Very difficult. People are always pleasant and try to be helpful but rarely can I get through on the phone without a wait longer than an hour. We usually plan to be on the speaker phone for about an hour and a half before connecting. They are terribly inconsistent about what is covered and what is not - if you call three times you will get three different answers.
Most importantly - DO NOT USE THIS INSURANCE IF YOU TRAVEL OR LIVE OUT OF STATE. They are completely useless in that regard. I have spent thousands because doctors charge me out of frustration or because we are told it is covered and later told it isn't. I would never use this if I had another option.