Health NetConsumerAffairs Unaccredited Brand
Where can I begin? From day one, when after hours of trying to speak to a human, and being transferred and disconnected over and over, brothers and sisters I knew we were in trouble. I have been trying to figure out my co-pay costs and whatever else I owe since an epidural over a month ago. My doc said it may be months until Health Net figures it out. The Tricare contract with Health Net is a disgrace and betrayal for all of us who served.
Health Net is the most incompetent healthcare company I have ever dealt with. I have spent three hours during the past month trying to select my primary care provider. First they told me to set up an appointment with my doctor and that would automatically complete the process. My doctor is on vacation for a month, so that didn't work. Then they sent an email saying I need to select my PCP. So I got online to follow the instructions and the screens online don't match the directions.
I fuddled my way through, not knowing whether I actually selected my doctor. Then I called and the representative couldn't pull my file up by my account number. She found it using my name. But she couldn't tell whether I had selected a PCP, partly because the company hasn't yet allowed them the authority to see a customer's PCP. The worst part is that Health Net gets $13,000 a year from the government for my healthcare -- twice as much as it did two years ago. Taxpayers are getting ripped off. This country needs to go to a single-payer system. Vote Democrat in 2018 and 2020.
If I could give no stars I would. I've spent 3 months trying to get this company to recognize their premium billing issue. I paid all of the monthly premium payments for 2017 (I have bank statements proving this). I then started to get bills in the mail for one of my 2017 premium amounts + the new premium amount for 2018. I called immediately to try and resolve their issue. I was told the issue was fixed and to pay my 2018 premium payment which I did. Fast forward to Feb 2018 and nothing is fixed. They pocketed one of last year's payments and applied the new higher premium amount for this year's premium to last December... I can't talk to anyone at this company who can do anything to fix the issue.
Everyone I speak to says they are "escalating this to their billing team" along with all of my account notes about the issue. Conveniently the billing escalation team doesn't have a number. I have evidence proving I paid and no one to look at it or hear me out. I am close to canceling service as currently I'm paying for healthcare that probably won't help me in an emergency because they say I'm behind on payments when I'm not!! I wish there was a local office where I could take my proof and get this fixed. Going to contact the Attorney General's office this week.
I don't know where to begin and I'm not going to spend more time here other than to list what I've learned from 3 years with this "health plan" and too many hours speaking with "customer support": (1) They are trying to rebuild their computer system and it's a mess. They have 3 different member IDs as they migrate to the new system yet the system does not always "know" about the legacy IDs -- worse yet, some cust support people are unaware. The result is you will often have no way to actually discuss your account with them. (2) Their online website is a total mess. Links are broken, data is incorrect, provider listings are out of date. They even changed their domain without telling members - or even providing a forwarding link. OMFG.
(3) The billing system is FUBAR. I received a bill for hundreds of thousands of dollars (monthly premium!) and -- they will have difficulty just figuring your latest balance. They've actually sent me cancellation notices due to the fact that their system simply has no idea what your balance is -- or: has it mixed up with previous policies that you may have had with them. (4) The "provider directory" is insanely out of date. They claim it's updated but I've called so many of these doctors only to be told that they've left the plan months ago. When this is pointed out they will blame the doctors for not updating their own profiles in the system. It's a joke.
This company is the worst!!! They keep sending me the wrong ID cards and every time I call they say the new card is "in the mail". Every card I've received in the mail has the old information from last year. In addition, the cards I've received only has my son listed and not me (I am the primary policy holder, he's only 4 years old). I have also had to call about questions I had regarding my schedule of benefits. Everyone I speak with gives a different answer. Some tell me I need a referral to see a Specialist, others say I don't need a referral as long as the doctor is in network. Which one is it??? I also find it incredibly irritating that there are only two Pediatricians on my plan and neither is close to where I live. WTF? I do not at all feel confident about this insurance plan and strongly dissuade others from signing up with this horrid company.
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Allwell was Health Net and we've been with them for years with no major issues on their end. That has changed with the switch to Allwell. Hours upon hours on hold, more hours trying to change PCPs and in the end, a PCP selected without our input. We've been told our new PCP was entered into the system - once we chose and cards would be arriving in a week to 10 days. That was three weeks ago. When the new PCP allowed us to come in without the cards, we were told by the office administrator the Allwell site has been down for the most part all year. Too late to change to a different Medicare plan now. Stay away from these bozos - they don't know which end is up or how to enroll new members and issue a ID card so you can visit your doctor.
This company has one of the worst customer service in the country. I had to wait 45 minutes today before I could talk to a person today. My prescription did not go through at Walgreens and after talking to an agent I find out that they have issued us a new subscriber number beginning January 1 and it is almost the end of the month and we still have not received our new cards. She gave me the number over the phone. Another claim from October 2017 that is unresolved has disappeared from their system. In my line of work I have dealt with the IRS, FTB, Social Security Administration and other government agencies and even though they are underfunded and have lot more work I have received much, much better customer service from them. People blame government agencies for poor service and praise the private sector. Well this is exactly the opposite.
2017 rates increased substantially for our family of 3 to $2250 for a mid-level PPO plan! Unfortunately, 2017 was also the year we needed to use our insurance. A family member's substance abuse disease required inpatient care and Health Net have rejected any and all claims for any reason they could. I have been working on these claims for over a year and now have the CA Dept of Insurance working on this as Health Nets tactics and negligence are in line with pending litigation brought on by many substance abuse providers (Google search this).
We have paid for all 2017 care "out of pocket" and are hoping to recoup some of the expense per our policy once we get resolution. It is unbelievable what Health Net has done to us and many others - it is CRIMINAL and am hopeful that the actions by victims will hold this company accountable. If you have someone being treated/needing treatment for substance abuse and Health Net is deploying tactics to avoid honoring the terms of its policy, I encourage you to reach out to your state agency and file a complaint!
I have had my medical insurance with Health Net for several years, always paid on time, never missed a payment. In Dec. 2017 I did not receive a bill for Jan. 2018 coverage, so I called Health Net in early Jan. to find out why I did not receive a bill, and to pay. I was on hold for over an hour, after finally being connected to a representative I was able to pay over the phone using my credit card and was told as of Jan. 1 I had a new Health Net ID # and to go or pay online I now had to go to a new website. I never received any notice of this. But after paying over the phone I went online to print a temporary new Health Net ID card that would be needed to see my Dr. After entering all information, name, new ID#, SS#, etc. a message said I did not have coverage.
So I called Health Net again, this time waiting again over 1 hour to talk to a representative. They told me my payment that I had made only a week before had been refunded, but they could not tell me why. The Health Net rep said she would check into this and call me back at 9 am the following day. She never called. So I went online again and via Health Net's website emailed them explaining the situation. I received a confirmation email that I would receive a reply within 1 business day. It's been several days and never received anything from Health Net. I called again today and after waiting again a long time to talk to a representative, was told yes my payment had been refunded, but again they could not tell me why they did this. I was never informed by mail or email that my payment was refunded.
Bottom line is Health Net has terrible customer service, but unfortunately my insurance agent told me the other companies have even more restrictive Dr. networks, so if I switch I may not be able to continue with the Dr. I have had for years. I can't imagine any other type of business with such terrible customer service could keep their customers, except in the insurance industry where there aren't many choices. All this after Health Net raised my monthly premium about 20% for 2018, (now over $1500/month for only me, Silver plan, no dependents). Because I have a middle class income, I get no financial 'help' from Obamacare.
What I've seen since Obamacare was implemented is more than doubling of my monthly premium, with significantly higher deductibles, along with much poorer service. It's pretty bad when you have to wait up to 1.5 hours on the phone w/ Health Net to get information, and to pay your bill, and days later find out (only by calling again and waiting on hold another hour), that they refunded your payment and they can't begin to explain why.
to show on my acct. I'm told my Dr. isn't listed as one of their providers (not true). My account has been suspended. I need to find out where to make a formal complaint.
I am very disappointed with Health Net, have been with them since 1/2017. This year despite increase in the monthly premium have paid on time, have not received the new ID card nor know the new group no. or the ID number. Cancelling all the medical appointments with the doctors. When I call no answer on the other end. My pharmacy will not fill my prescription. Do not know what to do. Frustrated.
As a physician as well as owner of a surgery center, I give this company the lowest of grades when it comes to their preparedness in taking over the Tricare contract. We are unable to get a solid answer as to covered benefits for the patient on all fronts and therefore can not provide the necessary services. This is very bad for active duty personnel and their families. Shameful!
Poorly Managed and serviced medicare advantage plan - Last year a lot of issues and complaints. No issue was resolved yet and this 2018 not even the member ID card is issued yet. Called many time, every time is a new excuse and no solution. I have to postpone my appointment because of no new member ID, and they don't care at all. But very active and regular to send notice for payments due. No respect to members at all...
I am a new patient with Health Net Insurance. When I received my card the only thing correct on there was my name; it had the wrong doctor and group. I have spent HOURS trying to get the doctor changed and when they sent me my new card it had the same info as before. This has caused me to cancel doctor appointments so that I can get my prescriptions refilled. I'm taking 1/2 dosage as afraid I will run out. I am on their database and have tried that way to update the doctor. I have also sent comments to them on their database and I get no answers at all. What do I do now? Go to the hospital I guess. I am so sorry I changed plans!
Health Net took over as the military and military retirees' health insurer as of January 1st, 2018. We were under United Health Military and Retirees for the past two years. Under Health Net, our co-pays have risen from $12 to $30 per office visit, and from $30 to $60 per emergency room visit. AND, doctors are allowed to now bill additional $30 co-pays for diagnostic work they do without the patient present - not even an office visit! What?!! Our monthly premiums also increased. I served my country, in war, honorably for 24 years. My many years of service during wartime rendered me sick, injured, disabled and unable to work. I am living on a fixed, very low, E-7 enlisted retirement income. My income did not increase and will not increase over 200% to adjust for these increasing costs for military healthcare. So how does Health Net justify a 250% increase in our co-pays?
When I signed up to serve my country in 1983, I was promised "free" healthcare for me and my dependents for life as long as I completed a full military career. I completed 4 years past the required 20 years. The government did not keep their promise. I've had to pay monthly premiums and co-pays since I retired in 2007. But initially they were $35/month and $10/office visit under TriWest. Then $45/month and $12/office visit under United Health. But now $30!? These costs are not commensurate with our retirement pay and not at all what we were guaranteed when we signed up to serve our country. Also, when I called Health Net today, there was a 30-minute wait time to speak to a human being. That's horrible customer service. Not everyone has unlimited calling or free minutes on their phone. It's no wonder why Health Net only has a 1-star rating. The government was wrong to contract with them.
I had my monthly payment set in their system to be automatically deducted 2 days before the end of each month, since payment was due on the first of the month. Yet, I kept receiving warning letters for alleged non-payment *every* *single* month. Something is seriously wrong with their system. I wanted to cancel my insurance effectively with the end of the year, since I am switching providers. I spent a grand total of 1:32:18 (yes, that's one hour, thirty-two minutes and eighteen seconds) on hold, to no avail. Since I am running my own business, this time reduces my available business hours accordingly. I should charge Health Net for lost income. I am going to refer this to my lawyer, if necessary. Health Net is like the Hotel California - you can check in, but you can never leave...
It's a long story but the gist of it is that I showed up for an appt. when I needed health care and I was denied service. I filed a grievance with my health insurance company, Health Net, and that is pretty much a joke. Though it is not completed yet it appears the misinformation the doctor's husband, James, who is also the office manager has told Health Net that I refused treatment. This is at best misinformation but closer to an out and out lie.
I have been paying for coverage all year and the times I have needed to use this health insurance for myself or my kids I find out this plan is not accepted anywhere. Even by the Dr. (specialists) they send me to, after seeing the Dr. I receive a bill for services telling me they do not take my plan. Then sending me a bill later telling me they do not accept the plan. Now myself and my two boys are sick. After calling Health Net for a local urgent care 4 referrals called all 4. None of the urgent care facilities they sent myself and my boys to take the plan (I have silver 70, suppose to be taken everywhere). I called Health Net helpline and they were rude and unsympathetic to my situation Telling me the urgent cares take my plan.
I call them while they were on the phone and was advised no the urgent cares (4) do not take my health net plan. Then the Health Net adviser then was surprised hearing it herself, she then looked into it and then confirmed that though I have and pay for insurance no one in my immediate area takes my plan. She then told me my only option is to go to a hospital emergency room. She then searched what hospital for me to go to and the closest one is a 60 mile drive (to and from). I live in a very populated area of Orange County, CA with Dr. and urgent cares all over the place within 2 miles of my home. I do not know how Health Net gets away with this, terrible service and no coverage but still takes my hard earned cash. Run far away from Health Net. In my opinion this is a fraud.
If there was a way to give a Zero star or negative stars, I would do that. There is no positive experience dealing with Health Net as an insurance company. Providers who hold contracts with Health Net are good. But Health Net treats its paying customers like dirt. All I wanted to do was to cancel my insurance with this company (Healthnet.com) for my Dental and Vision care and the cancellation process is not existent, not explained to customers, and extremely complicated to get out of. You can check in any time you want, but just cant ever leave.
"Relax," said the Health Net Insurance Representative /Customer service, "We are programmed to receive (your premiums every month). You can check out any time you like, but you can never leave!" Very very bad experience. Unless management policies change, they are going to lose customers and market share because their customers experience with Health Net customer service is horrible. Something that can be done very easily to way too complicated.
Horrible, absolutely horrible service. They received an order for an MRI two months before my wife was to have this procedure and got a call the evening before that her procedure had been denied; this is a follow-up to make sure her chondrosarcoma has not returned. I spent five (5) hours on the phone trying to straighten out their denial with no resolution. I got so fed up, I cancelled the policy and will never, ever deal with this abominable company ever again. Don't do it!
I use Health Net as my supplemental insurance for MediCare. I pay no deductible when I visit my Doctors and also pay no deductible when I use the emergency room at my local hospital. My monthly premium isn't cheap at $275 per month but my coverage is great. I didn't qualify for Obamacare or MediCal and was glad to have found Health Net. I just wish it included dental and vision because I pay for a dental plan separately with another company. I have had no problems or issues using Health Net and they've paid all my bills without hesitation.
What they call affordable is the low payment that they offer. However, you are nailed with over $1000 worth of fees at the beginning which for a low income family is NOT AFFORDABLE. Do these people understand the words LOW INCOME? I can barely afford to make the premium payment, and certainly can't afford the $1,084 start up. And they suspend your account when you cannot pay the astronomical start up fee. Unbelievable! I can't believe the government is backing this kind of consumer genocide. When it comes to insurance, this company is about the money and not the customer, so avoid them at all cost.
I had no choice but to sign up for this insurance in Arizona thru the Marketplace. Even though, I was approved for Tax credit assistance for the whole year of 2017. And, Ambetter sent me a letter billing for my share. Through their negligence (by misapplying my January 2017 payment to someone else's account) and no mention of balance due for January 2017 tax credit on any bill until June 2017, they are billing me for $488.00 which is the Tax credit portion. And since I am not able to pay the amount, they have cancelled my health insurance. They do not return phone calls to have this resolved and if they do they pass the buck!!!
If I could give it 0 stars I would give it 1 million "0" stars because they deserve it. If you need to be referred to a specialist don't count on seeing the specialist anytime soon. They take about 2 weeks to process your authorization (They say 5-7 days, however that is business days and even then they take longer to process it). Once you have the specialist authorization approved you are lucky to have an appointment scheduled within a month. And oh... If you try calling the medical group to find the status of your authorization be ready to wait for at least one hour due to heavy volume calls. This is an unacceptable form of treatment to any human being especially if you are in a debilitating state of pain. I urge you to please select any other health insurance to prevent this happening to you. And yes I am a real human being not a robot.
This company uses bait and switch. You get their insurance. And then they switch to another for your area (Inland Valleys IPA, Horizons IPA, vintage IPA). Not them. They do not return phone calls. They do not update doctor info so you can actually see a doctor and get treatment. They assign a case manager to help ha ha ha. They do not return calls. Is this medical fraud? They reject letters of authorizations so you cannot get necessary surgery. If you are smart do not get with this insurance company. You will not get any help. Even if it is life threatening and needed.
Since December 2016, I made premium payments to Health Net for new account. However, I'm still make payments on existing account. I tried to get reimbursement for the payment in Dec 2016 for new account. I made dozens of phone calls, but after 6 months, I still can't get the money back. It's very frustrated experience.
Had BCBS PPO for years until the premiums tripled through my husband's employer so we went with HealthNet. I recalled about 10 years ago HN was pretty decent so we enrolled. Claim mistakes, denying claims based upon "pinhead-ery" reasoning, not giving members access to info online, and every provider I use hates them with a passion. Husband and I have an embedded deductible EPO plan (both individual and family deductibles) which is another opportunity for HN to FUBAR every step.
Claims have been denied for idiotic reasons. Like a few who have posted previously, if you have any diagnostic imaging done, they will muck it up. Had to have a Gallbladder function test as part of post operative care which originated under BCBS. HN has the nerve to continuously deny this claim and their reasoning kept changing. First they said it was denied because I needed a pre-authorization (a lie), then it was because it wasn't an emergency (say what?), then they only covered the procedure but not the radiologist (no joke). I called and called explaining that any diagnostic image NEEDS a radiologist to read it and sign off on it. That is how healthcare works! HN paid the radiologist as a "one time payment favor."
Healthnet outsources mental health coverage through a company called MHN. These idiots process claims without verifying if I had met my deductible so it is denied every time because they believe my deductible hasn't been met. I have met my deductible in spades and they are always baffled when I call to get claims paid. They are now pushing through a claim for the third time because of this problem. The second time it was processed to where the claim had a negative balance.
Virtually no access to pertinent information. Every claim has a running tally of how much has been applied to both your individual and family deductible. Problem is that their amounts make no sense. Customer service can't tell you a breakdown at all. I noticed that the amounts applied to my deductibles were dropping and not rising the more claims were processed. Double check each EOB as I bet there is a mistake on it.
Please consumers beware, if the bill does not match what the policy was suppose to be, CANCEL your insurance. Call to Cancel with Health Net, and if you're covered through Covered CA, call to cancel with both Health Net and Covered CA. We stopped making payments thinking Health Net would cancel our plan, we never used the insurance and we paid about $1,000.00+ in payment, when our plan called for about 101.00 a month based on two people and income. We called to fix the rate but they said that would have to be done through the insurance agent of Covered CA. The insurance agent was of no help. Health Net sent out letter after letter billing 200+ one month, 500+ next month, and when we saw those bills, we stopped making anymore payments. After that, Health Net mailed a letter saying they would be forced to terminate coverage as of a certain date after not making 2 months payment.
Now, they've sent out the last payment of 101.00 to collection agency, claiming we owe one more payment and ignoring the bills they've sent out. It's been almost a year and they are billing us for coverage which should have been terminated. It's a horrible company and if can happen to us then it will happen to you if you stay with this company. Our case is being investigated and if it doesn't follow through to have our account terminated since our last payment, then we will have to report to the BBB. We don't want the money back, we just want to get away from this company as far as possible.
I recently submitted my own claim, Health Net LOST it, then - when I sent it certified mail - denied it because the form was supposed to typed out, but their PDF is not fillable. Clear handwriting is evidently NOT okay, and I will be resubmitting this claim again after filling that form out in Photoshop. This is really stupid and seems to be designed to make you give up.
I just got a letter of denial regarding the Prior Authorization of a much needed medication that I have been on for almost 10 years now! Their reason for denying my request was because my patient records show that I have not tried any "comparable" long-acting opioids such as **. I was trying to get my 75mcg ** patches approved (these are not in Health Net's formulary) because it's costing me $241 a month for 3 boxes with 5 patches each and there is not a single pill on this earth that is going to be comparable to **, neither in effectiveness nor long-acting enough. They are trying to compare a pill like **, that MAYBE lasts up to 12 hours at the most, to the ** patch, which lasts up to THREE DAYS!!! There is NO comparison to be made and ** is much stronger than **, which would mean I would need to take more than just one or two ** tablets to equal the level of pain reduction I receive from the ** patches.
This is absolutely ridiculous! How can they expect a chronic pain patient to go from almost 10 years on a very powerful synthetic opioid down to an opiate that is less powerful and also less effective at pain reduction?!? This is so aggravating! I swear, these people have no clue how certain opiates work (or don't work) because I've tried ** and ** in tablet form and it had absolutely no effect on my pain whatsoever. I've only been with this new pain management doctor since October (my previous PM doctor didn't take my insurance and was no longer accepting cash patients, so I was forced to find a new doctor) and at my very first appointment I was told that I would need to change insurance companies as they would no longer be accepting the insurance I had at the time (Anthem Blue Cross) after the new year.
So now I have a mediocre pain management doctor and really ** health insurance that only covers the costs of doctor's visits and minor prescriptions. When I had Anthem Blue Cross, I didn't pay a single cent for doctor's visits or my prescriptions! I had also been prescribed 120 tablets of 10-325mg ** for the last several years and had to get a Prior Authorization for that amount because Health Net only covered the cost of 45 tablets without the PA. That's less than half of what I was being prescribed! However, my doctor and decided I would obtain greater pain relief if we mixed the ** and reduced the change time of my patches from 72 hours to 48 hours so I would have more effective pain relief without needing a breakthrough pain medication.
I wish I could go back to Anthem Blue Cross, but that would mean having to get another referral to a new pain management doctor that accepts their insurance and I've only been with this pain management doctor for 7 months... wouldn't that seem suspicious? Health Net might be good for some people, like those who don't require monthly meds and doctor's visits, but it certainly is not good for me! I can't even work because of my pain, so guess who gets to pay for my prescription(s) that aren't covered by insurance... my parents. I can't expect them to keep paying that kind of money every month because it is very hard on them as they are both retired and my father is disabled. All in all, Health Net sucks the biggest, hairiest, sweatiest balls!
Health Net expert review by Joseph Burns
Health Net offers coverage to people in Arizona, California and Colorado. It is a California Market Plan associate, which means that low-income patients in California can get discounted insurance via Health Net under ACA rules.
Choice between HMO and PPO plans: Consumers have the ability to decide whether they want an HMO plan, which offers a limited amount of in-network doctors, or a PPO plan that gives them access to more doctors.
An ACA Health Insurance Marketplace company: Under the Affordable Care Act, or ACA, every state must offer low-cost health insurance through either its own Health Insurance Marketplace or the federal Health Insurance Marketplace. Health Net is affiliated with the ACA Health Insurance Marketplace, which means consumers can expect lower costs and the ability to use tax credits to cover part or all of their premiums.
Large variety of plans: There are lots of plans available, including Medicare coverage and coverage for students.
Customer service: Although Health Net offers round-the-clock customer service, the sheer number of people calling in may lead to long wait times.
Deductibles: Health Net’s low premium rates often mean high deductibles.
Best for: Students, senior citizens, employees
Health Insurance Contributing Editor
An independent journalist, Joseph Burns is the health insurance topic leader for the Association of Health Care Journalists and contributes to AHCJ’s Covering Health blog. He has also written about health policy and the business of health care for a wide variety of publications, including Healthcare Finance News, Hospitals & Health Networks, Managed Care magazine, Ophthalmology Management, TaxACT.com, and The Dark Report.
Health Net Company Information
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