Jan. 12th, 2024, from ***************************** stating "they had not received my first premium payment, 'we've sent several letters but we haven't heard a response" therefore the policy has been canceled, which means that you no longer have Health insurance care coverage from Healthfirst". The statement about sending several letters is a complete lie, how easy that was for her to lie to me, she know that I would not be able to contact them with all their protections set up on line. Now the question is where did my payment go. I called, I waited on hold 20+ minutes before speaking to a human, who could not find the account or my name or any payment, I got no where talking with her. She spoke over me the whole time. I tried again a few days later. waiting on hold 30 min. spoke to someone, went through the same, gave my SS# can't find a payment can't find account, no card no policy, then she tells me she will send a new card and to use ID# *********, after another week goes by and still no card, and now prescriptions are costing me more at the pharmacy, I called again waited 30 min. on hold, spoke to someone, again they have no receipt of payment, no account for *****************************, my check for ****** went to Bonuses for Executives. Not for insurance coverage. The women told me to contact *** health, and see what they could do, the woman from *** health said she would contact, Health first but it may take some time to get a reply, its over 3 weeks and I have not received payment.
Business Response
Date: 03/06/2024
Dear BBB,
This has been resolved. We outreached the member and advised that the payment has been located, the check will be mailed out in 3-4 weeks. We also advised the member that she is enrolled with Healthfirst ******** plan effective 3/1/2024 and provided her with the member ID. Member is satisfied with the outcome.
Sincerely,

Member Services Department
Initial Complaint
Date:02/15/2024
Type:Product 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.
Healthfirst gives incentive rewards when having annual Physicals and other routine exams and procedures. I took the ***** ****** Screening and submitted the rewards form but did NOT receive the $25 gift card as expected. I go through this EVERY year after routine exams and procedures. I want to speak to someone who can help resolve this matter. I spoke with a Supervisor from Healthfirst who placed me on a conference call with Blackhawk ****************** The representative from Blackhawk took my information and told me to give 7-10 business days to receive the card a month ago and I didn't receive the card. Please Help!
Business Response
Date: 02/25/2024
Dear BBB,
We attempted to contact the member numerous times to assist with the inquiry. The member has returned the call on 2/23/24 and was assisted by an agent and connected to our Rewards vendor.
Sincerely,
Member Services
Initial Complaint
Date:01/08/2024
Type:Order 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 signed up for health insurance coverage through the ******** of Health for myself, my husband and my child. My husband and I have coverage through one company and my son has coverage through Healthfirst. i have paid the first premium payment and have been trying to get on their website for weeks. But there is an issue with being able to log on with his date of birth because he is a minor. I have made numerous calls to their customer service to resolve the issue, but they keep giving me the run-around and have told me I need to update my household information with the ******** Marketplace, which I did call them again and confirmed that it is all correct. The issue is with Healthfirst's website. But they refuse or are unable to resolve the issue. So i am unable to go online to find doctors, get information about benefits, make payments or anything else. I have been on the phone with them for no fewer than 5 hours total trying to resolve what is seemingly a simple issue. And no one there is interested to solve the problem despite several "escalations". I need the issue resolved. If it is not resolved by this upcoming week, I will terminate my coverage with them. Please advise on my recourse with them and how to seek remedy. Thank you.
Business Response
Date: 01/09/2024
Dear BBB,
We spoke to the head of household on the member's account and resolved the member portal login issue. The member portal account is active, and the head of household was able to access the account successfully.
Sincerely,
Member Services

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Healthfirst, Inc. is NOT a BBB Accredited Business.