Consumer Complaints and Reviews
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!
I had no choice this year and had to select Healthnet "Ambetter" for my insurance. It's only been 4 months into the plan and I have had more claims denied than paid. I've done everything correctly, got referrals from my PCP and made sure the doctors I saw were in the plans network. They are denying several doctor claims stating the billing codes were processed incorrectly. However, when I try to get involved to help resolve these issues, the doctors all state the coding is correct. These doctors are not connected in any way, so I believe Healthnet is to blame. I now am getting bills for the office visits because the doctors say they have done everything correctly and cannot resubmit something that is correct.
I also had a huge issue with some tests being paid by Healthnet in February of this year, just a month after Healthnet started. Again, I did everything correctly by making sure the facility was in network and the doctors ordering the tests did receive prior authorization from Healthnet (Evercore is their 3rd party administrator for auth's). After I had the tests done Healthnet came back and said there was never a prior authorization (even though I got a copy from the doctor's office) and would not pay the claim until medical records and prior auth was fixed. After spending hours upon hours of my own time I finally got this fixed and Healthnet did pay, but now they are not wanting to pay the radiologists that read the tests results, stating they now need medical records, even though they somehow got what they needed in order to pay for the tests themselves!
I am honestly to the point of not feeling comfortable even using this "junk" insurance because it seems in the 4 months I've had this insurance I've had nothing but BIG issues. Furthermore, I should not have to spend hours upon hours of my own time fixing the issues that should not be occurring in the first place. I have had health insurance my whole life and have never had claim issues. I could understand a mix up from time to time but this is consistently a pattern with this Healthnet insurance.
My honest thought is they would rather deny claims and hope people are ignorant enough to fall for them being stuck with the bill than to do the contractual thing and pay for these claims that are valid. I could understand claims not being paid if I did not go through the proper HMO channels (out of network doctors, no referral, no prior auth, etc) but when I do everything correctly Healthnet should be held to the same standards I am expected to. If this continues and my claims do not get fixed the next thing I will be doing is going to the Department of Insurance for my state to see what recourse I have.
Our provider want to help to treat veterans but getting paid has been hard. I am on hold with Heath Net VA Choice for 6 hours and 35 minutes. Health Net has worst provider service and if they treat the veterans, they should be ashamed of themselves and our government should be ashamed that they have given them this contract.
I am a physician who decided to accept the VA patients in an effort to help them. Unfortunately they carry the worst possible insurance in the world - Health Net. This company drives my office staff nuts. Can practically never get hold of them on provider line to ask them why they have not paid the properly submitted bills. When you finally get them once in a blue moon they give you a spin around and excuses. Unfortunately the bill has to be passed on to the patient.
Health Net discriminates against and punishes patients and pharmacist for not using their Mail Order Pharmacy or CVS. I have had Mail Order Pharmacy with Group Health. There was constant problems. Ranging from medication errors to meds stolen off the front porch. Health Net requires its patients to use only their Mail Order or CVS pharmacies to receive a 3 month fill/refill of medications. If not a patient can only receive 1 month at a time of medication. I have over a dozen medications which means multiple trips a month to my local pharmacy. They have removed the role of the pharmacist from the patient health care team. I and my family have devoted our lives and careers to Teaching Hospitals and Emergency Medical Care. I am disgusted at the money grubbing insurance and pharmaceutical companies and the raping of health care!
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This is the worst health insurance I have ever had in my 30 years of employer provided healthcare plan. Impossible to find a doctor who takes the insurance, and then 9 times out of 10 they deny the claim anyway and you have to wait on hold for extended period to try to fight it and get it straightened out. I would dump it if I was allowed to go without insurance.
This is the worst health care provider that I have ever used. When you need help with insurance questions they are not open, and when they are open, the computers are down and they can't help you. They switched doctors on me and I went to my appt to find out that I wasn't covered by Health Net anymore and can't receive a referral. I have been lied to by the phone operators on multiple occasions. The frustration is not worth the price of the cheap insurance. Stay away!!!
Provider trying to get claims information - This is the worst company I have had the pleasure of working with. Customer service is non existent. Spent 4 hours on the phone on hold yesterday only to be cut off when someone finally picked up. When you do finally get through after hours of being on hold, they can only help you with 2 patients maximum. They are a typical government run agency and that is not a compliment.
My experience? I almost got rape by a Dr in Downey Ca and my health care Dr female, see her for more than 20 years and knowing my health issues for such long time she could not diagnose my symptoms and on Nov 4 of 2016 and due to the fact that I requested a test by myself I was diagnose with pancreas cancer and tumors on my liver? Nothing to do and get cure. Do not trust those Drs that work for this groups. They do not know when something is going wrong with you.
Drs that do not keep up today with the medicine, please change group or change your Dr or change your HMO for PPO and your Health Net. Stop making money for yourself. Do something for your customer. Get Drs with better skills and experience on any case, but, your service unsatisfactory and you should close your service. They do not help. They kill you. About almost being rape, since that happened May of 2016, I been writing to many of your offices complaining about it. The answer for you, zero... and the Dr continue working like nothing happened. Please get off this insurance before is too late. Do not trust no one on any of those groups. There is not skillful doctors to take care of a headache.
Health Net changed my primary care Dr without my consent. I have tried for 7 weeks to get my Dr back and Health Net keeps lying to me. My card for my Dr says one name and on their computer verification system I have another Dr. I am paying $350 a month and cannot see a Dr because Health Net will not fix the problem. The Dr they assigned me is not taking new patients! This is the worst Health Ins company I have ever used. They are taking my money and getting away with keeping me out of having a Dr who can see me. Health Net This has got be illegal.
The worst Ins. company I have ever had. They deny all your medications, and do not pay them. They pay anything they like and want you to switch your medications with whatever they think is ok with their budget. I will drop this Insurance. Please reconsider to go with this ins co. They are scam.
Be sure to video tape and record what the agent says your coverage is. Also they don't even honor their docs for how much my co payment is 10 bucks??? They have me paying full price for a generic prescription. Really??? Epic fail and they take 220 out of my checks for insurance. Why am I paying for this? It's even worse when you call the 800 number. They don't listen and they just talk down to you. I've called multiple times and they've hung up. I've looked for a sound answer. All I got was dead air nonsense from these people. I don't recommend them to anyone. I hope that Health Net gets shut down. They are horrible. They make it difficult for the working class to get affordable medications while the lazy bums get free medications. The ratings should be negative not on positive scale.
Health Net should be ashamed for how poorly stitched together their system is. I can't begin to explain all of the trouble I had with them, I will just focus on the current issue that so infuriates me that it drove me to go out of my way in order to review this terrible company. Due to the overall dissatisfaction I have had with Health Net, I decided to join my wife's insurance group through her employer. I cancelled my plan in December, successfully, so that coverage would end 1/1/17. That part was fine. The problem is, Health Net is continuing to debit funds from my bank account. That's right, Health Net is charging me for coverage that does not exist.
I have spoken with 4 different customer service agents. It should have been three, but the third hung up on me, seemingly accidentally, so I had to call back and start over with a new agent. Agent 4 informed me that agent 1 had not actually done what he said he had done. So Agent 4 took care of it, which is to say that he requested an urgent refund request for the first erroneous payment. The second erroneous payment could not be requested because it is still pending in my account. I was told I needed to dispute the payment with my bank. Well, that costs $30 to stop a payment. Instead I filed a free claim with my bank, which will hopefully work.
I tried online to get through BillMatrix somehow and remove the autopay account to stop future erroneous payments. No luck. The entire system thinks I am no longer a customer, and therefore I have no access to autopay functions. I effectively have zero power to stop these payments myself, or through a customer service agent from Health Net. Unbelievable, right? It's really just another example of the incompetence of the Health Net infrastructure. Avoid this seller at all costs. Pay more for a company that has its program together. Trust me.
Health Net has not been able to handle keeping information correct, and not taking care of appointments for veterans. When you try to call and get thing corrected they say that things are taken care of or you will get a callback. But you never get a callback, and things are never taken care of. To where appointments get cancelled because they will not get the correct information. This was suppose to help veterans but it has made matters worse. Health net need to be put out of business, before someone dies due to their incompetence. I will not rate them. They don't deserve to be rated at all.
Stay away from these people. I was shopping to renew my insurance in November. Already had Health Net and received a letter that if I didn't make any changes during the open renewal I would be re-enrolled without having to do anything. Went online to check premiums for the plan I had. Heart almost stopped when I saw my plan was now 400.00+. So called Health Net who assured me that the price was a mistake because of the new regulations for 2017. She assured me that my premium would now be 1.00 with the same coverage. Sounds great but too great. So called them again. Another person reassured me it would only be 1.00. Went to pay it today and made a 12.00 payment for the year. Called to confirm that they received it. The lady told me that was wrong I owed 400+ and Health Net had cancelled me because I didn't pay on the 1st. Went round and round and she finally got someone else on the line. He confirmed it was indeed 400+.
Told him that isn't what I was told twice. They admitted that they were looking at the documentation in the computer and someone did indeed quote 1.00 not once but twice. So now if I want to keep the insurance I must pay 400+ for January. Told him he was crazy. He finally told me I could enroll in the Bronze plan for around 180.00 but my rx deductible is 500.00. I took it because at this point I had no choice. So hopefully by next week (what they said) I will now be reinstated for crap insurance. These people should not even be allowed to market insurance. They are completely inept.
This company Health Net is the WORST I have ever had to talk to. They changed some dates on coverage and when told about it, they kept saying it was discontinued yet they (Health Net) kept sending letters stating that there was coverage. The left hand didn't know that the right was doing. So glad that we changed health coverage...
I created an account here just to warn all of you how bad these guys are. They canceled my company's coverage the day after payment was due because they hadn't received the check in the mail, never mind the fact that they hadn't told me about their online portal to automate payments. I've never missed a payment and the check was dated long before it was due but coverage was canceled nonetheless and they wanted a $100 fee to reinstate, even after they had received all money owed. On top of that, I have spent the better part of an entire workday on the phone with 8 other people on 6 different phone numbers trying to resolve the issue. It has yet to be resolved. The people on the other end of the lines were also rude and short with me. Save your time and go with someone else.
I am extremely frustrated and not sure what to do regarding this issue. I canceled a policy with Health Net quite some time ago, via phone initially. When I continued to receive a bill I once again contacted their customer service only to be told that a plan could not be terminated via phone, it had to be submitted in writing. Why did the operator to whom I spoke initially lead me to believe that she could cancel my policy in the first place?? Regardless, during my second phone call I was given a fax number that I could use to facilitate my request. Still kept receiving bills even after this. Made another phone call to a surly customer service representative who informed me that apparently there is no one in the Health Net system who checks faxes for this number.
I questioned her, "why would you have a customer fax number and no employee resources to follow through." I was told it was an outsourced department... after being told one incredulous thing after another and receiving no satisfaction, I emailed Health Net Customer Service, printed out the letter and sent a copy registered mail to them as well.
I received a letter from their claims department that essentially regurgitated my letter back to me and in closing Health Net decided that my multiple attempts to close my account were not valid. They kept sending bills and have since sent me to collections. I have notified the collection agency of this situation and have let them know that I am in dispute with Health Net, and that I am happy to send them (the collection agency) copies of the file I have documenting the communications and multiple attempts at account closure that have been ignored.
I have yet to have a response from the collections agency. I feel that I have done everything within my power to take care of this in an appropriate and timely manner and feel that I am erroneously being sent to collections for monies I do not owe. What can I do to settle this? My next step is to file a claim also with the Better Business Bureau to see if they can offer assistance as well. Thank you.
Had Obamacare and was glad to have it rather than having nothing, after a $50,000.00 hospital bill the year before! But Health Net became my worse nightmare and still is. I wish I knew about them before Signing up! Staying on the phone for 1 or 2 hours and the person finally comes on and has no idea if insurance will pay for what I am having done? "What" don't you work there? Then tells me to call back later to talk to supervisor. Is one not there? No! Ok give me a direct line. "I cannot do that." OMG really I must spend another 1 to 2 hours to reach her!!! And she might be on a call, can she call me back, No! This is awful service...
It took 3 days to finally reach her and she did not know so I asked the doctor to call! OK so nowhere to turn I have 18 months before Medicare "oh yea" so a month before I call Health Net and cancel the insurance then. Now don't forget to do this people. I called Covered California and Cancelled. This was almost 2 years ago. Health Net has turned me over to collection saying I did not give 30 day notice! I even gave the name of the person I talk to but they say she does not work there! I don't care she work there then! It's a nightmare month after month these notice from collection. We have A+ credit. I am so angry... Health Net has so many complaints. Something should be done to them to help us... Where do we turn? I don't know my order number. It's been a long time ago...
Health Net used to be a good insurance but unfortunately now they have one of the worst coverages and approval processes out there. I have been ping-ponged getting a knee injection medicine called **. First they denied the specialist's request for the medicine. After several months delay they authorized it but the Pharmacy (CVS/Caremark) was not releasing the medicine claiming they are not allowed and all special drugs should be sold by Acaria (a different pharmacy that has contract with Health Net on certain drugs!).
I called Acaria. They said they are not contracted with my medical group (Lakeside Medical Group was selected as an authorized entity for all my health needs/services during initial subscription processed by Health Net!). I also called Lakeside Group - Glendale, they said they already released the Authorization. To make the story short, after 4 weeks of long phone calls (mostly on hold), no medicine!!! I guess shareholders' interest is more important than caring for members at Health Net! DO NOT CHOOSE HEALTH NET.
As if the care at the VA is not horrible enough this makes it even worse. FYI, to all of you that call them or they call you the veterans healthcare system is giving them ALL of your information. When I say ALL of your information I mean ALL of your information. Your medication lists, your service connections how much and what for, the progress notes and all of it! You may as well print off your medical record and hang it on your front door. They lie to applicants and the employees and say it's a 'federal job' in a 'federal building'. It's a joke!
They have souped up security and hang a few flags around. They like to play some kind of sick mind control games. I swear I think one of the managers was drinking on the job. He was spilling coffee, had glassy eyes and was laughing about something when no one was around. The security officers like to go out off work with the employees and enjoy their alcohol. Anyone who has ever been around someone who has been drinking knows they can get any information out of them. Do you and your loved ones a favor and find a real doctor and a real insurance company. KNOW YOUR RIGHTS! YOU DESERVE BETTER THAN THIS!
Health Net ca has denied my 5 year old daughters cancer treatment. They have denied our appeals and our daughters doctor even called the senior medical director who is md and spoke to him personally submitting evidence of why it is standard of care. Shame on you Health Net like brain cancer in my five year old is not enough to deal with.
I am a Medicare Health Net subscriber on their HMO Plan. I get denied with everything from this "Junk" Medical Plan from medications to facilities. They will do nothing to really help you or see that you get the proper medical care you need. My last denial was to see a facility for a procedure of which is on their plan and list but not in my area. I live in Central CA and wanted to go to a facility that I have been to in the past and feel more comfortable with. I have been treated and visited all Health Net's doctors and facilities in my area and two of them actually worsened my condition. Since the facility is on their plan I did not see a problem here but I forgot I am dealing with Health Net and this "Junk" HMO! I will not be renewing my Health Net HMO plan this year and recommend to anyone thinking of using this plan beware and do not sign up for this "Junk"! You will regret it!
I paid almost $700 a month for Health Net HMO coverage from July through November of last year. I have injuries from a fall that need addressed. But by the time I went to a PCP, got a referral to see an orthopedic surgeon, got a referral from him for an MRI, had the MRI, then got a referral to a neurologist, the neurologist could not see me until February of 2016, two months after my contract job would end and I wouldn't know if I'd have another job. It took me a month to see a specialist, then took a month for the MRI, then took a month to see my specialist again. The office staff for my specialist told me that they double book. The waiting room was always overflowing and I had to wait two hours each time I saw my specialist. Ridiculous.
On top of that, Health Net now says I owe them for the 'grace period', even though I stated to HN customer service that I was not interested in keeping their insurance since I could not even get in to see a specialist until February of the next year, almost three months away. I was not worried about the 'grace period,' however. I moved here from Kansas in 2014, and healthcare recipients never pay for the grace period in Kansas. I had no clue laws were different in California. I only verbally notified Health Net that I wouldn't be paying for insurance in December. Now, they've sent it to collections - Capitol Recovery Corporation - without any warning and say I had to have put it in writing to have avoided paying for the 'grace period' payment.
Funny that HN customer service never told me that I had to cancel my coverage in writing in order to avoid additional charges. I would NEVER use this company again and would highly recommend that no one else does, either. In addition, I was on auto-pay. I would have had to cancel the auto-pay in order to not have been charged again, which I did in October.
Your company is contracted to set up appointments for the VA and it has been months and they still have not made an appointment for my husband to receive physical therapy. I've called the first group many times and they send the information to the people who schedule. After many call the 1st group has repeatedly told me they put urgent on the request because it has taken them so long to make the scheduled. Your company should be ashamed at this terrible service. I worked in a doctor's office for 20 years - making an appointment for a patient is super easy. Please do not take on a contract with the VA when you can't do what is asked of you. Who is the CEO of Health Net and what is the phone number. You all should be ashamed of what you are doing,
Health Net for our veterans is a completely disaster for our veterans. I have spent the better part of a year trying to find just one specialty doctor, who will accept The Choice Program under Health Net, and in my case thirty five doctors have turned down the VA Choice program, because Health Net is a third party insurance company with requirements that are too stringent, and many many doctors are not getting paid. So, this joke of a VA program by a Secretary of The Veterans Affairs is simply pandering to his personal cronies in the healthcare insurance industry, leaving our veterans to have to go to the VA Medical Centers, where surgeries are delayed, denied, and botched. My advice to veterans is to go online, and look up all of the Inspector General reports at your VA medical center in your area, to see how many veterans are truly at the mercy of many incompetent doctors, and nurses within the surgical center.
The new motto within our veterans speech is " DELAY, DENY UNTIL THEY DIE". This is what happens within a completely corrupt organization, such as The Veterans Administration, run by lobbyists, insurance companies and former executives of corrupt corporations. Just so you may believe my story, I ask that you review the recent death of a Veteran in New Jersey, who set himself on fire and died in front of a Veterans Clinic, where he could not receive his medication for a mental health issue. Didn't make the news did it... Wonder why?
Last Oct, open season. I was told my plan premium and deductibles would not change. In Jan they did mislead to renew with them. Now I pay deductibles for insulin and much more. While straightening out 50-day supply instead of 90, they sent me drugs from Jan and Feb without a deductible being charged. Thought they would bill me, they. Mar didn't need but in Apr needed to renew my prescription. Made sure it was 90 day and what the cost was to pay $101.
Dr. sent in update prescription and now they won't send me anything until I pay all the deductibles. They neglected to bill me for from the first of the year. That's right! Holding my insulin hostage for their blunder. I could have paid each month's bill but they didn't send it? Or even ask for the money. They waited until I had days left of my insulin and refuse to send until I pay all of it. They don't care if I die or that it was their fault! I could only pay up to the monies I had saved for this month and that paid up for Jan, Feb and will get the new prescription but only have 16 dollars left to get insulin and they won't send it even though they sent it without payment in Feb. They want me to die! Now I must go a month and wait 'til my next SSI check to get my insulin. That's right. A whole month without insulin because this greedy, lying, Health Net insurance company is so incompetent!
Having insurance through the AZ Obamacare exchange in AZ is worthless. Banner refuses to accept this. It is like being on welfare. Terrible terrible Obamacare = insurance not quality medical care. Top doctors and hospitals will not accept this insurance. Might as well have no insurance. Inferior care, service.
The only good thing I will say about Health Net is that when one of my family members needed intensive treatment for an eating disorder, Health Net gave us a single-case authorization for the best facility (that was out of network) and even covered residential treatment. On every other front, they have been absolutely awful. I was in an accident last October, and was referred for a CT scan. I waited 3 weeks for a prior authorization from Health Net for a CT scan, and it finally was allowed. But then they only paid the claim for the scans themselves, not the $78 bill from the doctor who read the scans! Four months later, I am still trying to get them to pay it, meanwhile pleading with the radiology lab not to send the bill to collections.
I was also referred to another out-of-network specialist, and after waiting 3 weeks for authorization I finally had an appointment. What do you know, Health Net denied that claim as well! Everything is like that with them. I think their business model has been to stonewall and not pay for anything, so that they could show a higher profit and be bought out by a bigger firm. Lo and behold, I just read that they closed a merger deal with Centene in late March for $6 billion. Nice work if you can get it.
Last November I went to ER. FOR A KIDNEY STONE. I was there for four hours and I'm getting charged $8,000 for been there for four hours. I used their hospital and still they came out with this amount of money. After deduction I have to pay $2,400 out of my pocket. What if a need surgery? It will cost me thousand out of my pocket. What's the point of having insurance? I asked Health Net to send me a details of my policy in regard to emergency needs. I never received the details of my policy.
Joseph BurnsHealth 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 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
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