Consumer Complaints and Reviews
I became a member of AARP's United Healthcare Supplement F on 7/1/13. I have found that over the course of time whenever tests are ordered by my physicians, it seems to take at least 2 weeks or more to get prior authorizations. On 5/5/17, my Cardiologist ordered a ** Stress Echo as I have severe cardiac issues, and as of today, 5/12/17 no approval has been received by my doctor's office. In fact, they were sending another notice to find out what the delay is with getting this approval.
These kinds of delays have happened many times before this. Prior to this Supplement F, I always had Medicare Advantage Plans which only took 2-3 days to approve. I am paying almost $170/mo for this coverage (far more than with any Medicare Advantage Plans), and this is the kind of service I am getting. These tests are all Medicare approved, so why is it taking so long to get approvals to have these vital tests done?? Maybe you are hoping that the patient dies before the tests are approved!! It is ridiculous to have to wait so long to get prior authorizations. What's the problem?? I am very frustrated over the kind of service I am, and have been getting from United Healthcare!!
Website for: myAARPmedicare.com DOES NOT FUNCTION. I was encouraged to sign up for electronic communications and receipt of EOBs. Yet, when I logged into the above website using either Safari, Firefox, Chrome or Internet Explorer and try to view EOBs (or view information about my benefits) I get a "white screen." I called a "web specialist" and they said they are aware that the website has a problem and know about the white screen and have been trying to fix it for a "long time" and are getting similar complaints from others who are unable to access information on their site. I was told that they currently ONLY support browser version which are 5 years old (REALLY!) and do not support updated software.
I am told that I can not request paper versions of my EOBs because that must be done on the website. [But, I get a white screen and can not use the website. Oh, sorry!!! ] This situation is not acceptable. AARP/United Health Care is willing take my premiums but don't prioritize providing information to me after they get my funds!!!!! Arrrrgh! AARP should threaten to withdraw their trademark naming until UHC provides an acceptable service. Shame on United Health Care and AARP.
I called the 800 number which was on the letter I received from AARP-UHC dated 03-07-17 stating a claim had been denied by my supplement policy because I had Medicare Complete. I evidently must have signed up for this program over the phone. I get my care at the VA along with my meds. I have had the supplement policy for 4-5 years now and have been very happy with the coverage and payment of claims. I simply want to cancel the Medicare Complete policy. I have spent an hour on the phone going through a myriad of phone prompts that got me to the wrong department.
I talked to three representatives who all said they could not cancel my policy. I kept asking for a supervisor but never was connected to anyone with the authority to cancel this policy. They signed me up over the phone and I can't understand why they can't cancel me over the phone. This surely cannot be as difficult to accomplish as they are making it. Is there a Veteran's representative that I can contact to get this situation taken care of? After being on hold several times, being transferred several times I am really upset that a health insurance company is causing my blood pressure to rise.
I am a writer, and I have written a blog about my experience with AARP Medicare Complete HMO - it is below: I usually like to write about things I know about, but today isn’t one of those days. I am a moron when it comes to insurance, and I really don’t care to learn more about it. But, in order to get by in life without major headaches, we really do need to have a basic knowledge of insurance. Otherwise, you may get into a mess just like the one I am in right now.
Since 2014, I’ve had Medicare for my insurance because I am on disability for complex spinal problems. I usually buy additional Part D coverage for my prescriptions. But last year, I had particularly high medical bills, so I looked for secondary coverage to help cover expenses this year. I looked up plans available in my area, and during my research, I came across the AARP Medicare Complete HMO.
This plan sounded great! For just $89 per month, there are no co-pays for visits to your primary care physician and $25 co-pays for visits to specialist. In addition this plan has some dental and hearing coverage which I need. Prescription coverage was good for me too as it covered most of my medications. I was so happy when I signed up and breathed a sigh of relief thinking that my coverage was very much improved.
That feeling of confidence quickly faded into nothingness this week. I have had problems with my right knee for years, but this past weekend, I injured it somehow which led to searing pain in the front of my kneecap. I was barely able to walk. Stairs were particularly hard – I had to take them one stair at a time without bending my hurt knee. A day after the injury, I was unable to fully straighten my knee, and any attempt to bend it resulted in severe pain. I put ice on it and rested for about 1 1/2 days, and the symptoms improved, but the pain never fully went away.
This week, I made an appointment to see an orthopedic surgeon, Dr. **. I had seen him several times in the past about my hip and knee. He had even x-ray'd my knee previously and determined that I had chondromalacia in my right knee. Yesterday, I went to his office only to find out that since I was now in a HMO, I had to have a referral before I could see him. Ugh.
This morning, I had an appointment to see my primary care doctor, Dr. **. When I explained to her that I needed a referral, she looked confused. “But I thought you were on Medicare,” she said. I replied, “Yes, but I got additional insurance this year. It’s a HMO, and I guess I now need referrals to see specialists.” She looked confused and then told me that her office may not accept this new insurance. I was stunned. She left to check it out and came back without any further information. The billing manager for the office wasn’t there today, and she really couldn’t tell me if they would accept the new insurance or not, and she wasn’t sure if she could give the referral.
I went straight home, really angry and irritated by what I had just learned about this new insurance. Honestly, I have no idea how all this works. I don’t know all the specifics of how HMOs are run. I called United Healthcare and told the young lady on the other end of the phone that I was confused and irritated that I had been to two doctors, both of which could not treat my knee because of insurance issues. She explained that I still have Medicare, but it’s now all under United Healthcare. I’m still not exactly sure how it all works, but I did learn that I can’t go to any specialists without a referral. Everything has to go through a primary care doctor when insurance is a HMO.
At one point, she offered to give me a one-time referral while everything was being looked at regarding my primary care doctor. Well, it turns out that Dr. ** isn’t a preferred provider, so United Healthcare could not give a referral to that doctor. OK, so now my patience was running quite thin. Then I asked her to check and see if my spinal surgeon, Dr. **, was a preferred provider. This was of utmost importance to me as I had absolutely no intention of leaving him. After two failed spinal fusions, Dr. ** was able to successfully fuse my spine in 2012. He had been my trusted spinal doctor since that time, and I will not go to anyone else.
Well, it turns out that Dr. ** wasn’t a preferred provider either!! At that point, she said that one of the options was to discontinue this AARP plan and go back to original Medicare. I was confused… I thought we could only change plans during the open season (Oct – Dec). She said that I could still change it now, so I agreed with her, saying that if Dr. ** wasn’t in the plan, I had to leave. I asked her if I could get a Part D plan for prescription coverage, and she said yes. She put me on hold, and I waited for quite a while, but when she came back on the phone, she apologized for the wait and told me that she was going to get another lady on the phone who would be able to discontinue the plan. The call was transferred, and I began the discussion with the second lady.
This second lady proceeded to tell me that she could not discontinue the plan over the phone. WTH?? The first lady told me otherwise. Now I was really getting mad. She gave me a list of ways that I could discontinue, and I chose to do it online. She told me to go to http://www.aarpmedicareplans.com and fill out the form on the site. After asking me a bunch of questions, she told me that I could get part D ONLY if they approve my request to discontinue the plan. WTH?? They might not approve it??
So, I asked the lady for clarification – “So, they may NOT approve my request to discontinue the plan?” Her answer was “yes”. At that point, I was so disgusted that I ended the call. I went to http://www.aarpmedicareplans.com and did not find any form to discontinue the plan. I decided to send an e-mail that detailed why I was so disgusted with United Healthcare and this AARP plan. They have since sent a notice to me that a case had been opened.
This plan is awful. If I stay with this plan, I would basically have to start over. All the doctors that I have been going to for years and who know all the details of my health over the past ten years or so are not included in this HMO plan – ALL of them!! I would have to start over with all new doctors. In addition, the first spine doctor that I had screwed up my back. It wasn’t until I went to Dr. ** that my spine was finally stabilized. I am NOT willing to go to just any doctor…some doctor that some HMO says I can go to… to treat my complex spinal issues!! Beware of the AARP Medicare Complete HMO plan. It’s one thing if just ONE of my doctors wasn’t in the plan… but NONE of them are in the plan!! This should be a BIG RED FLAG to all those looking for good health coverage through AARP. Shame on you, AARP, for promoting this insurance plan!!
Update: I received an e-mail saying that they are forwarding my complaint to the Appeals and Grievance Department and that they would get back to me in 30 days. 30 DAYS!!! What about now? I have this knee pain and need to see my orthopedic doctor now!! But God forbid that they do their job and address this now… no, go on ahead and take 30 days… that’s no problem at all (obvious sarcasm). By the time they finish pushing around all the papers, it will probably be open season again. Pathetic!
I work in the senior health market. I'm independent and I just stumbled onto these reviews while searching for another topic. What really bothers me is when I sit down with Medicare beneficiaries and try to tell them what I do know about AARP so many swear by them and believe they are some sort of senior advocacy group. Are you aware that they overcharge for supplements 5% every month in addition to making you buy an annual subscription to their magazine?
Are you aware that congress was lobbying to have their nonprofit status removed because of it? Not to mention they don't even offer Plan G which is the most cost effective Plan. Their rates increase dramatically and I can replace them all day long and save seniors hundreds a year. Today I took a woman from 220 a month to 155 payment a month. It really is a shame to see these stories, so many are a victim to their tireless advertising and co branding. Same holds true on the life insurance side... Well that's my .02 cents. Good luck.
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When I was sold both the Plan F Medical Supplement Plan thru AARP UNITED HEALTHCARE. I was told NOT to fill out the medical questions part when I got the actual paperwork! I would have had to lie on my husband's paperwork so I decided to go to another Plan BUT unfortunately kept the prescription drug plan with AARP UNITED HEALTH CARE!!! HUGE MISTAKE!!! Their prescription drug plan doesn't cover my medications or my husband's (even though we gave them a list of ALL MEDICATIONS). They lied!!! Help your seniors not to let them pay for other's lies!!!
I have been online talking to United Healthcare representative as well as their supervisors and I have been unable to get adequate Health Care away from home. I now have to drive back to where I live to get taken care of to be seen by a doctor without having to jump through hoops and get all sorts of referrals. Recommendations and in care facilities should be able to get look at for and that I should have been able to deal with where I am right now.
During open enrollment, I compared 19 plans. AARP/United stated they would cover all my meds. They did indicate that ** they limited coverage to 3 boxes per month all strengths. I called to confirm and joined. 1/2017, prior to first doctor appt, called to confirm. Was told yes, med would be covered. Surprise at pharmacy, only two boxes would be covered. My doctor tried to get an exception which was denied. Every phone call is a different lie. I was told Medicare limited the amount of meds dispensable as of 1/6/17. Called Medicare and they denied it.
I finally received a letter from AARP/United that states I exceed a Morphine Equivalency Dose calculator. I had a bungled spinal fusion. Am in constant pain, rarely leave the house. I also have four herniated discs in my neck the two doctors have advised against surgery. Going to a pharmacist and entering the values into the Morphine Equivalency calculator, we come up with a total of 299. AARP/United maintains I'm at 367 & thus the reason they refuse to cover the meds I've been on for 8 years. I'm paying 3 times as much as my previous insurer Humana that I never had a single problem with. Avoid AARP/United at all costs.
My Primary Care doctor and I are extremely dissatisfied with the inefficient bureaucracy of this company. I tried for 2 months to order 5 medicines through OptumRx home delivery, was sent page after page of denial and approval at the same time for my medications and I finally received 3 medications way after my due date and needed to make a weekend emergency call to my Primary care doctor since I had completely run out of my blood pressure medication waiting and waiting for my mail order.
I tried to take advantage of the OTC supplies, made many calls for the ordering form which I never got and could not activate an online order (I am very savvy). The Silver Sneaker program would cost $20 if I want to participate in water aerobics. I incurred a very painful colon infection and was prescribed a medication from my doctor which was more helpful and less damaging than **. It was my birthday. I had to argue with a stuck up pharmacist at OptumRx to allow me this medication for pain. He again asked me to have it authorized again by my physician and therefore I am stuck for 3 days without that very much needed medication to wait for the office to open Monday. My Primary care doctor, whom I trust and respect, told me that his office no longer deals with the inefficient paper war coming over his fax. I am really disgusted with the unknowledgeable employees who cannot even discuss common sense issues.
I was told this supplemental insurance would cover what Medicare doesn't pay, but this apparently wasn't true. I recently received two invoices for payments in 2016 that were adjusted for Medicare, and Medicare paid their 80%, but UHC paid $0.00. The amounts are not that much, and I am able to pay them, but considering what I paid in premiums for 2016, this is ridiculous. I have changed back to a Medicare Advantage plan where I know upfront what my co-pays are. And they are much less than what I paid in premiums for a so-called insurance plan that is useless. I wish I'd read the reviews before I bought into this.
I just signed up for this plan for the second time, after a year off; it was recommended to me by a United Healthcare rep. I have been trying to get my prescriptions for 4 days now, and have had to visit 3 pharmacies, all suck. It has been one long mess after the other, first one pharmacy didn't carry one of my drugs, which were all listed when I was looking for a new plan, ha! The next pharmacy said I had to call every months, 3 days before to remind them to order one of my drugs.
The final pharmacy, Walgreens, where I have been struggling for 3 days with, said one of my drugs weren't covered. The gal on the phone said she was sorry and could not help me; I told her to put someone on the phone who could because UC told me this plan carried all my drugs; now I'm screwed for 2017! So I did get a lady on the phone who supposedly cleared everything up; NOT!!! Next thing I know, we have to go all the way back to my Dr to have the one dr, not my PA, sign the prescription. So Walgreen wasn't going to fill my prescription, which I am almost out of!!! The story continues and I still do not have my drugs after 4 days...
AARP/United Health care removed the silver sneakers exercise program from Michigan. They expect me to drive 50 miles to a YMCA to exercise. I guess I will just sit at home and wait for my body to fall apart, because they would rather I have surgeries that they pay for instead of trying to keep healthy. Poor decision makers. Always the bottom line not health of their customers, who pay high premiums.
THE WORST EXPERIENCE. I am a nurse practitioner, a Army Veteran, I have breast cancer, I have worked with insurance companies coding, billing, approval and denials and I am still unable to solve my premium problem with AARP/UHC. Being a Veteran with pharmacy coverage I did not need AARP/UHC Part D as I was getting my medications from the VA. According to the Part D guidelines, Veterans with pharmacy coverage can cancel Part D at any time during the year. October 11, 2016 I called and received an email from UnitedHealthcare_CustomerCare with instructions on how to disenroll from UHC Part C and below is how the email read:
"Dear Valued Member, Thank you for contacting us about your decision to disenroll. As we talked about, there are many different ways to ask for a disenrollment from your plan. Written requests can be submitted online or through mail/fax with our form or a letter you hand write. If you enroll in a similar plan during a valid enrollment period, you'll automatically be disenrolled from your current plan. The last option is to contact Medicare at 1-800-633-4227. If you'd like to submit a disenrollment request online or by mail/fax here are the links to the forms: Online - Fill out the form and submit the request online. Disenrollment Form (Online). Mail/Fax - Print the PDF form. Fill it out in black/blue ink. Mail or Fax it using the directions on the form. Disenrollment Form (PDF)."
I cancelled my AARP/UHC Part D using the online option and received a copy of my PDP Disenrollment Letter between UHC and Dorothy ** is Signed and Filed. The letter was attached and printed. The same day after I submitted the disenrollment online I received this email below from UHC: "Attached is a final copy of PDP_Disenrollment_letter. Notifications have been automatically sent to all parties to the agreement."
AARP/UHC continued to deduct Part D premiums from my social security check November, December and January. In fact they increased my Part D premium for January 2017 and took out even more money. I have contacted AARP customer service to find out when they are going to stop taking $$$ from my SS and they told me they did not have my disenrollment I submitted online. I spent over an hour on the phone with the person at AARP. Since UHC sent the disenrollment letter via email I thought I could send it to them via email. No. I had to print the disenrollment letter UHC sent me and fax it to UHC. I tried to get the AARP customer service to transfer me to the Disenrollment department and they would not. I was very frustrated. I asked for a supervisor and she was not familiar with the online disenrollment. AARP is the gatekeeper and will not transfer me to the Disenrollment department.
After faxing my disenrollment forms (that UHC send me online) I received a phone call from AARP telling me my disenrollment was denied. How can it be denied? How do I disenroll from AARP??? I called AARP (I was on the phone with them for 2 hours) and they still did not accept my disenrollment form and I told them I disenrolled Oct 11, 2016 and they still did not accept my disenrollment. The worst part - I submitted prescriptions to Walgreens and told them I was going to pay cash as this prescription was from a car accident and St. Farm would reimburse me. Walgreens called AARP/UHC and was told in November that I did not have Part D coverage with them and I would have to pay cash.
So I'm paying AARP/UHC premiums and do not have Part D coverage according to AARP??? I am knowledgeable about insurance. How is the lay person suppose to deal with this if I cannot solve my own disenrollment??? I am going to report this to the Florida Department of Insurance. DO NOT BUY PART D - AARP/UHC INSURANCE AS YOU CANNOT DISENROLL! Does anybody have any suggestions?
I pray this was a isolated issue but am afraid it wasn't. I had one of the worst customer service experience in my life today when I called AARP or was it United Healthcare. I was in the process of calling in my prescription for my medicine, which in the past I have paid out of pocket. But, then I remember oh I have a prescription plan I won't have to come out of pocket the $65.00. Am excited now, so with my beautiful laminated member ID card and Welcome Letter in hand I called customer service. I wanted to confirm what I would be paying for my prescriptions. So I call give them all info they needed am waiting for a simple response.
Instead I get very disturbing info my enrollment has been cancelled. I say, "What? what the, cancelled, I didn't cancel. Who cancelled? I know I didn't. What now!" Am on hold, for a while. They couldn't seem to find out what happen. Then they said, "Jenna." I say, "Jenna who? That is not me." Am not understanding what has happen. What happen was AARP made the mistake in cancelling my plan their mistake, internal breakdown of procedure or communication. Their mistakes clearly but they refuse to acknowledge their responsibility in this and make this right, not even a apology. I'm left with no plan and forced to come out of pocket for another year until open enrollment. So unfair, so unprofessional, so heartless. Thanks for nothing AARP/United Healthcare.
All I needed when I called today is proof of the premiums that I am paying this company and it is a lot. The internet site is a joke and requires you make up a 51 character password and no matter what after 3 hours none of the passwords I made up worked at all. All technical support wanted to do is tell me that I was wrong and that they had a 1 character password I had to make up. It honestly was a 51 character password no matter what you used nothing at all worked. Customer Service and technical support would not print off how much my premiums were in the computer. I am sure this had to do with the HIPPA lawsuit that caused the entire HIPPA crap to be passed.
All I need is to be able to print out this sheet for food stamps and customer service and no one I talked to after making 4 phone calls when my time is valuable would help me. I hate your GUTS AARP Medicare Complete. You do not care at all about the money I pay for you to do me a service and give me medical care. You would not help me at all get in the computer to find this information. All customer service and technical support wanted to do is argue with me and tell me that there was not a 51 character password required for me to set up my own account when there was. Get into the site yourself to see. I was in the site over 3 hours trying to figure it out and customer service and Technical Support did not give a GD about helping me get this information I needed for Food stamps. Please never ever never ever sign up with this plan.
Their phone staff is incompetent and not caring and they do not give a damn about you as a customer. They made in the trillions of dollars in 2015 in revenues and this is how I get treated as a customer. I hate your guts AARP Medicare Complete. You deserve this bad review because your 4 reps could care less about what I needed from the food stamp office when I really need it real bad. Never have I been treated so bad by a company I have done business with by telephone or by mail. You guys really suck super bad. I plan to tell 10 others and so on and so on where you will hardly have any customers ever. You do not deserve to have me as a customer.
AARP Medicare does not care about clients even enough to supply information. I was contacted by AARP who assured me I needed their service. Didn't I want their delivery services for my drugs. I am disabled and moved to a different community from a large city to a rural community. I retired from civil service and am a part of the retiree union plan coincidentally through OptumRX. I thought both were necessary encouraged by the phone staff. I told one that it looked like the plans duplicated and the phone staff UnitedHealth/Medicare assured me this was not the case.
So I went from paying $3.00 per month union dues and $17.00 to pick up my meds from CVS to $30.00 pickup service plus $63.00 Medicare fee plus $17.00 monthly. I finally ignored the advice of these agents and cancelled. Now my account has been turned over to a collection agency. AARP/UnitedHealthcare who take their monthly payment for the entirely unnecessary (for me) Part D - their people who answer the phone will tell you anything to keep you enrolled. Shame on you AARP. You of all people perpetrating this on the elderly and disabled who you claim.
When I called to cancel my Medicare Supplemental health insurance, I was informed that I would not be able to receive a refund and that my policy will remain in effect until the end of the month. I asked to have my policy cancelled effective 8/03/16. I was told that was the law in the state where I live...NJ. Really??? That needs to be changed if true!
Address Verification (Shut Down my Account). I suddenly had my account shut down and got charged 359.00 for medicine that I have purchased for 60 dollars. I am forced to pay on Credit Card because Florida only lets you fill prescriptions on your last day of Medication. (**) None left to take. I called AARP and they would only resign me up as a new Applicant and rather than making good on the day before, they said they was going to refund my payment they previously accepted. Pissed OFF!!!
On June 16, 2016, OptumRx received a new prescription from my doctor for **. The prescription was processed and my credit card billed $90 on June 18, 2016 and an email confirmed shipping on that date. A USPS tracking number indicated that the medication was shipped from Kansas City, MO, June 20, 2016 (June 18), via first class mail. Repeated inquiries utilizing USPS tracking number indicates that the package was accepted by USPS June 20, Kansas City, MO. Out of medication, I telephoned and spoke with a supervisor at OptumRx June 25, who promised if the medication did not arrive June 25, I could call back and OptumRx would ensure that I received medication until the issue was resolved.
When the medication did not arrive, another supervisor took the call, and refused to help me. She repeatedly stated the medication was shipped "standard," nothing could be done until June 29. After I repeatedly stated that a package sent first class from Kansas City to New York should have arrived by now, and that tracking information indicated that it never left its origin, something needed to be done. She refused to help me and told me to wait until June 29, even though I was out of medication. OptumRx has the worse customer service and the worst service in general of any mail order pharmacy I have ever utilized. I have had nothing but problems with them since I signed up through AARP. AARP has done nothing to help me.
Sold United HealthCare AAPR supplemental with comments that ALL costs not covered by Medicare covered by Supplemental FALSE - my mom went directly to skilled nursing, under Dr orders, without a 3-day stay in a hospital, and Medicare and Supplemental denied payment. My mom is now out $12,000 plus having to pay nearly $300 a month in premiums vs. her previous Medicare Plan C health insurance at less than $40 a month. We have been ripped off. I would never recommend this insurance to anyone who is cost conscious.
The subject Medicare Rx plans can be viewed at https://pdp.aarpmedicareplans.com. I did a side by side comparison of the Preferred and Saver Plus plans and found that the Saver Plus plan is less expensive and offers more coverage than the Preferred plan. I spoke with several AARP representatives who confirmed that the lower cost Saver Plus plan is superior in cost and coverage to the Preferred plan. But, many seniors, including my 90 year old parents no longer have the mental capacity to conduct a cost analysis of the plans. Recently, I discovered that last year my parents switched to the Preferred plan because they assumed that the word "Preferred" meant that they would receive greater benefits. But in fact they are now spending more.
They also have a medigap policy through Gilsbar that has a High and Low plan. Last year, they also switched that policy from the low plan to the high plan. As with their AARP Rx plan, the High Gilsbar plan is more costly that the Low plan and there are absolutely additional benefits included in the High plan. As with AARP, I called several Gilsbar representatives and confirmed that there is no advantage to purchasing the High plan. There is a pattern of deception that I doubt is limited to just the AARP Rx plan and the Gilsbar medical coverage plan. This may be something that consumeraffairs.com may want to investigate further. I am more than happy to provide additional details upon request.
I have paid out personally close to $600.00 out of pocket. My plan has paid under $200.00. I pay approximately $1200.00 a year for insurance coverage plus more out of pocket for meds than my insurance company does. You are making money off of me and providing me with subrate care as far as medicine available to me at a reasonable price. I am angry and can't wait to get off this insurance policy and pray there is not more perpetrators like you to choose from. For more detailed information on the challenges put before me by your company I would appreciate a phone call as it would take up too much space allotted in your format and feel pretty sure it would not be read...
On 1/21/2016 I visited one of my doctors on a follow-up call after surgery. The doctor submitted an invoice to the insurance company for $79.00 and I paid my $59.00 co-payment. I have been billed several times from the doctor's billing team that I owe $27.00. I have call customer service five times about this issue and the billing team three times. I have been told that was "balance billing" and it was an illegal practice and not accepted. After 60 days I received a letter from the insurance company stating they had checked their records and they were correct.
The billing team has told me that the invoice had the correct code number but they denied paying the invoice. The only solution left for me was to tell the last customer service rep that I would not hang up until I had an acceptable answer. He (Greg) was not able to tell me why the invoice was denied as others could not either, but was able to connect me with Candace, the escalation manager. She told me that Medicare allowed $45.00 for the service and since the doctor only performed only this service and nothing else that I would not be responsible for the difference between the $45.00 that Medicare would pay and the $79.00 of the invoice. However I should get back from the billing team $17.00.
This is the first time that an invoice from a doctor has been this low and what the plan approved amount less than my copayment. I asked, "Why do I have insurance if the plan doesn't pay anything but Medicare pays and not the insurance company?" She said that they had arranged for the discount reducing the doctor's invoice for me. I am to receive a letter from Candace explaining this whole situation. However, I'm not holding my breath as I have been told about receiving letters before and for some reason the postal carrier never brings them.
Paying $158 a month. Hospital/ambulance, RX plan and Cigna dental/hearing/eye. The same day the money was withdrawn from my account. Was told all pharmacies take this insurance and I would only pay $10 for generic and $25 for name brand. I was told a packet of my coverages would be sent which I did not receive. I received only my cards. I figured I would just wait until I picked up my meds to find out exactly what they would cover. Picked up my script that cost $200. Only 5$ was paid! I called them and then they tell me I have to go to yourdiscountrx.com to find out where my medication at what pharmacy would be covered. Why wasn't this initially told to me???
I asked for them to send me a contract and a listed coverage with what I'm paying for. I waited on the phone with them while they emailed. They sent me a brochure! I was then told I WASN'T COVERED FOR VISION. In the state of NJ a contract in writing must be provided showing the insured and insurer agreeing to the terms. Once I mentioned this, I was then told a manager named Tatena would return my call in a half hour. It's now been 2 hours and no call.
A reminder to everyone!!! Get it in writing! Insurance is regulated by the commissioner in every state. All insurance agreements are between the insurer and the insured. If something wasn't covered that should be and you have in writing, the contract is breached and in void! By law you are able to get your money back regardless of what this company says. Find out who your state insurance commissioner is and send a simple email. I should have demanded a copy of my coverage right away and not waited until I picked up my expensive medication. So far not happy.
The costs we ended up paying for our drugs were 175% higher than the prices they quoted me on a phone call. They suck you in with low monthly rates and charge you totally higher prices for the prescription than what they quoted. Bait and switch. Getting out as soon as possible. Also chucking their healthcare plan.
Letter came in Oct. My medication is not longer covered. They gave me two different ones I could take. 1 I was allergic to the other my Dr. gave me new prescription for. Jan. sent in new Prescription, paid 105 out of pocket. End of month Jan 31st, I am in the donut hole. They charged me in total almost 2300 for one prescription. Call them. OH. Had three other prescriptions totaling over 700? & now over 3,000. End Jan they said they never sent letter. I have copy of letter. Made phone calls for over 4 hrs.
Finally got someone in consumer advocate. I faxed her everything. Said she would get back within the week. Three weeks later. Nothing. I cannot get other prescriptions as I will pay full price. Finally got someone else who said she would get back very quickly. That was last week. Haven't heard from anyone as yet. Very disturbed. I am about to call a TV station and hopefully they will put this on the news channel and expose this for what is happening now to senior citizens. This is absolutely a disgrace. I will take this as far as I can. It is totally unacceptable. Oh, they did tell me I could get the other medication. So letter was sent in error, meanwhile I am in the donut hole as of Jan. 31. I have paid for the full year upfront. Any suggestions would be greatly appreciated.
Cost was $75 then appealed twice last year 92015 and cost was $2 (from Tier 4 to 1). This year (2016) I appealed and my physician appealed like we did in 2015 and they put the medication at Tier 3 because of some new rule to make more money. The cost is $35 instead of $2. I cannot change companies until the October 15 through December 7th enrollment period. As a result, I pay $68.60 a month to United Health Care and they charge me $35 for one medication per month and $2 to 10 for the other three medications I take. I will definitely be changing Rx coverage next year as United Health Care is only interested in making money and doesn't care about its clients!
My BIG mistake to go back to AARP Medicare Advantage this year. I don't have too many issues with the Part A & B side of the plan but then I haven't had enough general health issues to properly rate it. I do have BIG issues with Part D and this is why I left the plan for two years. I won't be back next year. Every effort is made to limit drugs and keep expenses down for senior citizens who have paid into the systems for decades and have earned the right to affordable health care. Drugs are moved to a higher class or eliminated for no apparent reason. Exceptions are denied because of no lower cost alternatives (which have not worked) when their own formulary shows the alternatives. It's all a sham and an effort to force the cost burden on senior citizens rather than just pay for health care.
In the last four months, AARP has messed with three of my medications. The latest has been one that I have taken three pills a day for over two years. Now they say they only allow two. Also, they have made this generic drug a 3 tier instead of a 2 tier. Now I am trying to get it approved as it has been denied. They are messing with my health and well being.
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