Western Health Advantage - Sacramento, California

Gardenia F.

There is no continuity of care. Western Health Advantage questioned the appropriateness and medical necessity of the medication I have been treated with for past 2 years by my former doctor. So I had to pay out of pocket for my medication myself. Never was able to meet my doctor so I have seen a physicians assistant for every appointment. From the get go they billed me for the month prior to my enrollment. This insurance is a scam. I do not know how they have a contract with covered ca. Thus insurance company is the bottom of the barrel. And if have had any experiences with this company then you know this is true. If you have a choice not to use this insurance do your other option or you will regret it.

Casey

I switched a year ago from Kaiser because of the increased premiums. I am much happier. The care is better and my premium is lower. It's much easier to see a specialist. I have not had any issues with my insurance denying coverage for anything. It has been difficult to find a a primary health care provider in my area but that is happening with every insurance company so I can't fault them for that. The urgent care is great if I need to see a doctor right away. Health care in this country sucks but having experienced coverage with several other companies in the past 10 years, comparatively, Western Health is excellent.

Homeira S.

They didn’t cover even my antibiotics. I was Diagnosed Pneumonia and my Dr priscibed me antibiotics. I was waiting to get it, finally I was aware that the insurance doesn't cover it. No body could believe it. Finally my Dr. Replace it with another one. Therefore I received it after a long time. This already happens two more time. So I change my insurance company and picked Blue Shield for 2025.

Devin G.

Western Health, I am writing to express my extreme dissatisfaction with the level of care, or lack thereof, I have received. I enrolled in your plan with the expectation of timely access to medical services. My initial experience has proven this expectation to be entirely unfounded.

On March 6th, 2025, I contacted your office to schedule a routine appointment. The first available date provided was June 11th, 2025 – over three months in the future. This delay is unacceptable. I am paying for health insurance that, in its current state, is incapable of providing me with timely access to basic medical care. This constitutes a clear failure to fulfill your core obligation to your policyholders.

Furthermore, the process for obtaining necessary lab work is unnecessarily convoluted. Requiring an initial consultation before ordering labs, followed by separate appointments for the tests and results, is inefficient and creates unnecessary delays. This process demonstrates a lack of patient-centered care and a prioritization of administrative procedure over actual medical need.

These issues are not simply inconveniences; they represent a fundamental failure to provide adequate healthcare services. The excessive wait times and inefficient procedures demonstrate a systemic problem that renders your insurance plan effectively useless in providing timely access to healthcare. I expect a prompt resolution to these issues and a clear explanation of how Western Health intends to address these systemic failures to ensure that policyholders receive the care they are paying for.

M B.

I saw the low stars and had to comment- I am on a WHA HMO, it is limited, but I have been able to get referrals outside WHA as needed and things have gone okay with the insurance company. For what it is, we have not had problems with this company- the doctors, wait times, unavailability is another issue, and are not the insurance co's fault.

Keith C.

The worst. Good at collecting your monthly premium but do everything possible to not pay your medical bills and generally screw you over.

Laura N.

Another fail for this insurance company. You mention anything and they file a grievance on your behalf; esp. when it wasn't even asked for. They have next to no physical therapists. They have ONE approved, within 150 mile radius for Fairfield/Vacaville. That one provider does not answer phone calls. You can only leave a message, and they don't return those messages. You call back for assistance, and the reps, "who are empowered to try to resolve the issue (per Sherri - one of the managers), can basically ignore what you are asking for and call your medical group (like you haven't been speaking with them for months to get this resolved already. Absolutely a poor excuse for an insurance company. They network with only large groups and your care is almost non-existent because you are limited where you can be seen. For what they get in premiums, they need to do better because they have mastered being a abysmal where patient services are concerned.

Brianna J.

This insurance company is a mess. I highly recommend you go with a different company if you are able to. We've had them for almost two years and it has been a fight to get basic healthcare. Their favorite term to use is that something isn't "Medically necessary". For example, telling me that a breast pump isn't medically necessary for me after I give birth (it's a legal requirement to provide one) or how my daughter has been seeing a specialist since she was a year old. When we moved here they told us it wasn't "medically necessary" for her to see that specialist even though they had her medical records. So two different doctors in the area rediagnosed her for the sake of this insurance company and they still deemed it as "medically unnecessary". I fought with them for a year and a half before my daughter was able to see the specialist she'd needed to be seeing that entire time. In addition, their billing is often incorrect and requires hours upon hours and multiple calls on the same bill that was supposed to be fixed. Steer clear if you're able to, or be prepared to have to go to many lengths to advocate for you and your family.