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I was a member of PJP Health Agency. I had an insurance policy before but I gave it up. Since they represent self-employed persons alledgedly, they have extra benefits that I thought would be useful.
I think I paid somewhere in the area of $200 to $300 a month for a single person, age 35-40, non-smoker, and living in New York.
At any rate, when I actually USED any service I always had to pay the vast majority of the bill! I'd get a lab test done that cost $90 and they would pay something like $7 of it. I'd have a doctor's visit for $125 and they'd pay something like $14 of it. It was ridiculous. A total waste of money.
It wasn't really an "insurance" plan so much as a "discount" plan. Nothing at all like any other plan I've been on. I would highly recommend you get a real schedule of service with real dollars for various types of tests that they will pay and compare it with the same from another carrier.
Aside from all this, it was presented to me as an association for self-employed which also just happened to provide a health plan. In reality they are just insurance salesmen, not looking out for the welfare of their customers as self-employed. Just abusing that perspective to sell insurance.
This is a company that sells medical discount plans.
I needed coverage as a full time student, so I went online an I was contacted by a repesenative of PJP Health Agency. Not only is the plan cheap, but it covers NOTHING. Knowing it covers next to nothing, I called the company in August 2010 to ensure that a "well-woman" exam was covered under my plan. I was informed it was, so I saw my doctor for the first time in 3 years.
After the visit, I received a prescription I needed to take, which, come to find out, ARE not covered. So, as a full time student, living on my own, I am paying full price for prescriptions. Fine, no big deal. About 4 weeks later, I got a bill from my doctor saying that PJP Health Agency was refusing to cover that bill because it JUST SO HAPPENED on that day that I went to see my doctor, my insurance plan was invalid. I was not covered. So, after some debate, they decided to pay it.
Last week, I received the SAME bill from my doctor, saying PJP Health Agency again refused to cover the bill. This time, their reasoning was that my exam is not covered under my plan. I find this comical because I CALLED TO RECEIVE ORAL CONSENT TO SEE MY DOCTOR. THE INSURANCE REP TOLD ME IT WAS COVERED. And now all of a sudden it is not. With numerous phone calls between PJP Health Agency and my doctor, it has been determined that PJP Health Agency just does not want to pay. The rep I spoke with first said the visit wasn't covered, but then 15 minutes later he said it was indeed covered, but he didn't know what to do. I demanded to quit my plan and get my refund check, but he said I had to cancel my plan within 31 days of signing up. That too is hilarious because another representative told me my plan was not activated for the first 30 days, so essentially after those 30 initiative days, I had ONE day to decide if I liked my health insurance coverage or not. I could not use my plan for the first 30 days, so how in the world was I suppose to know if I wanted to be under their insurance if I wasn't allowed to use it?? To me, it's a complete scam ripping off college students.
I asked PJP Health Agency what they covered and they said accidents and sicknesses. Well, if I'm sick, I can't get prescriptions to be healed because they don't cover prescriptions, so really, WHAT THE HECK AM I PAYING FOR?? I was ripped off by PJP Health Agency and I'm mad at myself because I believed all the lies the agent told me.
This company is a fraud and a ripoff. Beware of them.