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I have been battling with Health Net since February due to a refund I am owed. I was charged for services at my dental office that are supposed to be covered under my plan. The dental office will not cooperate, so Health Net stepped in and said they would issue a refund this past July. Here I am, in November, no refund and yet another promise from their grievance department that I should be expecting a refund check on behalf of the dentist office from Health Net.
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Tricare recently switched to Health Net and we have had nothing but problems since. We received thousands of dollars in bills because Health Net said we went to an out of network ER. When we asked where should we have gone it took them an hour of them searching and they referred us to a rehabilitation center. This was an incorrect referral. Turns out the ER we went to was in network, Health Net's records were incorrect. We've used their website to update information/enroll and received confirmation letters. After a few times of my children being seen it was recommended we CALL Health Net to verify everything is correct. Turns out our records were changed by a Health Net employee. We were never notified and now we're stuck with the bill. Health Net stated the letter we received didn't matter. Their employees are unprofessional and lack the knowledge to appropriately assist their customers.
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Since 7/9/2019, my husband has been trying to receive treatment for extreme pain in the lower back and upper piriformis muscle. His pain is debilitating and he has seen his doctor and a chiropractor on an ongoing basis. 7/15/2019 He received an X-Ray that showed significant bone on bone in L5, F1 space. Both his Dr. and Chiropractor believe it is either a bulged or blown disc in his lower spine. His Dr. then recommended physical therapy. Which we tried to do, but Health Net had entered his birthday incorrectly and informed us that we needed to go through Covered California to fix it. 3 weeks went by and still no physical therapy approval. The pain was now beyond unbearable, so we return to his Dr. on 9/5/2019 for some kind of relief or further treatment. His Dr. recommends an MRI to determine the correct diagnosis and course of treatment and or surgery. The MRI request was sent to Health Net.
On 9/16 more than two weeks later we call Health Net - they tell us the MRI has been denied because their third party reviewer National Imaging Association, Inc. (NIA) denied the MRI due to lack of medical necessity. But when I spoke to NIA, they said actually they said it was denied because they could not open a fax from our Dr's office!!! So instead of rectifying the situation, they just denied the MRI without telling anyone. We were told to appeal the decision. Since that original denial, we have been going back and forth with Health Net and our Dr's office, pleading for an MRI. Health Net has done everything h=in their power to deny the MRI and subsequently medical treatment for my husbands debilitating pain and suffering.
Today is 11/4/2019 and we are still being denied basic health services for an injury that is getting worse and worse every day. I am appalled and disgusted by the lack of humanity and the waste of money we have paid this deplorable insurance carrier - and what recourse do we have? But their bill always gets paid. We are talking about basic preventative screening, an MRI for a back injury! At this point, our fight has gone on so long that surgery is inevitable...Health Net is responsible and will be held accountable. SHAME ON YOU!
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Health Net cancelled my daughter's health insurance because I paid late 3 months in a row. It was my understanding that I was allowed to pay late, just not be 3 months late. I called to verify this and was told that, yes, I can pay late as long as I'm not 3 months behind. Well, I paid late 3 months in a row (NOT 3 MONTHS LATE, ONE MONTH LATE FOR 3 MONTHS IN A ROW). On the third month, without notice, her plan was cancelled. Now I am having a hard time re-instating the plan because they just don't care. If I had any idea this would happen, I would have paid the late premium on a credit card and dealt with that later. This company is heartless.
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I simply wanted a rate for coverage. When I understood the rates I let the rep know I wasn’t interested. After that in one day I have received 100 calls literally back to back no matter how many times I have said I’m not interested, put me on the do not call list or let me speak to the manager. They rudely hang up in my face and call right back. Next step BBB.
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Tricare Health Net Federal Services since they took over from United Health care has cause me nothing but problems. First there were delays in all my referral for me and family. Then they started send my referrals to a Base that was 80 miles away when it was out of area telling me I had to go there for care. My co-pays were always coming up different for same service on TRICare Prime Option I had to call to correct often. Then the latest was getting a much needed referral authorized for a procedure for my wife out of network because my network group could not preform the procedure. I had to pay upfront getting it done. Now I have my congressman fighting for me to get reimbursed.
I have spent many hours on the phone (getting different stories with every different person I talk to), faxing documents (HFNS telling me they did not get all documents in Fax), and writing email's (most of the time they do not get answered). We need to get United Health care back. Spread the word tell you congressman we need a change. For those who think we do not pay much for our insurance - Yes we pay less than other's but we had to go through many hardships to get it. We are not talking about what we pay but we are complaining the service that is provided to Military members and family.
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After reading numerous BAD reviews (not at all surprising) I find that I can relate to every one of them in some way through my own unpleasant experience with Health Net. I’ve had endless problems from day one. Customer service reps are absolutely worthless and a total waste of time. I almost always have to go through two or three “supervisors”, all of which usually have different answers or EXCUSES. I have collectively spent DAYS on the phone with these people trying to get answers and correct wrongs and inconsistencies, most the time, almost always, with NO RESOLUTION.
I have had problems with EVERY ASPECT, ON EVERY LEVEL. From their phone system to customer service reps to supervisors and everyone and everything in between. I just spent three hours and forty five minutes on the phone with Health Net trying to deal with yet another problem, spoke with four different people and as usual, NO SATISFACTION ON ANY LEVEL. I have never dealt with anything like this before. I don’t know how they get away with it, but they shouldn’t, not in this country. In my 53 years on this planet I have NEVER dealt with a more unprofessional, incompetent, UNETHICAL organization of any kind.
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Like the insurance but wish it covered eye care and hearing aids and testing. D coverage is great. I have a PPO policy, so I go to whichever Dr I choose regardless of their location. This is so much better than my former HMO with the same company.
Have had Health Net for about a year and never really used it. My old primary wasn’t a part of their provider list so called in to ask about choosing a new one. The person I talked to gave me a list and I chose one. Booked an appt with my new primary for a women’s well check. Arrived at my appt and the lady at the front desk was having trouble with my insurance so she called Health Net while I’m present. Everything is cleared and I go in for my well check.
A couple weeks later I receive a phone call saying my insurance denied the claim because the doctor is out of network. I call Health Net and customer rep verifies the doctor was on the list, I also verify online that the doctor is on the list and he calls the doctors office and proceeds to apologize to me and says the list hadn’t been updated in a couple months and tells me to file a grievance. I do just that and provide the details along only to get a letter a couple weeks later saying I have to pay my bill of $432!
Did I mention I pay my own insurance of almost $1000 a month and now they want me to pay a bill they know they are responsible for because it was their mistake! If I wanted to pay my own well check I could have stayed with my previous primary physician that I had been going to for years! But I wanted to save the money since I do pay for my own insurance! What they did is beyond ridiculous! I’m really thinking of writing to the BBB because this is outrageous!
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My wife provided with 2 different incorrect insurance cards for 9 months resulting in denials of service. Customer service seemingly not trained fully enough to be cognizant of the consequences and taking a lackadaisical and unprofessional attitude. Company is not proactive in informing insureds on limitations of service vis-a-vis approved testing facilities for their individual plans, resulting in my wife getting unpaid medical bills through denial of claims as well as denials of service from potential providers. Company should snail mail list of approved "vendors" but prefers to be passive and let consumers find out "the hard way". I know of someone who was once trained to work in their call center and, therefore, I have "inside information" of their inadequate training procedures and harsh attitudes to their own employees.
I chose them this year for my wife because the previous year's plan doubled in price and Health Net represented a small price increase with similar previous year benefits. I learned the hard way again that if it seems too good to be true it probably is. Next year I will be forced to choose another company. In the meantime, I am forced to battle them on a large unpaid bill because of their lack of upfront information.
Customer support tends to belittle problems and tell people not to worry rather than take the correct approach and go out of their way to nip the problem in the bud. There are a few customer service employees that are really interested in really doing their job, but it is a small minority. Even some of the supervisors are less informed than the first-line support personnel. Their methods of determining who is chosen to be a supervisor is not necessarily based on justifiable qualifications. I realize that people are drawn to them based on price, but my experiences with them are telling me that I got what I paid for...a cheap price with cheap service.
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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 Net Company Information
- Company Name:
- Health Net