Neighborhood Health Plan

I’m dropping NHP asap. It’s enough I keep encountering reputable doctor’s offices that will not accept them because of problems with billing — delays and rejection of bills. It’s enough that I’m nickle and dimed for every ‘extra’ copay. It’s enough that they refused payment for prescription needed to prep for colonoscopy. Really.
Today they rejected MRIs needed for surgical reconstruction of my deformed club foot. I’ve always experienced falls from toe drop, but as I age I don’t bounce so well, and fear the frequent falls and injuries I am experiencing. We went through every level of internal appeal. They consistently suggest first a 6 week program of NSAIDS, RICE, PT, bracing and casting. None of which can possibly correct my toe drop problem, as my doctor confirms. Surgeon asked reconsideration twice, still rejected.
I can go to external appeal through the state of Massachusetts: 4 months. I feel it’s winnable, but we’ve already delayed treatment for over a month with NHP hassles here.
If NHP is all you can afford — you have my sympathy. Don’t expect a high quality of care, don’t expect a concern for your health and safety. I’m switching out.

My employer recently switched us from BCBS to NHP and it’s been a bit of a mixed bag, My primary accepts the insurance but grudgingly, his office HATES NHP so that’s not a great sign. My wife and I have had a few difficulties with prior authorizations but NHP so far has managed to come through in the end. My biggest problem with NHP has been the pharmacy coverage. I have Multiple Sclerosis with profound daily fatigue. the medication requires pre-​authorization. my BCBS insurance had given me lifetime authorization and has been honoring my physician’s prescription in full for a decade. NHP did authorize the medication but only for three years and will only cover HALF of the prescription, I’m prescribed two pills daily, NHP will only cover one. I am very upset that NHP has more control over my medical needs than my doctor. this is disgusting. I’m surprised this is even allowed.

If I could give negative stars I would, this company certainly deserves it. Talk about a horrible business, if that’s what you want to call them, they are almost as bad as the Health Connector! I hope they feel great for what they did to me and the crap I’m still dealing with because of them. I had major shoulder surgery in October and started with my physical therapy in November. I was covered, and I paid for the month of November out of pocket like I did the other months I had them. Well apparently now in February they are denying payment of all of my physical therapy visits for November, saying I didn’t have insurance through them, which I have documentation from them directly stating that I do, and I paid for the month. They have absolutely no idea what they are doing, and they system they use clearly is not good at all. They don’t even have the same information as the Health Connector but they are a subdivision of them?!? How does that work? How do you people feel about doing what you did and causing so much stress to me that I almost had a heart attack, and I’m disabled?!? Fair warning to anyone who is considering getting them, save yourself the hassle and stress and don’t!

Absolutely floored by the wonderful customer service I just received over the phone. Pleasant, polite, professional and I was even wished a happy belated birthday. Thank you!

I strongly do not recommend NHP as an health insurance provider! They treat their members poorly. My family has had nothing but administrative nightmares since we have had the insurance. The latest incident involved increasing my physical therapy co-​pay from $ 35 to $ 60 without notifying me or my provider. The result was nearly $ 500 in unexpected billings. When I called to file a grievance, they denied it without due process or consideration. Other incidents involved our child’s specialty medical provider claims being denied after they were already accepted and confirmed, routine denial service at CVS due to confusion of NHP member numbers that seemingly change every quarter. In addition, when we went on COBRA for a few months but still remained within the NHP network, we were subjected to an endless amount of running around, needless phone calls and paperwork simply to maintain our coverage. My advice if you can afford it is to pay a higher premium and get better service. We have an option to jump ship and get a new insurance provider in the near future and believe me we will be doing that!

AVOID. This insurance DOES NOT care about you.

Call me what you’d like, but I am seriously giving a health insurance company five stars. If you are a prisoner of the Health Connector, NHP is by far the best choice. It is accepted at just about every major hospital, including Mass General, Brigham and Women’s, Tufts, and Beth Israel.
I had NHP for an entire year and utilized it well. Several specialist appointments, a slew of labs, multiple x-​rays, two ultrasounds, a dozen physical therapy sessions, a vision exam, and a tube of Retin-​A Micro Gel that retails for over $ 500. Every time I called with a question, I got an actual human on the other end with minimal effort.
Let me be perfectly clear: I never encountered a single billing or authorization issue. None. Zero. They never once made me want to punch a small child in frustration.
As someone who worked in patient services, I tend to take negative reviews with a grain of salt. Most people know jack shit about their insurance benefits. For all I know, a patient’s ordering provider improperly requested prior authorization for, say, an MRI and that patient ended up with a large bill. Who do they blame? Yep, their insurance company.
Health insurance companies aren’t inherently bad, but you definitely need to cover your own ass. Read up on your benefits for crying out loud. Because when you get that outrageous bill in the mail, you’re the only one who’s going to cry about it. Your doctor and your insurance company won’t give a damn.

I absolutely love them! I have been on Neighborhood Health Plan through years (for a while through Masshealth) and now that I am working full time, though connector care. They have covered my $ 400 a month prescription for years with no problem. I had to get surgery and it was not even an issue. I don’t know what all these people are saying but I have NEVER had one issue with getting things covered.

Absolutely lousy insurance — bad service leading to terrible outcomes. My shoulder injury is so severe I can barely move my arm yet in spite of repeated requests from my orthopedic surgeon they refuse to authorize an MRI (a basic requirement for evaluating suspected tendon tears in the shoulder) for one ridiculous reason or another inspite of having met their protocol requirements leaving me no alternatives except excruciating ongoing pain. Now they have me «appealing» their decision — a month long process. They won’t talk directly to my doctor and evidently make decisions on what is appropriate care based on case «evaluation» by a third party (a sub-​contractor no less) who has never set eyes on or talked to the patient or the doctors involved in the case. Avoid this company and its plans at all costs. I am complaining to the regional insurance authority. NHP are beyond cheap, their service is appalling and their stated mission statement on their website is a farce. Trouble is, I doubt they care enough to do anything about this sorry state of affairs.

I reluctantly applied for insurance through MA Health Connector when neither of my new employers provided enough hours for me to get coverage through their plans. But I have been amazed at how good the Neighborhood Health Plan is. I was able to keep both my PCP and a specialist I have to see twice a year. The paperwork is simpler than either of the two insurers I’ve had in the past 15 years (Blue Cross was one). Unlike either of my prior insurers, NHP has not made any billing errors or surprised me with refusing coverage for something I thought was covered– and I actually do read my policy. And the coverage is better for my purposes; this may not apply to everyone, but I have only had to pay co-​pays so far. No extra lab fees, hospital fees, uncovered meds, or anything else I’ve experienced through other insurers.
Most impressive was what happened a few months ago. I was briefly hospitalized, and a few days after getting home I received a call from NHP. They asked how I was doing, if I had been treated well, if I knew that I had Rx coverage, etc. Then he gave me a phone number and told me to call if I need anything!
It’s dirt cheap. That’s, of course, the point. But if I could afford to pay more for Neighborhood Health Plan, I would.

same dr, hosp, ded for ½ of BCBS. A no brainer in this regulated industry.

A Useless website, filled with outdated and incorrect info and a search that you can’t use. CS reps who are clueless and equally useless. The company is terrible. Avoid if you can

Very limited options outside of greater Boston.
This plan is offered at work and many staf live in the Merrimack Valley & NH and that area has very litle PCP or Dr’s offered in the network.
I have found poor customer service, wesbite to have incorrect info, and good luck trying to get a real life person to talk too.

NHP Insurance Coverage began 1 Jan 2012
Now 17 Jan 2012 no insurance card received
Emailed NHP asked when card could be expected 4 encrypted emails later I finally got an answer that it could take up to 3 weeks.
Went to CVS with my Group # Member ID # to get a prescription refilled. After 1.5 hours on the phone the Pharmacist gave up and gave me a discount. A 15 day supply cost me $ 12 more than I had been paying when I had UHC insurance. They told the pharmacist that I needed prior approval to get this medication that I have been taking for the past two years. It is not some exotic drug it is a generic. So far my experience with NHP has been terrible and going down hill. I hope the hell I never have a serious claim.

These folks deliver everything one can expect from a medical plan without a hassel and on time.

As a graduate student and contracted employee my employer doesn’t offer me health insurance. I bought NHP through Commonwealth Choice. (the ‘clearinghouse’ if you will for individuals buying their health insurance.) I had been with them over a year when I switched my plan. I asked about my automatic billing, which I was assured wouldn’t be changed. Lo and behold they canceled by automatic billing, then my policy for non payment — after 1 month! I never got a notice or a phone call to notify me that my coverage was cancelled. This was back in March, and I’m not allowed to buy new insurance until August 1. This is supposed to be the safety net to make sure everyone has insurance? Now I’m going to be penalized on my taxes because of their clerical error, not to mention risk going without insurance for5 months.

I don’t recommend this for anyone buying an individual plan. It is impossible to talk to someone who knows anything — even though they’re as friendly as can be — and their billing is totally disorganized. I’d recommend paying extra for a health insurer that causes fewer headaches.