Oregon’s Health CO-OP

I was one of the first and very enthusiastic members of the COOP and have referred many of my friends and practitioners to them. My current recommendation is to stay far away from the COOP and move to another insurance company as soon as you can. They began with great integrity, but sadly, they’ve lost their way. I had a preventative colonoscopy screening done, which according to my member handbook should be at no cost to me, but they are charging me (about $ 1500) because I had polyps removed during the screening. I have already spoken to a lawyer and it is against the law what they are doing. I have the law in writing which says that according to the affordable care act, even if they remove polyps during a screening, it is still to be paid out as a preventative screening. I am now taking this up with a lawyer to pursue it further. I have also informed my agent about the COOP’s practices and have recommended her to not send any more clients their way. I will not be deceived or lied to by a company I pay almost $ 500 a month.

Having the same billing problems as everyone else. I paid every month, then I get a cancellation notice. They say I didn’t pay on time, but I paid online and their own payment history system shows I paid on time… They still tried to make it sound like my problem and to get reinstated I would have to pay current plus an extra month??? I tried paying online and now I can’t because my «insurance has termed». They’re only open M-​F so I have trouble waiting on hold during my lunch break to get through! I asked if they were going to send me a reinstatement letter and they said, «why would you need that in writing, we’re talking on the phone…» Why would I need an important document in writing??? An insurance company that doesn’t see the need to send out documents??? Just take the customer service persons word fort it??? Thank God I’m healthy and don’t need continuing care, but what would I be in for if I needed emergency care??? Just tell the ER staff… No really… I have insurance… The nice lady said I did on the phone???

One star for attempting to start a local cooperative and another for friendly customer service. The big issue we had is that every payment we submitted, though clearly shown as deposited by our bank account, never seemed to register in our OHC account. –Meaning every new billing period we had to call snd contest EVERY bill, demonstrating that our account was always paid in full. Regardless, the letters in big bold, red writing that we were in danger of loosing our coverage kept coming. Life is complicated enough! Canceled after 5 months.

DO NOT JOIN! You will be treated horribly. You cannot count on this insurance company at all. Customer service will listen helplessly to your problems, then do nothing to resolve them.
Oregon Health Co-​Op is a nightmare! Like other reviewers, I wish there were a way to give this company zero stars. The billing department is the worst billing department of any company I’ve ever experienced.
Pure nightmare.
DO NOT JOIN!

These guys do the right things by their members. I had a select plan but didn’t understand… When I got a bill from my doctor that said I owed more than my copay, I called Oregon health coop and said I didn’t understand… They explained who I could go to and then they paid my doc so I only had to pay my copay. I definitely will stay with a company that listens and makes exceptions for my mistakes.

Absolutely horrible company, very disorganized, no follow-​through. It’s gotta be a Ponzi scheme, they don’t pay claims and continue to charge their subscribers premiums despite canceling plans. Insane. Can’t believe this place hasn’t been shut down by the insurance commission! Customer service is clueless, staff turnover even at the highest level is frequent, so one you get to speak with someone who can help, they are gone the next time you follow up!

RUN!!! RUN FAR AWAY FROM THIS SCAM OF AN INSURANCE COMPANY!
I was really excited about Oregon Health Co-​Op but that is no longer the case. They canceled mine and my husband’s policies over the summer without notifying us, I only found out when I went to the doctors in October and they couldn’t find me in the system, not because I was canceled but because on top of canceling us they had my information incorrect.
We were canceled in June but they continued taking money from our account until I found out what was going on in October. We should be refunded for 4 months total but they are stating that our account is zeroed out and they have paid us what they owe. They did make a refund of a little under $ 1000 but that didn’t even equal two months of payments, I have no idea where they even came up with that refund amount. We are owed at least another $ 1000+ and we’ve been going back and forth with customer service for over a month now.
The reason we were canceled was because a service rep set up our autopayment for the 15^th of the month instead of the 1^st, so every payment from then on was past due without our knowledge. It seems unreasonable to cancel us for their error.
When you call customer service, don’t think that you are going to be talking to a rep that has any knowledge of the co-​op or your account. It was obvious to me that they outsource customer service to a third party company and the employees are poorly trained. If you ask to speak to a manager they will not put one on the phone, most likely since it’s hard to talk to a manager that doesn’t exist.
Every month when they deducted money from my account I was sent a receipt with a reference number confirming payment. The service rep told me that the reference numbers confirming payment essentially meant nothing and she couldn’t find any record of my payments. She wanted me to send in my bank statements for those months for them to look over. I’m definitely hesitant to hand over all of that information to a company that I do not trust so that seems like a last resort to me. After several more phone calls I got ahold of someone that could look up our reference numbers and she did admit that she saw all of the extra payments. I asked her why we would be canceled but have money continuously pulled out and she said that the company sometimes cancels but then doesn’t update the payment options. That seems pretty illegal to me.
I’ve already wasted at least 20+ hours trying to track down the money owed. I feel they are giving me the runaround and hoping that I’ll eventually give up. I will not.

This company is a serious cluster$#$*. I just received confirmation from the State Department of Insurance that my complaint has been received and I urge others to reach out and complain as well.
Their absolute disaster of a billing system and inept customer service representatives (a third-​party administration company based in Texas) has nearly destroyed my credit and has threatened my family’s ability to purchase a home in the future. I have spent more than 40 HOURS on the phone with the insurance representatives, my health providers’ billing departments, Providence Hospital, and various labs/​radiology departments trying to keep them from sending us to collections.
I called prior to signing up to make sure my current physician was covered under the Silver Select Plan and was assured that he was. So we signed up for the plan. We received our welcome packet and cards with a random physician selected (not even the same one for both of us). So, I called again and made sure my physician was covered under the Silver Select plan and was assured he was and they changed our primary care physicians to our prior physician. Everything seemed fine.
We made our premium payments on time. Come April, we received a letter stating that our balance was past due. I called and the rep said they’d fix it, no big deal. Come May, I get another letter stating that we were now three months past due, although I had made timely payments. I once again called and was assured everything was fine. Come June I get yet another letter, now stating that my coverage would be terminated effective June 1 if I didn’t pay my (already paid) March through May premiums. At this point I was going through a lot of health issues and this really angered me. I called and spoke with a representative who stated that although it showed I was current in the system, it ALSO showed I was in arrears as of March 30^th and that they «couldn’t find» my payments. She actually stated the burden of proof was on me to show I had paid my bills! Luckily, I don’t trust any insurer and had made PDF copies of my receipts, which I had to email to OHCO in order for them not to cancel my policy! The rep went so far as to say I shouldn’t worried if it did get canceled because they would pro-​rate it backwards. WTH?!? Oh, that’s a ton of comfort.

Poor Ophelia!!! I mean is there anyone else who answers the customer service line? Cheesh. Look at how many people have ALL spoken with Ophelia about their sob stories. Well I had a sob story too. Ophelia helped me, then Teresa.
Yeah I was kinda pissed at the lack of experience on the part of the customer service people, then I found out that OHCOOP was basically a start-​up company and was still learning the ropes. So I took this into consideration. I took my problem to the member forum that OHCOOP provided. It was close to where I live, so it was convenient, and I got my answers there.
The member forum was really inspiring. You could tell that they didn’t have all the answers. But they had like their top 5 people there, the CEO, etc. That was cool. I got a good feeling after talking with them. They are willing to listen to and address any issues from any of their customers any time.
Pretty cool. I could tell all those involved with me from OHCOOP were all truly trying to help me out from the get-​go.
Okay. So I’ve read all the reviews which basically summarize to: «I wish I could like this company» or «They look so good on paper» well I like this company and they not only look good on paper, they do good. I have the opportunity to choose a new insurance company right now but I am going to stay with OHCOOP. I believe if we all help each other as in the idea of a cooperative, we all have a better chance at realizing our goals.

If anyone directs you to Ophelia (manager), ask for someone else. She’s been handling my case in which I’m simply owed $ 200 and has yet to return a single one of my dozens of phone calls. Not a single one. Customer service is an abomination in general though.
«Can I speak to a manager?»
«They’re in a meeting right now»
«All of them?»
«Yes»
x5
Update: they failed so poorly that they agreed to part ways with me at no cost and waved my last two bills.

I have been a member of this coop and so far have loved it. I get the kind of care I need without some HMO getting in the way. I also believe in supporting nonprofit health care as part of cooperative. Health insurance companies are some of the highest profit margins and it really makes you wonder how many members they had to screw over and how bad in order to make murderous profits. A new coop that’s just getting started and is underfunded is going to have hiccups. Stay with it and we will all benefit from personalized, humane and affordable health care for all.

Oregon’s Health Co-​op made a HUGE mistake in January 2015. They told a provider that all services at their clinic were 100% covered for me. Turns out that NOTHING was covered. Even worse, OHC made this same mistake for EVERYONE in their Select Network. Now they are reprocessing the claims and say that they will cover what they originally said they would. So far nothing has changed. I was instructed to send an appeal to the Oregon Health Co-​op Appeals Coordinator, I did and I never heard back. 3 months later I called and asked to speak to the Appeals Coordinator and was told that there is no one that I could speak to, all appeals must be handled through email or mail.
Also, there are NO providers in the Portland area covered by their Select Plan! Every single provider I see is out of network!
This is the worst insurance policy and the worst insurance company I have ever dealt with. Do not waste your money.

Like many other reviewers here, I signed up with Oregon’s Health Co-​op because I believe in the idea of non-​profit insurance and assumed I’d get better coverage and service. And like most others, my experience sadly proves otherwise. I am now disputing $ 1,000 in erroneous out-​of-​network charges and counting the days until I can switch to another insurance provider.
I signed up for the Simple Gold Select plan in December 2014. Before making an appointment for physical therapy in January, I called the PT clinic to make sure they are in network with my OH Co-​op plan, and they confirmed that they are. In March, before my primary care provider made a referral for me for lab work, she called to make sure that one of the largest imaging labs in the area was in my insurance network, and the lab also confirmed they are.
In May, I discovered that I was charged out-​of-​network rates for the lab. I first called OH Co-​op, and I finally got through to a supervisor who checked her database and assured me that the lab was in network. In June, when I got a bill for out-​of-​network charges from the lab, the representative at the billing department told me she thought there was an error because she was sure that the lab was in network. She called the insurance company to investigate and was told that the lab is part of the Broad network, not the Select network, and that previous OH Co-​op representatives had misinformed the lab about its network status. Despite admitting its mistake, the insurance company refused to correct the out-​of-​network charges.
The same thing happened with the physical therapy clinic. In January, the PT received verbal authorization to implement my treatment plan, and I received written notification from the insurance company. When I called the PT clinic, the billing representative told me that that OH Co-​op admitted their error, a full six months after I started receiving treatment, but they were unwilling to adjust the charges.
More than a month ago I filed an appeal to dispute these erroneous charges and am still waiting to hear back. Meanwhile the billing representative at the lab assured me that they will not penalize me because they have a number of other patients with OH Co-​op insurance who are in the same boat.

This place is a class-​action lawsuit waiting to happen. First issue: I signed up for the silver select plan during open enrollment in 2015. The first thing they did was make a giant mistake on billing. I paid our initial bill the beginning of January to activate our account, and then at the end of January I paid the bill for February 1^st manually. While I was in the system, I signed up for direct debit, at which time they charged me again, thus double charging me for the month of February. When I noticed the double charge on my bank account I called and was told that I could have the payment applied to my March payment, which I agreed to (and now regret agreeing to). Come March 1^st, they auto-​debited my account again and did not apply the credit, such that by March 1^st I had paid for 4 months worth of insurance, not 3. Finally I canceled the auto debit and gave them an earful to get the credit applied.
Second issue: When it came time to find a doctor for my annual exam I was referred by a friend to OHSU, which is renowned for accepting a wide range of health insurance companies. So I searched the Oregon Health Co-​op website and did see OHSU listed as a covered location. Then today when I searched for OHSU again I could not find it on the website and so I called Oregon Health Co-​op to confirm that I could go to the OHSU Richmond clinic and they told me that OHSU is not covered at all under the select network. I then asked them to help me find a covered gynecologist in the Portland area and they listed one name in Hood River, one name in Silverton Oregon, and one name at the Adventist health care center in deep SE Portland. Despite my qualms about getting health care provided by a hospital whose mission statement states «in partnership with God», I decided to make an appointment at the Women’s Health Care Clinic at Adventist. So I called the clinic and the receptionist had to transfer me to her manager to confirm that they excepted Oregon Health Co-​op and she stated that they were made aware that Oregon Health Co-​op has a shortage of providers in the Portland area and thought they were in the process of being contracted as a covered provider, but where were not finalized yet. She encouraged me to confirm with the insurance company and get a reference number and name because she had already experienced two patients using Oregon Health Co-​op; one claim was accepted and the other rejected.
I called Oregon Health Co-​op again and when I asked the person to confirm the name of the physician that they had already recommended, she could not find the physician’s name in their system, and when I said that they had themselves told me that name a few minutes prior, she said that if the location was being contracted, and had not been finalized they could not guarantee coverage. So I asked her to provide the name of ANY gynecologist in the Portland Metro area who could give me my annual, and she provided a different name at the same location at which time she asked me to hold so she could search the original name I had given again, and this time saw that gynecologist’s name listed as covered. I guess I will keep my appointment for next month and cross my fingers reference number in hand, hoping that I will not have to pay for the visit out of pocket. What a disappointment to spend hundreds of dollars on health insurance only to be referred to a Christian-​based facility or a facility 1 – 2 hours out of town. All of the comments above about the website are absolutely true as well. It is infuriating. I wish I did not signed up for health care at all. I would’ve preferred to just go to Planned Parenthood paid out-​of-​pocket for service there, since the rep on the phone also informed me that Planned Parenthood is not covered either.
Oregon Health Co-​op is an interesting name, since they’re out of Corpus Christi Texas. Scam!

I’m in love with the coop on paper; in reality I’m beginning to get the sinking feeling I’ve participated in something illegal. Are these guys a money laundering operation? I mean weird charges, all paid, but reported; exams I never had etc, impossibly nonsensical phone conversations. Really, are theses guys ripping off the gov’t or something? I sincerely hope they really are just new to this…
All that icky out of the way, I did receive healthcare so even if it smells a bit you will get «what you need» (lol) from these guys.

It’s been a tough year for this company, they went from really small to really big. I can’t say outsourcing has gone well; but I’ve spoken with them and they’re working on shifting it. If you need help get a hold of someone local. By far they’re an insurance company that holds the values most of us hold– patient care focused, simple and straightforward copays. I think of we stick with them things will get better.

Barely one star, I think their heart is in the right place but if their heart has a problem, I hope they have someone else as their insurer!
The website interface is a disaster. You would think there might be a spot to pay your bill when you sign in to the system, but you would be wrong. Sadly, I go through the same steps trying to figure out where to pay the bill and if they think I owe something. Their websites and associated pages are a tangled web of signing on giving different bits of information on every page in hope that you will crack the code into getting in to just pay your bill. Maybe FAQ page would give you a clue how to find it? Nope, for some reason on my Mac it doesn’t show any FAQs! Really, nobody had a question?
If you do eventually find and break the code into paying your bill and would like to complain to them about the site and help them improve, don’t go looking for a «contact us» button because the only thing you might find is a phone number that will be useless.
Frustrating that the only way to vent is on pages like this that they will never read. At least if you are reading this and are debating whether to sign up with them, this may save you. Don’t sign with them, go with an established company until this one gets its act together.

zero stars, do not believe the «different type of insurance company» stuff they tout. They’re exactly like the rest. Rude, unhelpful customer service, which ive just learned is not even part of the oregon health coop, its a separate customer service company apparently and can do nothing for you.
When i cancelled my membership i had forgotten to remove the autopay, which should stop when an account is canceled, you cant auto pay nothing.
anyway, 3 phone calls and over a month later i have no refund and it took 2 calls weeks apart to finally have the insurnce cancelled. At this point they cannot tell me the status of my refund. So basically as of now theyve stolen my money.
STEER CLEAR!!!

Ok I’m leaving a second review. By all means, please find a plan with another insurance company. While I love what they stand for and my plan works for me, their online systems are abysmal and no calls are ever returned, emails answered, or phone appointments kept when I schedule a call online. They have 2 online systems to log in depending on if you want to pay a bill or look at your account, plan and provider visit history. Payment history is on one system, and making a payment is on another. They don’t post invoices, only a table with your amount paid and the amount by the government. The system always says I pay by check, when I pay by Visa debit card. It’s as though I enter my CC and someone on the other end keys it in manually and goes to a notebook to mark off that I paid for the month.
I just received a letter today saying they are canceling my coverage due to non-​payment as far back as 2 months!!! My bank statement says otherwise, as do the receipts I make a screenshot of because there’s no downloadable PDF or other way to print receipts. Even the table on my billing history says I have paid up! I am rarely late with a payment anyways. Recently, they finally started listing the transaction number in an email confirming my payment. They never did until this month. Again, I love what they stand for, but if you want to spend hours dealing with every little problem that arises — like not covering Rx’s listed in their own formulary (I spent 7 – 8 hours on this ordeal; see previous post), or being threatened with policy cancellation because they keep records on stone tablets and communicate with homing pigeons — then go for it!

Like others so far, I WANT to love this company. I do believe they’re trying to create an insurance model that’s better than the others and, in fact, their plans *are* better in many ways, but their implementation, web UX and customer relations are SO bad, I cannot help but give them a bad review. It’s frustrating because I want them to do so much better.
My troubles started when I booked one of their plans on
. I was instructed wait for communication from OHCOOP for the next steps. After nearly a month, I’d received nothing, so decided to call customer service.
The kind woman on the phone explained that she didn’t know communication had been delayed, but advised that she had found a very similar plan to the one I selected and that, if I wanted to, I could choose that one instead.
«Of course,» I said. And this is where the problems begin.
Turns out, rather than dropping the plan I’d selected and starting the new one, she started *both* of them.
No problem, honest mistake. But, because of their incredibly slow «official» communication, I didn’t even know this had happened until they had invoiced me twice for each plan!
Fixing this issue (to date, it is *still* not fixed) so far has required more than 3 hours on the phone with one agent or another. That’s not 3 hours of conversation, of course, because my average wait time just to talk to someone is nearly 30 min.
The front line staff is very apologetic, but frustratingly unequipped to actually fix anything.
This is all added to the fact that their website/​database is constantly breaking – probably because they’re trying to use the cheapest out of box solutions to run the whole company (I believe I have 3 different logins to manage different pieces of the account) and the stress of managing my insurance policy is probably going to require it’s own Dr. visit. Ugh!
Please, OHCOOP. Get your act together. I’m rooting for you, but you’re failing miserably.