Consumer Reviews and Complaints
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.
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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!
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!
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.
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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