The deluxe rider is a $40 a month optional vision / hearing and dental rider. The medical card I received has the Deluxe Rider added on to the end of the plan name. The printed information states nothing about this plan being administered by any other insurance company. The only number on the card is the one for Secure Horizons. AFTER checking with my vision providor, and being told they accept Secure Horizons, the calim was turned in and refused by Secure Horizons, because it must go to another insurance company (the one who administers the vision plan). Only it is a company not named in any literature, and one the doctor's office never heard of and does not belong to. Now the $400 bill I have has been refused, because according to Secure Horizons "they" don't cover vision and the providor must file the claim with another insurance company - under a Secure Horizons Member Number. BE WARNED - THE DELUXE RIDER IS A SCAM SOLD UNDER MISLEADING AND FALSE REPRESENTATION BY SECURE HORIZONS! Don't get taken by this company - find some other medicare advantage plan!
The complaint has been investigated and resolved to the customer’s satisfaction.
I signed up for the deluxe rider. When I recieved my "new" id card, it did not have the rider listed. I called and secure horizons said it was an error and I will be sent a new card. Re. the rider: I called secure horizons twice and on the second call I was given the website : www. optumhealth.com I tried to sign in but it said I was not a member although they cashed my first check for $39.00. I was however, able to get into the provider directory (under solutions heading) for Vision and dental. There was not a word about hearing. I think it is a case of deceptive advertising but it due to poor management and lack of effective organization and and training and poor business practices. For info:
OptumHealth
6300 Olson Memorial Hwy.
Golden Valley, MN 55427
Phone
[protected]
Further info on the Deluxe Rider:
Vision Care providers can be found on www.optumhealth.com website. Also [protected] for further info.
Dental care providers are also listed on the optumhealth website.
Hearing is totally different: it is provided through EPIC www.epichearing.com which contains little info. Call [protected] for more info and local providers.
No, they didn't volunteer this info. I had to dig it out.
I went to the OptumHealth website and had absolutely no trouble in creating a user account which I can now log into, find a provider and also the total costs for any and all services.
Try www.optumhealth.com, then click SOLUTIONS. DENTAL next you must create an account using your UHC membership number. After you've logged in you can switch back and forth between vision and dental to find providers.
This happened to me today in South Bend Ind (Aspen Dental) (One of many dentists AARP supposedly works with) as i was getting my teeth looked at.
The dentist office could not find who or where the claim was suppose to go after finding out the services are sub contracted out to other providers byAARP. Therefore i was refused serviced that the deluxe rider was suppose to cover.
Why sell coverage if nobody accepts it?
I have had Deluxe Rider about 3 yrs and got it when Newport Audiology was a provider. Secure Horizons claims and payments at that time were sent to Arkansas. The next time I used it was dental and had no problem submitting and receiving a small portion of money as reimbursement. Several items were refused due to price, required more info or not covered. In 2009 I had extensive dental work done in the amount of over $1100 and in less than 4 weeks the permanent bridge detached. It was unable to be reattached due to bone loss and weak teeth that it had been attached to. Had the dentist told me that I would have gone a different process. Dentist then suggested a larger bridge covering 10-11 teeth including all my front teeth that would require almost all my teeth extracted except for a bridge on the left and 2 teeth (one on each side in back that were both root canal and crowns many years ago. I went to several other dentist for recommendation and prices and finally had a complete upper denture in September 2010. I had submitted the 2009 claim in enough time for processing and each time I called SH and connected me to check on it and dental said it was not received, not in system, give it more time, maybe incorrect (but they don't notify you of required corrections) etc.
Finally after many mailings and attempts to correct and close to cut off time I sent the claim in requesting return receipt. It was received and it was denied due to PAST THE DATE. I filed 2 appeals and grievances to no avail so lost reimbursement on my portion due which I really needed for next step involving a full upper denture. I submitted that claim through a lady at the Grievance area and seems it was never received or in system. I called her and when she checked on it a portion of the amounts were processed. They had codes showing various reasons rejected: involving more information, narratives, x-rays, not within price range so all those were denied. I have now resent those with required information this week for payment hopefully and return receipt required. In the 2011 "PROVIDER DIRECTORY" is the very first time I have seen any list of dentist to use. Prior to this I was told use any dentist and submit claim for reimbursement to you. I thought I was purchasing the Deluxe Rider from Secure Horizons and didn't realize it was not a part of them but it has been a real hassle dealing with them and getting ANY reimbursement. I am 70 and spent a lot of time and postage trying to obtain what was due me and still not all of it! How many other SENIORS just give up? I almost did but I have paid my premium all these months/years and felt I wasn't going to give up. When the 2nd denial that went to grievance was denied they sent it to MAXIMUS (a federal agency) that works with Medicare Claims. They too denied and closed due to the fact no monies owed to the facility (which I paid for before submitting information on Deluxe Rider). I feel they gave me a run around to not pay any on the amount of $1100 items for a potion reimbursement. Once I get this all completed I intend to check elsewhere for dental and supplemental insurance plan and tell everyone I know the problems I have incurred since United Healthcare has taken over. I still don't know if it is SH, AARP. Optimum, United or exactly who has the rider and apparently neither does Customer Service that I have spoken with all they do is connect me to another number. Also I couldn't explain to anyone processing claim that it reimbursement to me and not dentist as they even came back to say the bill was paid! Also they had me go online and do a dental form and include my ORIGINAL receipt with member number top/bottom/both sides should item become detached. They would not take it on walkout statement I provided with all the information they required and a copy of paid receipt. I was to get all kind of numbers for dentist such as SSN, Dental/Tax Payer ID and some I never had been requested but all of what they needed was on my walkout statement! All I can say to YOU ... THINK VERY CAREFULLY BEFORE YOU PURCHASE THIS HORRIBLE INSURANCE!
I took out the deluxe rider, and paid straight from my checking account every month, after 10 months of paying for the rider, I went to the dentist for a teeth cleaning, the dentist called Medicare Complete, they told the dentist I was not covered by the Deluxe Rider, I contacted Medicare Complete after 2 days they finally found the payments I made, and said they will pay the Dentist, after 2 months they finally paid 100.00 to the dentist, after all the problems and how much I was paying for the rider I decided to cancel and just pay for Eye Doctors and Dentist myself, just 30 days later I received a letter from the dentist, that The Deluxe Rider was demanding the 100.00 be returned to them, I was shocked to say the least. The Deluxe Rider paid Nothing and is still sending me a bill for 39.00. What a Racket. WARNING MEDICARE COMPLETE AND THEIR DELUXE RIDER IS A SCAM>