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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.
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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???
On January 1, 2016 we were "insured" by said company. They denied ** prescribed by my optometrist, stating a "lack of diagnosis" despite the horribly chronic dry eye I experience. They denied my cystoscopy, trying to confirm interstitial cystitis and dilation for stenosis (I've had the procedure in the past). The office told me I would have to pay $800 up front and billed for the rest. About a month ago I want to a doctor on the weekend within the same practice for complications due to fibromyalgia, previously diagnosed years ago.
I asked for ** since it's the one thing I know worked. I got off of it in the past due to side effects but now the side effects are worth it. UHC denied the claim stating there are less expensive alternatives. So I tried the lesser, **. IT DOES NOT WORK. I have also tried others such as **, **. So my provider told me they should be able to get it approved. Went to my provider and they said it was on UHC to approve it.
So after going round and round between UHC, Walgreens and my provider for OVER A MONTH, I called UHC. Keep in mind, I have damn near lost my job, I am in horrific pain, am behind on bills due to lost time. Sue was the unfortunate soul to take my call. I explained that I know it's not her fault. She then asked my address, told me it's not what they have on record. I explained to Sue that they have sent the rejection letters to this address.
I am way more composed here than I was on the phone. Once I told her that I tried the other drugs and that I had been to my doctor's office just today and that the balls in their court she put me on hold to speak with their Prior Authorization Department. They have one of those!!! She came back on and told me that not that it would but it COULD take up to NINE DAYS to approve it!
I stated that that wasn't good enough! I at least pay them to have better answers than that and I wanted SOMEONE on the phone that could give me better results! We pay entirely too much for such ** answers! She then began repeating the same thing over and over. At that point I told her to enjoy her paycheck and hung up. This is the kind of service you get when you pay exorbitant amounts of money to UHC.
Stay FAR away from this insurance company!!! As a provider I am completely disgusted with the lack of help ANYONE is. I am writing a review as I sit on hold waiting for yet ANOTHER representative to try and get me to a supervisor. I have been at this now for 2 HOURS... all for a simple transfer to a supervisor who could assist me with a virtual payment problem. I received a virtual payment in the mail which I did NOT authorize to be set up for virtual payment. I called the so called number that Optum/United Health Care gives you... mind you it is not a number advertising how to opt out of virtual payment, only a number to activate the virtual card. I called and told the lady I did not want virtual payment.
She informed me that United Health Care/Optum's policy is to fax over on company letterhead our contact info/Administrator info-name, telephone number, email, address, signature of Administrator. Then why you wish to be unenrolled in this way of payment. I have NEVER with any other insurance company had to do this. I am able to call the number, tell them I do not wish to be enrolled and they take care of the rest. Why does Optum/United Health Care make the provider do all the work, when it's their action/policy they implemented?? Well, I have tried to contact someone to speak to and NO ONE has been able to get me to a supervisor who deals with the virtual payment process or issues. I will not recommend United Health Care/Optum to anyone ever. The worst service I have ever had in dealing with insurance.
I have never in my entire life had so many bad experiences with a health care insurance than I do with United Health Care Military West. I have had to call so many times and never do I get the same answer twice even in the same hour. Today I called asking to talk to a supervisor only to stay with the original CS that picked up the call but he never answered the questions I asked only saying the PCM has to do this and that, which is not what I asked in the first place.
First of all the PCM had nothing to do with the original authorization/referral in the first place and should not have anything to do with it when all I wanted was more units added to the original referral that was put in by the orthopedic doctor because I was not completely where I need to be with therapy and need some more help. The first person I talked to said that if the referral wasn't expired that all I needed was to have the facility ask for the units along with a note saying I am just about there but not quite there yet. So the therapist does and UHC Military West puts it in as POS.
After calling three times no one seems to know what to say or do and cannot answer my questions. The one question was if the orthopedic doctor put in the referral in the first place and it was approved why does the PCM have to do it when all I need is more units to finish out my therapy. No one can answer that. All I get is the same stupid answer the PCM has to put in the request. Also the PCM is the one who referred me to the orthopedic in the first place because the problem I have. I really dislike having to deal with government insurance but have no choice. Please get your crap straight and make sure that everyone knows what they are doing because like I said I never get the same answer twice even if I call within the same hour. I mean no one gives the same answer, which is really frustrating because they tell you one thing and do the totally opposite.
I'm 31 yrs old and 5 yrs ago I was diagnosed with Colonic Inertia (basically a paralyzed large intestine). I had my first colonoscopy 5 yrs ago. They found polyps at the time and that's when they diagnosed me as well. I was told from now on I have to have one every 5 yrs. Well this year was my 5 yr mark. I went in to have the procedure done and then had a $875 bill sent to me. I called the United Health and they said that because I have a condition, family history of cancer and I'm not over 50 yrs old they won't pay for the procedure. They also said that when I'm 50 they still won't pay for it because I have a condition. I told the lady she was crazy because I have condition they would rather me not have the procedure done and wait until it's an emergency and they end up paying more! This is getting ridiculous...
The same day I got a bill also for a MRI my neurologist ordered because I have a history of mini strokes. The bill was for $3400! United Health said that won't cover it because my neurologist scheduled it at the wrong hospital. If I had known I could have drove 10 minutes down the road and had it covered at another hospital... I have called and yelled at multiple people but no one cares. I have no idea how to fight these! I'm beyond frustrated!
I am retired and live in Las Vegas, NV. In 2014 and 2015, my medical insurance carrier was United Healthcare and my primary physician was Dr. Lara ** in North Las Vegas. I liked Dr. ** but dealing with United Healthcare/Healthcare Partners was HORRIBLE. My doctor would put a referral in for me and it would take the Referral Department over three weeks to contact me about the referral. Then it would take another three weeks to get an appointment. I won't even go into the types of poor physicians United Healthcare solicits within their organizations. Then, even though my insurance plan said I was entitled to Chiropractic manipulation, they refused to assign me to a Chiropractor. I appealed and won the appeal. The UHC Appeals Supervisor said she couldn't understand why the Appeal had to even be filed and that my contract with UHC said I was entitled to 12 Chiropractic manipulations a year! Period - They still refused to assign me.
Finally, I told Dr. ** that I had had enough of this terrible medical insurance company - United Heathcare! In the Fall of 2015, I told Dr. ** that I was changing at the beginning of 2016 to an Aetna PPO plan and asked her if she was a participating member with Aetna. She said she was, but advised me to double check with the front office staff to make sure. I did so and they clarified that she was a participating member of that particular plan and I would be able to keep her as my primary physician. I joined AETNA in 2016. The nightmare begins: Dr. ** works at a United Healthcare/Healthcare Partners Office and the office staff/billing department within her office refuses to file claims to Aetna using Dr. **'s correct Tax I.D. number with Aetna. Therefore, filing claims is useless because they get denied when her incompetent billing department staff REFUSES to submit the claims ACCURATELY.
In February 9, 2016, I had my first yearly "physical" (Wellness Report) through Aetna with Dr. **. Upon arrival at her office, I used my Aetna Insurance Card for the first time. No co-pay was required for the Wellness Physical and none was asked for. In mid April I called for an appointment but could not get in to see her and had to see a Physician Assistant. It was LATE in May before I received a bill from Dr. **'s office. The bill was for both visits saying that AETNA had denied the claim and I had to pay immediately.
I called the office and asked the office Lead what was going on and she claimed that Dr. ** was a United Healthcare / Healthcare Partners doctor only and she was not a participating member with Aetna. I called Aetna and found out that Dr. ** definitely WAS still a participating doctor and had an Aetna Tax I.D. number. The claim her office had submitted contained Dr. **'s United Healthcare Tax I.D. number listed on it and, of course therefore it was denied.
AETNA was so helpful and supportive in their efforts to get this claim paid. They immediately got me in contact with a Grievance Specialist and he spent hours on the telephone with Dr. **'s Billing Office. He explained over and over to several different people who declared they were in charge, that they needed to use the correct Tax I.D. number that Dr. ** had with Aetna (and even told them exactly what the Tax I.D. number was to put on the claim) to get the claim paid. Meanwhile, UHC/Healthcare Partners Office continued to badger me with calls and letters telling me I had to pay this bill or it was going to Collections!!! I refused.
I spent time filing a Grievance with Aetna and even more time filling out papers to file an Appeal. I lost time from work due to high blood pressure and migraine headaches worrying about the actions of United Healthcare/Healthcare Partners office. My husband and I have a five star credit rating and I couldn't believe this was happening. I lost over $300 in pay from work trying to deal with this throughout the vast three months. Of course, the Appeal went through as rapidly as possible and Aetna wrote a check to Dr. ** (outside of the usual way to get a claim paid and because that was the only way we were going to be able to resolve this nightmare at Dr. **'s incompetent billing office).
My biggest disappointment came when I wrote a confidential letter to Dr. ** personally to alert her to actions were going on within her office, and how her patients were being harassed. I asked her to contact me. There has not even been one call, text message, or note from her after over two years of being her patient. Today, I'm still receiving bills from her UHC office regarding the so called $10.00 co pay they feel I should pay from my February 9th, 2016 visit for a Wellness Physical. I send the bills back to the billing department with notations that this is not a valid charge along with a copy of my contract with Aetna. United Healthcare does not care about people. They only care about $$$. They are not out to help anyone but their bottom line regardless of who and how it hurts. I've read literally thousands of letters online from so many people that have been hurt due to this company. Their actions are illegal.
I am more than frustrated with this so called insurance company. According to their policy, there is a three-month grace period for paying your premium. I paid my premium from September 2016 on October 6, 2016. I understand that before paying it, they would put claims on hold. However, I was denied getting my prescriptions. I paid them $579.00 yesterday, received an email today saying that they have received my payment and thanking me for paying my premium. I STILL CANNOT GET MY MEDS! It is still being denied due to "nonpayment of premium". I have called the company and spoke to 6 "incompetent people" with one person telling me that "well if you needed your medicine then you should have paid your premium by the due date. The next person telling me "I'm sorry that you do not understand the grace period" keep in mind that I was reading directly off of their site.
I've talked to reps, supervisors, and a so called manager. They are like complete robots. They have absolutely no empathy or sympathy for the human race (their customers). They have my money, it's out of my bank, I received the email, and I'm still waiting for someone to push a button to update my payment on my account. They also tell me it will take 24 to 48 "business hours". So, essentially I could die if this was medicine that was life or death. These insurance companies have to be held to some type of standard. People are being taken advantage of because we only have so many options on the healthcare marketplace and people in states like NC cannot get private insurance because of this crap. My pharmacist said that the last person that had this problem with the same exact health plan that I have had to wait 3 weeks to get their medication.
Several calls to ascertain coverage for medication. Requiring lengthy hold times. Proves that it 'pays' to frustrate the consumer. Keeping pharma costs down by training help desk 'helpers' to relate confusing detail about coverage. Insist that there is no online tool consumers can use to check out pharma coverage. Train 'helpers' to ignore consumer request. No supervisor will take your call, obvious absence of training. Calls end with: "Is there anything else I can help you with?" when clearly you've wasted an hour in the rabbit hole of talking with yet another apathetic untrained underpaid rep. But it works! I pay out of pocket! Because if I use my insurance - only misery. 'Condoms for sex workers' on our national ballot but none relating to regulating mangled care. We are to blame.
On 9/20 signed daughter up for Cobra as she no longer qualified on family plan due to age. I was told her SS did not match the SS they had, they would not tell me what SS they had but later I found it was my husband's as the insured and UHC had put it on her name. I was told by UHC that would have to be fixed before they could take a payment or proceed. So we waited and called about every 3 days. Finally they can take a payment so we make it. I am told fastest way is credit card so I make it. They tell me in 24 hour policy should be active, 3 days later still not active. Call again. Long wait. A guy tells me "Credit cards take longer. Make the payment directly out of checking and policy will be active in 24 hours. I will have my supervisor fast track it." So we make a 2nd payment out of checking. 4 days pass still policy is not active.
Talked with a supervisor on 10/4. She tells me, "Yes you have 2 payments made and cleared however the information you have received is not correct. It will take 48 to 72 hours." I know we are not quite a 72 hours but policy is still not active, called again today after on hold for 63 minutes to speak to a supervisor and just got one. I had asked all along on every phone call if my daughter got a new policy, new card and number. Everyone said "no she will use her current card." New supervisor says "she can't use it because we have to issue a new policy and that will take 24 hours." I explained to her I have asked everyone I have spoke to if that is required and they told me no.
On hold right now for her to update to new policy. Told her if it is not active tomorrow I wanted a direct number to call a supervisor at and they cannot do that. If I could give this company a negative 5 stars I would. Someone needs to regulate this, working people cannot be on hold for an hour and call back many times. I am filing a complaint with local insurance board. I deal with a lot of bad as a business owner. This is one of the worst cases of customer service ever. Definitely will be considering other carriers on renewal time.
Hands down the worst health insurance I've ever had. Most current issue never resolved to my satisfaction. Manager never returned call. Placed on hold for extended periods. Appeal process is a joke - I was denied after a thorough explanation. The one time I was sick they did not cover a penny - I paid completely out of pocket. Even after paying out of pocket I continue receiving bills. I recommend any other insurance company.
This is a total ripoff. I would recommend UHC to anyone. None of their plans provide value to plan holders. They hammer you with deductibles and fees and charges. Only basic meds are covered. KEEP AWAY from United Health Care.
I have been covered with UHC for almost 2 years now. I was with Blue Cross previously for 3 years but their rates became too high so I switched. Too bad for me. I have never once used my healthcare ever in all the years I have been covered by any company, but recently I was on holiday in California and got severe food poisoning to where I had vomiting, diarrhea and stomach pain so bad I could not stand up or walk. I had to wake my friend in the middle of the night to call an ambulance to take me to the ER. My thoughts were at least I have health insurance.
I recently received my claim statement and was shocked to find out they are paying almost none of it because the facility I went is not in their network. Here however is the problem when I looked it up apparently NO facilities in California are in their network, at least none I could find when searching within 100 miles of OC where I was and also Los Angeles. So apparently it's just too bad for me that I happened to be away from home and in area where no facility I went to would have been in network.
What a fraud this is. We cannot control when and where something happens to us. I should have had the peace of mind that I have insurance but that has been stolen from me along with my monthly premium payments they have gladly taken for 2 years. I would have been no worse off being uninsured and that really is not fair and this is why people are so upset with the state of health care and insurance in our country. I feel totally robbed by this company and come Jan 1st I will be moving on to another provider.
I have a supplemental drug insurance policy from United Health Care (endorsed by AARP for seniors). The monthly premium for my wife and I in 2015 was $52.10 Each. The premium for 2016 increased by 24% to $64.70 a month each. The new premium for 2017 is $80.50 a month each - another 24% increase! The pharmaceutical industry is out of control, the insurance companies go along and AARP continues to collect its endorsement fees, and the government refuses to "interfere" in the competitive bidding process lest the poor drug companies lose money. The whole system stinks from top to bottom!
I SUGGEST YOU KEEP AWAY FROM THIS COMPANY. Retired in May 2016 and it all started with the sign up stage. Continues to this day (Sept). Coverage I think is competitive but they could be more competitive if they got more organized. I have a letter from them saying they were declining coverage. Weird as I already had the insurance card for 3 weeks! CONSTANT calls (3 per day sometimes) to my wife and I asking the same questions even though the answers were in the paperwork. Now in Sept., they are trying to get confirmation on "other" insurances I have never heard of and to confirm and date of retirement, street address and other information that has been given many many times in writing and verbally
These call I now consider harassment as if we don't comply, maybe we will lose coverage? So, we will be going elsewhere for our insurance coverage. I have no experience with other MediCare Insurance coverage and this might be "Normal" but it surely is unprofessional, disorganized and harassing and wasting my time nerves and money. Let's see what a letter to the President and the Board will do?
Absolutely the worst customer experience in the health care provider business. No return calls, website approved providers outdated, extremely long wait time on phone.
I was a United Health Care member from January 1, 2015 until Sept 13, 2016. I became a member through the exchange program and qualified because I was forced to apply for disability due to severe back, hip and leg pain. I had back surgery in 2009 and haven't been the same since. I was able to qualify due to receiving financial help from my family. In order to remain on the exchange program you are required to file a tax return showing proof of income, and I had to file an extension in order to get some of the income verification. Sometimes my family would wire money, sometimes they would pay a visit to the physician for me, and sometimes when they would visit (I live in NC) my family all live in either Ga or TN, they would just give me cash. So, I had to have extra time to verify the income I received which was a condition of being allowed to obtain the coverage with the exchange program.
On or about May 31, 2016 the exchange program ceased covering any part of my premium, and I was responsible for the entire premium, $586.87. I managed to pay it each and every month with my family's assistance, however in August, I had mechanical problems with my car and needed to pay for expensive repairs. I contacted UHC, explained that I would need to pay my Sept premium a bit late, it was always due on the 1st of each month. I spoke with a representative named Mark and he assured me that as long as my premium was paid on or before Sept 10, 2016, I would not have a lapse in my coverage or any problem. I wrote his name down as well as the date and time of the call.
On Sept 7th, I called and paid the premium and it said the amount I owed was $547.64. Sometimes I would be told the amount due was over $580, sometimes it would say I owed $560. I feel I should have questioned this, as it was less than the amount I had paid previously, but it was after hours, I was having to pay using their automated system so I accepted the amount as there was no one to ask and as I was already paying my premium a few days late I just wanted to get the payment in to them. I wrote down the confirmation number, my payment was accepted, and I assumed all was fine based on information they had given me. My brother was kind enough to let me pay the premium on his credit card, and I remember just being relieved that it was a bit cheaper since he was paying it for me.
On September 12 I needed to see my physician. I received several prescriptions, one being very expensive and very necessary as it prevents falls from nerve damage I have and taking it and suddenly stopping it could cause seizures and various medical problems. I checked the computer that morning prior to seeing my Dr. and under enrollment and eligibility beside my name it showed me as an active covered member.
I went to the pharmacy and despite all this, my coverage had terminated. I called them several times. I had notes and dates of my previous phone calls and I referred to those and explained how very important this medication was to my health. This was on Monday, Sept 12, 2016. I explained I would be completely out of my medication by Wednesday, Sept 14th. They explained it could take up to five days to review but promised to send a note to the dept that made decisions regarding reinstating coverage to a member. The terminology they used for this was they would send an "escalated" ticket to that particular department for review.
I called several times a day, I emailed them many times. They did answer my emails, a generic type answer basically just stating it was being reviewed for reinstatement. I asked them to perhaps call me with updates as well since I was spending a great deal of time on the phone as well as the computer sending numerous emails. I never received one phone call from them, all calls were generated by me.
I barely slept, certainly didn't eat, and this consumed me with a huge amount of stress as I didn't know what I would do if I lost my insurance coverage. I would call and receive a different answer, depending on who happened to answer my calls. I was told the coverage lapsed due to the payment being late, despite the reassurance I had received from "Mark" that this would not happen as long as I paid the premium on or before the 10th. I was told it was because I didn't pay enough, and that the payment should have been $569.02. I reminded them that I simply paid the amount the automated system said I owed. Their answer was always conflicting, however they were all well trained to end the call by saying "well it is being reviewed". That same response was repeated by everyone.
On September 16, I finally received an email stating the coverage had terminated, the credit card was to be reimbursed and there was nothing I could do. I am still appealing their decision and even plan to contact the NC Insurance commissioner. All this could have been avoided if they had just given me correct information. I am now in the process of trying to find another insurance that fits my needs and my budget and it is not an easy task. Meanwhile, I am unable to afford any of my medications. I know it is dangerous to not have them but I simply cannot afford them and I cannot put any more burden on my family, I am very blessed that they are willing to help me to the extent that they do.
I am not suggesting anyone at UHC deliberately lied to me. I simply think they never received proper training as to what to tell a member and often are in such a rush, I do think they basically tell you what they THINK, not what they know but what they THINK, due to high call volume and being rushed. I don't know what happened to integrity in the work force, I know it still very much exists, but I don't feel it exists at UHC in the customer service department. What is wrong with the answer "I don't know but I'll find out?" and getting the correct information especially when you are dealing with someone's health and well being? I honestly feel that had they simply taken the extra few minutes to get the CORRECT answer this entire nightmare could have been avoided.
I am not contacting the Insurance Commissioner to be vengeful (well maybe a little) but really I don't want this to happen to anyone else. Finding yourself without insurance coverage due to someone being negligent does make you angry. I fully intend to contact the Better Business Bureau as well. So any of you out there that are shopping for an insurance carrier, my advise is to steer clear of United Health Care. Their customer service is terrible. Their information is incorrect. To them, you are simply an ID number.
I went to CityMd urgent care Facility to do my preventive physical check-up and immunization for TD and MMR which is supposed to be my benefits with no charge/deductible does not apply. And I called several times to United Healthcare and they said it because it was billed incorrectly as urgent so then I need to pay for it which be added to my deductibles which it supposed to be with no charge at all. I have called back and forth to CityMd and United Healthcare but can't resolve the problem. I am still a little confused because one representative said it should be covered by insurance if it's not billed as urgent regardless the facility and the other one said if you go to urgent care facility even if it's for preventive services I will still be charged. I am confused with their policy and definition of preventive service/immunization. United HealthCare representative not very helpful. Any thoughts with these guys?
When my father complained to a doctor with United Health Care that no one got back to me regarding my appointment that day (I had a job and a doctor appointment both within one hour of each other), the secretary told my dad, "It's your daughter's responsibility to keep her appointments and it's NOT our responsibility to return her calls." But when my father asked for a referral to another doctor who offers the same services but isn't quite as busy, the secretary said, "Someone will get back to you soon..."
In other words, when it involved my health, they were ** but when it involved the possibility they might lose a client and $750 per visit, they were suddenly concerned. So he hung up and called the insurance company for a list of all providers in my area. If they call me back, I'll tell them how I really feel about their level of service!
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