Consumer Complaints and Reviews
I have met my deductible and out-of-pocket insurance amounts. Earlier this year it was noted that I had three liver tumors. During the time frame, my PCP of 25 years was no longer part of the Compass program. UHC changed my PCP to a cardiologist. (There happens to be a internal med doctor with the same name, just different initial.) I called UHC and they said that this is the correct doctor. I finally called the cardiologist's office to ask if they could get me a referral to a liver surgeon and they were shocked that they were my PCP.
Finally changed PCPs and got a referral to a liver specialist but not a surgeon. He referred me to a liver surgeon at UNMC and I checked, UHC does not have any liver surgeons in network, if I want to see one, I can pay for it. I called and asked for a gap exception, and they refused that too. So I paid for two CT scans and an ultrasound, and the radiologist report states that it is at high risk for hemorrhage, and that a biopsy it not recommended because it would either rupture or hemorrhage. The radiologist believes a liver resection is required. It sucks not knowing or being able to afford to get this taken care of while I am healthy. So after my family has paid premium, deductible, and out-of-pocket expense, we were "lucky" to only pay $20,000.00 for one year of coverage. I am not sure how this is affordable if it doesn't take care of your medical needs.
I had United Health Care for two years and it was a complete nightmare from the start. To begin with I set up automatic payment on the website. After two months, I received a letter stating I was behind on my payment. After I called the person on the other end said that automatic payment was never set up. So I paid the last two months and set up automatic payment with him.
Two months later the same thing happened. I called again and set up automatic payment with a representative. Two months later this kept happening and no one could tell me why. After this automatic payment was set up. I should also mention that I was paying $199 a month. When it came time to renew my insurance they increased the price to $267 a month for the exact same plan. Nothing I could really do about it so I just sucked it up and paid it.
Three months later I'm at my pharmacy picking up a prescription and my pharmacist told me that I don't have health insurance. I called United Health Care right away and the women on the phone told me that I haven't been paying my bill. Come to find out that United Health Care had been automatically withdrawing the $199 from my original payment but they had not updated my file to withdraw the $267. I had to make a payment right then and there for the missed months plus the current month and the next month as well and I had to wait 24 hours and go back to the pharmacy, on my lunch break again, to pick up my prescription.
Now every month I see my dermatologist. United Health Care sent me a list of approved dermatologists. Most of the doctors on that list had either retired, died, or did not accept my insurance. Finally after six weeks of searching I finally found a dermatologist that accepted my insurance. The first few visits were fine. Every month I have the same thing done at the dermatologist. On my fourth visit the receptionist told me I wasn't covered. I called UHC and they said I was covered and that the dermatologist used a different tax id number. The billing department at the dermatologist had no idea what they were talking about. My next visit was covered. The visit after that was not covered. This went on for awhile and every other visit I was paying over $200 out of my own pocket so that I could be seen.
I kept calling UHC about this. Sometimes they would say that they would reimburse me for my out of pocket expenses and that they would send it to my dermatologist. They never did. Sometimes they would say they would look into it and call me back. They never did. One time the woman hung up on me. Obviously I was mad and perhaps a bit rude on the phone but I was still calm and she hung up on me. After all of this I cancelled my insurance policy with them and went with a different insurance company. I called after my insurance was cancelled to make sure it was cancelled. I also called my bank and informed them that my insurance had changed and that I no longer gave approval to UHC to remove money from my bank account.
Fast forward three months later I get a voicemail from UHC that I'm behind on my payments. I called and talked to a girl and explained that I don't have health insurance anymore with them. I gave her my name and she looked up my account and said that my account had been closed and I do not have a balance and she's not sure why someone called me. I asked her to send me a statement stating that my balance is zero because next month someone different would be calling me and telling me I have a balance. I feel like there are a few other unprofessional things that happened in the last two years that I just can't remember. But as you can see I was never happy with them and I'm never going back to them again.
After several months of paying premiums for my AARP United Health Care Part D Prescription Meds program I have come to the conclusions that the "tier" system of rating prescription medication costs is designed to assure that I LOSE! EVERY TIME! EVEN WITH RELATIVELY INEXPENSIVE MEDICATIONS! I have spent hours on the phone with customer service and have officially requested special consideration only to later be denied.
My wife has United Health Care through her employer. She pays a high premium for the best plan they offered at her job. On top of this she has a very high deductable before they pay anything. Her Doctor and Doctor Doctor want her to have surgery on her legs due to varicose veins that have appeared. They think these veins may be causing her heart problems and are worried a blood clot could develop and go to her heart. After all the pre test she had (which we paid for under her deductable) that the doctors said met all requirements to have surgery the insurance denied coverage. With just a small amount left on her deductable this year. Even if the insurance company changes their mind (very doubtful) it will be next year and she will have to meet all of her deductable amount before they pay anything.
We asked United Health Care for the Doctors name and credentials and all they would say is their medical director. We asked for their name and credentials and were refused an answer. This insurance company has cost our family lots of money for insurance premiums and cost of Doctors visits, blood test, medicines, etc. with no payments on their part. This company is the worst, useless and greedy company I have ever dealt with.
I can't help but think the SYSTEM at UNITED HEALTH CARE is CONNIVING. I feel like I was tricked, and while customer service goes out of their way to sound nice, there was truly no sympathy for my situation. As I recall, the lady in the phone, in the nicest and sweetest voice ever said, "I'm sorry, there's really nothing I can do to help you out."
My situation: I was pregnant and chose a doctor under the network. Every time I had an appointment, every time I had to go for a blood test, every time I had to go for an ultrasound, every time they sent me to the hospital, every time I had to pick up a prescription, I called. I called to make sure that I was covered. I'm just that type of person. I didn't want to risk not being covered by insurance, so every time something came up, I CALLED. Every single time I called, they said it was ok, and that I was covered. Every single time I called, there was a sweet sounding person who seemed to reassure me. They are good at that, SOUNDING NICE... so you move forward with confidence.
Then one day, I receive a bill. A bill for blood work sent to a hospital. I called up United Health Care to find out what this was all about, and the lady on the line, again with a sweet voice, told me I didn't have to worry about it. That the hospital was passing it on to me for "some reason" -- yes, she used those exact words. I asked what the reason was, and she said that it was a bill United Health Care sent to the hospital and that the hospital should cover it but sometimes they pass it off to the patient (she even made the hospital sound bad), and that she would take care of it for me. She didn't take care of it. Now, in hindsight, this bill was sent to me because the hospital isn't covered by United Health Care. This is the same hospital that I gave birth in. This is the same hospital that I had check ups in. And mind you, every time I went, I called first to see if it was ok, and they said YES it was.
So now, after having had all those checkups, and my birth in that hospital, I call up UNITED HEALTH CARE to follow up on that bill for blood work sent to the hospital. They say it's not covered. That I have to pay for this myself. This made me ask about all the other services I had at that hospital. The woman, in the sweetest voice ever, told me that none of my check ups were covered. Nor were the births. Mind you, my doctor is IN-NETWORK and this hospital is the only hospital she practices in. How convenient for them that I know this all now AFTER THE BIRTH, AFTER THE CHECK UPS. They couldn't tell me this before I went to this hospital?! Why, all of a sudden, are they telling me that this hospital isn't covered AFTER TELLING ME IN THE PAST THAT IT WAS.
And now, it's their word against mine? What happened to all those calls I made with recordings that told me that the call was being recorded for quality assurance? WAS IT FOR THEIR ASSURANCE? And all the lady could tell me, in her sweetest voice ever, was, "I'm sorry, there's nothing I can do for you. The bill is yours and you have to pay it." So after paying over $750/month for insurance, I get no help in paying for my birth!?
I talked to my doctor about this and even she felt it was ridiculous. She is standing behind me all the way, and I am filing for an appeal, which the customer service representative told me was my only choice, even though she felt I had no chance of winning the appeal (yeah, she told me that). To the people at UNITED HEALTH CARE... may you receive the KARMA you all deserve for your trickery and fake sympathy.
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It's a good thing UHC has pulled out of the Marketplace coverage because they are so poorly administered (note when we had them through an employer they were amazing!). It seems once UHC made the decision to leave Wisconsin, my claims and account were poorly administered! There is no logical explanation to how they make their decisions to pay or not pay a claim. One day they approve a claim only to disapprove the next, without telling the consumer. Sometimes they will pay for a PCP (personal care physician) visit and other times deny it. It took me 5 months to get 3 physical therapy claims paid after repeated calls to get it done.
One out of ten agents you speak to understands what is going on. The others muddle through the process, giving you vague answers. Unless you stay on top of your claims, you will never know if they are paid until months later. I diligently play by their rules and constantly follow through with my account. All parties need to be paid! For instance, prior to a necessary follow-up surgery for an emergency condition, the preauthorizations needed were sent to UHC. Within a reasonable time frame, I received, from UHC, their letter of medical necessity approving this procedure for both the admitting doctor and hospital.
Today I discovered they denied the bill for the admitting doctor because my PCP hadn't put in an request (wrong, she did and I have the approval number), but they did pay the hospital bill portion for the service. When questioned about this, the agent "Joe" said he saw the approval and will resubmit it and to wait 10-15 business days for an answer.
A PCP visit and CT Scan bill for the same medical issue are in limbo. My PCP had called in a "STAT CT scan" for a preauthorization and was given permission, but now UHC stated they don't have enough information from the doctors to pay it. This is another case where they approved it one day and then denied it the next. When called about this they say they need more information and when I call the doctor's billing, I am told they never received this request! It's a constant battle to get things done!
Another complaint I have is about the totals for your deductible and out of pocket costs on your "myuhc.com" account site. They are often miscalculated them and you need to question their accounting. Finally today when I called the corporate phone number to find out whom I could contact about whom to complain to about the inconsistencies in my account, I was informed UHC does not own the Marketplace company using the UHC name, they sell their product to someone else under their name. They couldn't help me and only gave me the same phone numbers that they publish on their website for the marketplace accounts. Well, isn't that a surprise! Another dead end for the consumer! So good riddance UHC, I'll take my business elsewhere to a company who administers their clients in the USA!
After paying premiums for years our son was diagnosed with Type 1 diabetes. His blood sugars drop rapidly and when they become too low he could have a seizure or die. United Healthcare has denied coverage of a life-saving device that would monitor his blood sugar even after our pediatric specialist called the insurance company. What a scam! With a $10,000 deductible they are playing games and making us wait and appeal to move the case to a new calendar year so we have to start over with our deductible. This company has no morals!
This the worst healthcare company in the Untied States with the worst customer service not just in the healthcare industry but of any company operating in the United States. My wife and I have had to spend over 20 hours on the phone, have received inaccurate information, have been told we would be called back and were never called back as promised. If you have an opportunity to use any other health care provider other than United Healthcare - do it as fast as possible as United Healthcare is the worst company I have ever dealt with.
Subpar coverage compared to the providers I encountered at comparable previous employers. On my first phone call to them, I was rerouted 6 times. The 1st department said they would redirect me, then the second department said I actually needed a third department. The third department told me the second department would have the answers I need. It was embarrassing on UHC's part. I'm just hoping I don't need to use my coverage any time soon, which is sad.
After paying monthly health insurance premiums (which are ENORMOUS and that is considering my husband company also paying even more on top of what we are paying) we still have to pay outrageous amount of money for anything and everything. They would not even cover MRI required after an accident. It was with an in network provider. We paid 100%. Prenatal coverage is a rip off and anything else in between we still have to pay outrageous amount of money and that is with a PPO Choice plus plan. Worst insurance ever and I had several before. I cannot complain about their customer service since they have been helpful every time I called or contacted them. This review is toward the organization/owners who is ripping off their customers.
Call centers in Philippines and Jamaica - Good luck trying to get answers to any questions. And there are many. After you go through the older than dirt ladies voicemail cues-she sends you out of the country! Unable to understand. Also you'll receive emails from UHC stating to open your secure message center and when you call because there is no way to do this, they tell you you never received an email from them! Make sure you leave plenty of time to waste-1-1/2 hours should do it.
This is the worst insurance I've ever had. The online provider directory is frequently incorrect. They've dropped a major hospital group, mid year even though I can't switch insurance companies mid year. I'm required to have a referral from my PCP but they list doctors who aren't really in network, so I have referrals for visits that don't get paid because the tax IDs don't match even though there's no tax ID on the referral and even though the doctor's name, address and phone number match. I spend hours on the phone trying to get things resolved. I've been in tears several times because I don't feel well and I'm having to hassle with referrals using an extremely inaccurate online system and phone reps who are difficult to understand and don't even have access to accurate information. They have to call the doctors to see if their tax IDs match what they have in the system to find out if they're really in network or not!
I've never experienced anything like this in my life. Thank goodness I'm switching back to Anthem next year. Stay away from UHC. Even a doctor's office said they're the most difficult insurance company to deal with. There was even a time when my medication was on backorder at one pharmacy, so I went to CVS because they had it in stock just to find out they dropped CVS a few days earlier... also mid year. Then after more than an hour on the phone, the rep could only find 1 pharmacy in a 20 mile radius, which was the one that was out of stock. He finally said to just go to Target and see if it works. It did, but why did it take an extra hour for that??? LOTS of wasted time and frustration.
They tell you what prescriptions they will cover over the phone. After you go to pick it up, then you find out they deny it. They dictate what medicines you should take that only a doctor can do. They should not be allowed to change a medication that has worked for you especially after you have already tried several. They don't cover what they say they will cover. Their customer service is terrible and will give you a different story each time you call. They outsourced as well so there is big communication difficulties. I would not recommend using them. Worst one I have dealt with in 15 years.
We have UHC and it has been thru COBRA our primary insurance per years of service. We did not select Medicare B because our employer told us we did not need until off COBRA. UHC continued to pay as primary UNTIL we have claim of 21,000.00 for surgery. It then preauthorized and preapproved exact amounts with surgery team and with us, and agreed on copay of 1600.00, and then they paid the amount minus the 1600 to our surgeon and anesthesiologist offices.
Several weeks later they retracted and then billed us for 16,000.00 (sixteen thousand dollars) without indicated that this was because for first time without telling us they considered UHC secondary to Medicare B which we did not take on employers advice and on their history of coverage as well as their knowing we did not have B as we told them. So if you think preauthorization is helpful and your medical team gives you estimate and signed preauthorization and you sign and UHC signs, they will not honor it. They have in this case committed fraud in leading us to believe this surgery was paid, and would be, and that we were covered and authorized signed exact amounts out of pocket and now are forcing us to pay for shoulder surgery - we could have done after we got another insurance that honored their claims I.e., Group health etc.
I consider UHC to be not only a dishonorable insurance company, but one that will have no problem forcing back in time claims that were paid to be forced on client after the fact, after authorization, after office has confirmed they will pay and after surgery. There is no willingness to honor any statements or claims. WE do have attorney and we will appeal and the cost is on us, and buyer has to accept all harm done to them. Even our surgeons and anesthesiologists claimed this was unethical, wrong, and beyond what is the standard practice of any insurance. In fact anesthesiologist offered if appeal is not happening they will work with us to help. Not so with UHC that got us in this situation as we had many choices.
Do not sign up for any UHC if you want to trust in any way your insurance company. They have been dishonest and we are family that has had and honored many insurances over our careers that are multiple and have worked in many states. We are well versed in right and wrong and have had Aetna, Blue Cross and I can testify, they all honored their word.
Company I work changed ins carrier to UNHCR and OptumRx... Very unhelpful. Could not get anyone to understand that I had prescriptions that needed to be transferred from previous health ins. Horrible service. Incompetence. I had to return to my physician and have new prescription sent. Automated answering service when calling UNHCR malfunctioned every time I called. Intake person stated that my insurance was terminated... On and on... Several days of calling, long holds on phone... And yes I have insurance. OptumRx is horrible!!
First of all I was put on short term medical for 9 months. I was having an issue with my toe. Went through physical therapy. My ankle was bothering me I ended up getting a ** shot. After the 9 months was up, just finally reached my deductible. My insurance coverage was almost over so I started a new policy with United Health Care for the remaining of the year (3 months). Even though it was the same plan I had to start my deductible all over again. I found out I have torn a tendon in my foot. So I had to get ankle reconstruction surgery. I thought the surgery was covered. No one said any different to me. Finally got back claims saying that it was denied. I called the insurance company and said "oh it was a pre-existing condition" because I got a ** shot in my right ankle. How lame is that.
I switched my plan to United Health Care in July 16. And surprisingly, my 3 months refill for my meds was rejected by the prescription provider (OptumRx). I run out of my meds which I have been taking for more than a year. They forced me to use another cheap meds and it took them forever to send me the new med. For three weeks, I have been calling them back and forward to make the switch and every time, something happen. It is either the problem of dosage (I am only allowed to take one pill a day for example instead of two) so the doctor needs to change my prescription. Or their rep forgot to click on my shipping address so the order was not mailed. Or...I have checked my prescription and it was covered but then denied because of all the restrictions they put in the pre-authorization form. So please make sure you check that especially if your meds are Tier 3 (more expensive).
Thank you democrats for fighting to ensure the 45 million who were without insurance. Too bad there was no public option and we have use a private insurer, like this one. United Health Care gets a HUGE subsidy for me and every time I need help, my calls go OVERSEAS. Our tax dollars literally being used to hire people in other countries = cheap labor. UHC like other insurers is claiming that their profits aren't big enough so they are pulling out of the marketplace in many states. Really? They got all the millions of new people/subscribers with government subsidized premiums and they aren't making huge profits? Doubt it. Americans need to wake up - the most cost-effective health care systems in the world are SINGLE PAYER. I don't hear anyone complaining about MEDICARE - rich or poor, they like it and use it. And we paid into it and they do good research and monitor what is being done with the money paid.
Even if you don't like Hilary Clinton on other grounds, at least she is talking about expanding MEDICARE or offering us another public option. Health care INDUSTRY gets 1 out of 4 health care dollars - for administration! WHAT A WASTE. Try their websites -- I have NEVER been able to have access to my own documents, no matter how many calls to customer service website overseas to fix this. I am a healthy athletic person and UHC charges $550 a month for my insurance -- I have NO health problems! That is perfectly obscene, and someone needs to look at their accounting if they are claiming their profits aren't big enough. I think it is an industry blackmail at work - pure greed -- or completely inefficient.
My family doctor wants me to see a specialist. I spent one full day on the computer and the phone. Every time I got information, it disputed the previous information. I called United health care several times. They gave me names and phone numbers of doctors, when I called them they did not accept the insurance. I tried using the online lists, both of the insurance company and the doctors. I also used several hospital doctor lists. I searched the maximum of 99 miles away.
I became so frustrated that I was physically distraught, crying, while trying to speak with a representative. I would like to interject that I started working right out of high school, still only 17 years old. At the age of 23, I opened a dance studio which became successful. As the economy went up and down, so did my business. I never gave up, working other jobs to supplement my income. I took care of my elderly parents and still do take care of my mentally ill brother. This has led me to low income and Obama Care.
Now at the age of 64 being treated like I don't matter and haven't earned anything in life. I am forced to have this healthcare that doesn't support any doctors. If I don't sign up for it, I will be fined. Before this, I went to the doctor only when necessary and paid out of pocket. Now that's not allowed and there is nothing else. A representative at UHC told me to ask the doctor if they will accept the insurance as I am a former patient. I said I didn't think they would and she said "you'd be surprised, especially if you went there before".
I called the doctor and they told me if they did that it is considered fraud. No one at UHC seems to know what they are talking about and they are wasting our valuable time sending people who are already not feeling well on a wild goose chase. Meanwhile, people who have better plans go to the doctor several times a week raping the system. This is not caused by the patients, but rather by evil greedy doctors who have elderly patients use their office as a social gathering place while they sit in the waiting room. The doctors see them over and over for the same reason with no solution. I am now left with a health problem that has no answer and no doctor that will accept my insurance. United Healthcare should not be allowed to operate.
Simple. My required medication was preauthorized (PA). I was told that with the PA my Rx would be filled. I waited. Three days later I called. Nope. "We have to review the Rx, give us two days". Two days later another customer service (laughable) rep tells me they have 12 days to approve. I call 8 days later to check on progress. Nope. "We have 7 days and 22 hours to respond". If they are true to their word, it will be a MONTH from prescription to when and if it gets filled. How is this legal? Or more importantly how is this any way to treat people? Sad.
I've had so many poorly handled claims in 2016 it's almost funny. Like them telling me that I did NOT need a referral for chiropractic (I really did), then denying the claims. I needed to see a Massage Therapist. Again UHC told me that I did NOT need a referral. UHC denied these 2 claims saying that Massage Therapy was "excluded" under "Alternative Services". Yep, when I looked at their website, it did say it was excluded in that spot. But it also said it was covered for 10 visits/yr under "Rehabilitative Services," the same place where Chiropractic was listed. I sent them screenshots of both and asked them to tell me which was right. A few days later they added a new benefit category -- "Chiropractor/Spine/Back" and Massage Therapy was included, AND Massage was no longer listed in "Alternative Services Exclusions." Hmmm...
The major Whammo, however, was me accidentally discovering that my primary care provider (PCP) had been changed without my knowledge or consent on 9/1/16. I had just been in the hospital and was needing to follow up with my PCP on 9/5/16. I waited. If I had seen my PCP, there would not have been coverage!!! Oh, it could have happened so easily! My discovery took place on 9/6/16, and when I looked at UHC online, sure enough my doctor had disappeared from the list of providers covered. Even the whole facility my doctor works out of was missing.
I tried to work with UHC representatives. Their answer was "I don't know why this happened because I can't get a clear answer from OUR people -- I'll have to take this to my supervisor." Well, I decided enough was enough. I filed a complaint with the Insurance Commissioner. They have until November 2, 2016 to provide an adequate answer.
Both my husband and I were told that we should sign up with Care Improvement Plan, an advantage plan. We were told we could see any doctor we chose, and could also go out of network. I called at least 30 doctors that the representative gave us. None would accept the plan. The company set me up with a doctor who was 25 miles away, and my husband was told to go to a DO. One rep told me to go to those doctors anyway. Even they would not accept us. I finally called Medicare and related what had occurred. They immediately let me out of the plan and got me signed up with Mutual of Omaha even though it was not in the sign-up period. My husband was not a candidate because he is a diabetic. Our family doctor somehow saw him by what method I do not know.
I am often on hold for 45 minutes to an hour to get help, given conflicting answers and have to appeal many of their decisions. In general, there is tremendous incompetence and inaccurate information from customer service. I was sent a reimbursement check from the UHC FLEX acct. that bounced causing me to pay a bounced check fee that they did not compensate me for. But I think the worst aspect is that no one seems to know accurate information and I was constantly conflicting information from different representatives. Horrible and incompetent customer service and the medical coverage itself left me with high copays and far too many series uncovered. $150 for an MRI for example. Stay away if you can.
Call for verification that medical device is covered. UHC approves purchase. UHC denies reimbursement. This is insane. Call your congressman and demand that the Attorney General punish unlawfully denied claims with lengthy prison sentences, and the death penalty.
My doctor's office submitted a pre-approval for a treatment for very bad varicose veins that are causing me an excruciating pain and swollen heavy legs at all times. UnitedHealthcare denied the claim without mailing me proper explanation of benefits and even though my doctor personally called them to explain the condition that I have that it's called vein reflux. Basically many valves on two important veins aren't working as they should.
I don't understand how they can denied treatment for something that is a medical condition. I called Clinical Services for an explanation and a representative called Jenny... All she had to say was "I cannot understand what you are saying" in a very rude manner. Not only they denied my pre-approval, they also did not provide me an explanation, AND I had to deal with someone with no education on the phone that provided no information or help whatsoever. I asked for a letter with the explanation and now waiting to see if I can find a low cost attorney to represent me.
I have UHCP plan through my employer. I went for annual physical exam and doctor performed some basics tests as part of annual physical. I received bill of $300 for no reason as it should be covered 100% as annual preventative. I am calling customer service since March 15, 2016 and every time representative give me different answers and blame doctor's office. I call doctor's office and they blame insurance company. I called again United Health Care for this issue and now they say won't process claim anymore. United representative says I have to pay or appeal. Representative recommend paying charges because appealing wouldn't change anything as it's outstanding since more than 6 months. Worst insurance company and very bad at processing claim.
I would like to share my experience with United Health Care insurance company. My husband's company was just bought by another company. My husband's original company had been bought and sold before, so we've had to change insurances 5 times. We had United Health Care several years ago (before Obamacare) and we got rid of it then because they were terrible to work with and they refused coverage of a lot of things. Unfortunately, his new company has United Health Care and they don't offer another option. Before we were bought, we had Anthem Blue Cross Blue Shield PPO and never had a problem seeing doctors, getting medications, or getting procedures. I have been on my back for 85% of the last 4 1/2 months with severe pain, spasms, numbness, and tingling in my left buttocks, leg, and foot.
I was taking ** to help with the nerve pain along with ** (now, not covered) and **. I had just been referred to a neurologist when we were forced to change to United Health Care. All of a sudden, I couldn't refill my ** prescription even though I had been on it for awhile. They had to fill out this pre-authorization that was a hassle, which was still denied. The neurologist had to spend time gathering and sending all my past records, MRIs, and other tests for an appeal. They finally approved it but they would only approve 300 mg max per day when my doctor had prescribed 400 mg per day. This process took over a week, and was a major hassle for my neurologist. I had to get sample packs from the doctor's office so I wouldn't have horrible withdrawals. When I started looking at UHC's lists of all medications, I couldn't believe how many medications were listed with the words "Plan/Benefit Exclusion" next them.
Many of the best doctors are not in their network either, nor do they cover as many procedures. This is supposed to be a PPO...their best plan. It is the worst PPO I've ever had. My neurologist said I needed to see a neurosurgeon for possible surgery. I picked one of the leading neurosurgeons in our area only to find out that he and his whole group were not in network. In fact, a lot of the best neurosurgeons in our area weren't in network. Now I understand why. Good doctors won't waste time in dealing with United Health Care because of the money, time, and effort that it costs them and their practice. If you are considering an insurance to buy and you have a choice, run as far away from United Health Care as possible. If you don't believe me, ask your doctor's offices their experiences in dealing with United Health Care. I believe they will back me up. I hope this helps in your search for good health insurance.
I have been very loyal customer of United Health Care. I was able to pay my monthly bills on time however in month of September I paid 4 days late and my insurance was cancelled. I spoke to 5 different people explaining my situation that I simply was so sick that I forgot to pay in my grace period. "Please reinstate me because I'm cancer survivor and need my medication monthly and have coverage." All my requests was bluntly denied. They was nasty, rude and not caring people. I will never ever recommend this company to anyone. It's simply awful. Do not go with this company. Just avoid it. Customer service was not sure to who they should refer me. They switched me to 4 different people and all of them was in total disaster.
I was scheduled for my first colonoscopy and my doctor prescribed me medicine I had to purchase for preparation of the medical procedure starting the day before. When I called UHC, they confirmed coverage of the medical procedure as preventive. The day after I called again to inquire about the kit of medicine I had to purchase and they told me it should be all covered as preventive.
However, when I went to the pharmacy, they told me that they checked with insurance and I had to pay full price. I believe the pharmacy has no way to place the purchase of the medicine as preventive on their system. I called back UHC and they indicated that the medical procedure was covered but I had to pay for the medicine. I do not understand how is possible that the medicine prescribed by the doctor and required to prepare you for the colonoscopy procedure cannot be covered when the end result of the procedure depends on the bowel prep medicine you need to start having the day before.
Also, UHC has a clause in their policy that indicate that if the doctor requires the medicine for this procedure, I should call them to have it covered at no cost to me. However, when I called UHC about this issue, they still declined to pay. Is this the type of preventive care we need although we are paying for a health insurance? How can they cover the procedure but not the medicine that is required for the procedure? Shouldn't be all covered? This is not ** or any type of medicine for after the procedure. UHC needs to be aware that there is a reason doctors prescribe different type of medicine depending on patient risk, preexisting conditions, etc. Be Aware.
Good god! I've never dealt with an insurance company quite like this and guess I'm just piling it on with all the other reviews. My story starts with a job layoff. I had UHC when employed and chose to keep it through my state’s Healthcare Exchange (HE) - what a mistake! Problems first started (and have continued) when we did a considerable amount of research both on the HE and UHC sites. Both websites indicated our respective family doctors were a part of their Charter program. So we signed up. When we went to pay, we had to choose a Primary Care Physician (PCP), and were told that our PCPs were NOT a part of Charter, rather their Navigate plan. We had proof, printouts and the following hours on the phone and email, they collectively ended up conceding that their websites were not properly updated.
The HE reps blamed UHC ("it’s UHC's content we post") and UHC blamed the HE. It was nothing short of a circle jerk...sorry, more PC...a catch 22. After spending over a dozen hours and weeks on trying to get that rectified, we were told they were going to fix the problem and not subject us to the Open Enrollment a year away. So they supposedly make the change effective 01Jun16. What a joy. Success. Right? We only wish... The nightmare was only beginning. I went to the doctor (finally) on June 10th and have been paying for it ever since....
What has resulted since is more dozens of hours in failed attempts to sort it all out and to this day, 12Oct16, I still don't have it resolved and can't get the supervisor who promised me to call me back, to call back. While in the Charter program for some 30 days or so, we successfully assigned our PCP (previous family physicians – or so we think and have been told we did). This bit of significance becomes an issue later.
15Aug16: After receiving medical invoices from the June visits, indicating that “Your insurance company denied payment for the following reason: Coverage not in effect for date(s) of service,” I called UHC and spoke with rep Clark ** who advised that it "appears (my) costs should be covered" and he could not understand why they weren't being covered. Though he did then see and say we didn't have assigned PCPs??? I replied that we once had them assigned in the Charter program and after being placed on the Navigate program, we did so AGAIN during a tele call with a UCH rep AND online. FRUSTRATING!!!
We spent quite a bit of time on the phone and he supposedly took the time to reassign our PCPs - once again.which still apparently didn’t take...read on. While pleasant, it was clear he was not going to figure much more out. So he submitted the medical provider invoices for a "2nd Review," giving me an appropriate reference number, adding that I will hear back in 30 days or less. To date, we STILL have not received a response.
22Aug16: My wife receives a call (or notice in mail) indicating that no payment was received for our plan. Our credit card company replaced our card due to some data breach somewhere so we were able to quickly resolve by providing a new card – the significance of this will be evident later…read on. When speaking with UHC rep Joy **, to resolve this matter, my wife *again* had our PCPs assigned during that call as she was told by Joy that either no PCPs had been assigned or they were doctors we were unfamiliar with???
08Sep16: When attempting to get my daughters medication refilled, pharmacy personnel indicated that our "medical coverage had lapsed due to non-payment."??? Uh…we have credit card statement proof that all that payments have been consistently made. So this warranted another call to UHC and my wife spoke with UHC rep. Monique, who indicated our payment coverage was "up to date" but their system was faulty in some way. Okay, it happens… We ended up paying full price for the medication and not bothering with UHC regarding the same. Way too much hassle but then one has to ask exactly what it is we are paying for???
19Sep16: Received Explanation of Benefits (EOB) notice that certain Dates of Service (DOS) were not covered due to non-payment. Called and spoke with UHC rep Tami who advised "we are having technical issues due to changes in optimizing the system," "you are covered and have not lapsed (due to non-payment)," and "this is definitely a UHC issue." She added that we would receive an email notification or call back with an update and gave us a reference ticket number, for what it’s worth. To date, no update of any sort has been received accordingly.
26Sep16: I call and speak with UHC rep Tyrone **, insisting to speak with a supervisor (considering the history and the many, dozens of hours spent on the phone trying to fix THEIR errors). Tyrone exhibited a pleasant attitude and was wanting to help, virtually insisting that I explain why I wanted to speak with a supervisor. I tried to concisely explain and he dearly wanted to assign PCPs again (yep, you guessed it, again, doctors we have never heard of were somehow automatically applied despite all previous efforts).
I repeatedly insisted on speaking with a supervisor. Where did that get me…he hung up on me after one hour on the phone… I later learned it was apparently because it hit closing hour on the east coast. So I immediately called back and spoke with a LaShawnda who said she could not help me, advising I needed to speak with someone in the Navigate Department, transferring me to Erika. Erika tried to summon a supervisor to no avail but assured me her supervisor would call me back the following morning. That following morning I received a call back from Erika advising her supervisor was in training all week, would not be calling me, and that I should call the 800 number back and try to reach another supervisor (essentially starting the process all over again). Kind of her to call me back, but really…?!?!?
27Sep16: My first call with a Cory ** gets me nowhere, of course, and he transfers me to Tyrell ** in the Navigate Department. Once again, I insist on speaking with a supervisor. I get a hold of Supervisor Vernon ** who was very personable and pleasant, listened to my issues in total, and vowed to resolve them. The gist of the issue…finally revealed…was that when UHC went to correct their error and place us on the correct Navigate plan, not only did our PCPs not transfer but they dropped me, the primary member, as an insured in our four member plan, which we’ve been paying since May!?!?
He admitted he could see that my entire family of 4 were covered in my prior employer plan (up until the layoff), and again in the Charter plan. Yet when they transferred us to the Navigate plan, for some unknown or explained reason they dropped me – keeping my wife and two children covered??? He appeared to make honest attempts to address this while I remained on the phone (I was happy to wait, thinking I had someone who c/would assist) but in the end he said it was going to take the coordination of a number of different groups and more time, possibly in upwards of a week. So he gives me his direct line, days & hours he works, and says he will call me back.
Thinking I thought I had someone who was consciously willing to take an interest in seeing this through, I was happy to wait. 04Oct16: I called and left a voice message for Vernon ** considering I’ve heard nothing by phone or email. 05Oct16: I called and left a voice message for Vernon ** considering I’ve heard nothing by phone or email.
12Oct16: I called and attempted to leave a voice message for Vernon **, considering I’ve heard nothing by phone or email, but his voice mail was full. So at this point, I attempt to seek another supervisor to start the process all over again (needless to say I’m at my wits end and EXTREMELY frustrated in the process. Numb…Angry…) when UHC rep Grey ** tells me their "ISET" computer system is down so neither he nor any supervisor will be able to look up my account and assist, and he tells me to call back in a couple of hours. This didn’t go over well with me and I again insisted on speaking with a supervisor. So he passes me off to Assistant Supervisor Ajay who was able to confirm that Vernon ** still works for the company but is not available.
I seem to recall at this point that Vernon ** told me he is in North Carolina so I then begin assuming that he’s dealing with the hurricane related flooding. Maybe? I hope not but want to give him the benefit of doubt. But then the above protracted experience has me seething and wondering why a company the size of UHC would not have sufficient resources and back-up to take over work loads of such affected employees - assuming that is his situation.
One way or another, I am / we are simply at our wits end and have had enough. I have to speak out and tell someone. With any luck, someone who will actually care enough to assist us in getting this resolved. We’ve been paying premiums all this time and I apparently have no coverage. Sure, my family has coverage, but the UHC system is so fouled up that they can’t seem to tell that when the time comes – when they receive provider statements with DOS???
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.
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