UnitedHealthCare Reviews

Prescription Solutions doesn't care about your medicine, you, or the quality of your medicine. They are not accommodating and UHC Prescription Solution Pharmacy claims mailing overnight is expensive. Since United Health Care is a multimillion dollar company, I find this excuse to be highly unlikely. Further, Prescription Solutions provides a reminder call that is too early and therefore you cannot refill your medications due to needing a "prior authorization". The stupidity to this is that they don't even know their own rules. If you order your medicine too soon, the health care company denies it and requests a prior authorization. How can they not know a "no-brainer"?

It is up to you, the patient, to advocate for yourself. United Health Care Prescription Solutions Pharmacy will not accommodate you, the "patient." It is all about them, their schedule and their cost at their convenience.

I was re-evaluated by Dr. ** on 9/2008, a uterine ultrasound was performed, fibroid and polyp growths were noted. I was seen by Dr. ** on 10/9/2008, and options were discussed. Dr. ** expressed concern with the growths, as it had only been seventeen months since the previous D&C. A second DNC would be necessary to remove the invasive tissue and the Novasure Endometrial Ablation System was discussed. Novasure destroys the endometrial lining/vascular tissue, preventing the growth/attachment of invasive fibroid/polyp tissue. The D&C and Novasure Endometrial Ablation were performed on 11/19/2008. Post surgical results are positive. Bleeding is almost non-existent and I have experienced no complications or re-occurrence of pre-surgical symptoms.

Health insurance exists to cover medical necessities such as this procedure. I pay insurance premiums to cover this surgery. I pay my insurance premiums to United Healthcare with the understanding and expectation that medically necessary procedures will be paid to my physicians. UHC paid the hospital expense for this procedure. UHC paid the anesthesiologist for this procedure. UHC has repeatedly denied paying the gynecologist for this procedure, yet I pay my premiums to cover her fee every single month. Cost to me of $4,400 and threat of credit issues for non-payment.

In August of 2007, I had a breast cancer scare. I was told I had to pay for a deductible of $3000; the remaining balance was about $1800. I paid the hospital this amount. It took months and so many phone calls to finally find this out. Each time I called, I was told they did not have record of my calling the month before, so I had to start all over.

In November of 2007, I needed eye surgery on my right eye. Because I paid the deductible, again after months of calls and stalling medical people they finally paid. I had the same procedure on my left eye in December of 2007, which is still not paid. They paid for some but not all. I've been promised it would be taken care of on several occasions, to no avail. I finally spoke to Kelly on 6/2708 at approximately 10 AM. Kelly is a rapid processing associate, that called each medical vendor to tell him/her United Healthcare would pay. Kelly told me it was just a glitch in the computer system and they had been having problems. She said once I had the confirmation number, the company must pay. I explained to her that the stress of this was too much. I was in good credit rating and wanted to stay that way. She again assured me this would be my last phone call.

Since then, I have received those bills again and in fact, one company has put me with a debt collector that is threatening me to ruin my credit. Why would this company pay for one eye and not the other for the complete and exact amounts? I didn't have another deductible, since both surgeries took place before the end of the year.

The consequences of this incident is my stress level. I don't know what to do. Can anyone help, please?

On Friday (48 hours later) I called them again and one representative stated that it will take up to 30 days. I AM SICK I NEED TREATMENT FOUR WEEKS AGO! When I insisted, the representative put me with the conflict resolution person, who after having me on hold for a while stated that I need to talk to pharmacy, he gave me a pharmacy number to get release of medications. Ive never heard of pharmacy giving anybody release of medications, but I called my doctors office and asked them to call pharmacy. They called me 10 min. later saying that the pharmacy needs PRIOR AUTORIZATION FORM FROM THE INSURANCE COMPANY.

I know that Im caught in a vicious cycle of insurance company not wanting to authorize my treatment, and Im asking you to help me to expedite this process. The next week I will probably contact a lawyer to learn about my options, but what should I do now? Thanks. My health is deterioratng and I face disability IF I DON'T GET MY TREATMENT!

However, today after I contacted my PCP for a referral, I was informed by the Palo Alto Medical Foundation that they could not offer a referral. So I contacted PacifiCare again. Now the story changed: I could not be seen by a specialist and would have to return to Palo Alto in order to have anything covered! Only urgent care and emergencies would be covered. Is not seeing an orthopedic surgeon, to ensure that I will not have permanent damage, urgent and even emergency?

This is insane. I am now on crutches, struggling to get around to care for my 11 month old son and to ease the burden on my husband, who is teaching part-time, telecommuting full-time, and now doing most of the childcare and household duties for us. I am due to travel to Oregon in nine days to attend my grandmother's 100th birthday and to attend a family reunion celebrating my brother's return from a 2 year mission in the Dominican Republic. I have already been very concerned about traveling with my son just in a short flight to Oregon. Now I am being told by PacifiCare that I can only be treated if I fly back to California. I have many questions which I ask that you answer: Is PacifiCare ready to pay for this plane ticket? How will I drive myself once there, seeing as my right foot is in a gigantic boot? How will I travel with my son to a place where I do not have parents ready to pick me up? I can't leave my son with my husband, for his teaching schedule and telecommuting already makes for 60 hour weeks and time out of the house when he cannot watch David. Will I get treated if I pop into an emergency room in Utah and demand orthopedic surgery there? If so, then I understand better why our emergency rooms are overloaded with care that should be done elsewhere by those insured.

I was told today by the PacifiCare representative with whom I spoke that these are the confines of an HMO. Ridiculous. I cannot believe an insurance company would offer such deceptively incomplete insurance. I cannot believe my school district would sign up for such a plan, either! I have not yet contacted an attorney but am on the brink of doing so. I have lost the ability to communicate with people who don't listen. I feel deceived and cheated. This shoddy coverage is wrongful and should be considered illegitimate. Please respond in detail to my questions. I need a way to be seen by an orthopedic surgeon here in Utah, immediately.

We had the claim reviewed & even appealed the decision based on the grounds that 18 months after the surgery was an excessive amount of time to reprocess the claim and that the original error was not our responsibility to correct. We ultimately had to pay the additional amount in order to keep the bill from going to collections. The letter of response to our appeal basically said that the claim was processed according to our policy and there was nothing else to be done. Ethically, this is just ridiculous. After 18 months, if you made an error, I fail to see how I am at fault as a consumer.

In my discussions with their customer service and claims representatives, I was informed that there was no time limit for reprocessing claims or reevaluating claims. In effect that makes the policy null and void because there is no security that a claim is truly processed and closed. For example, a person could have open heart surgery in 2005, the claim could be processed and the patient's responsibility paid. Then, in theory according to UHC's stated policy, in 2035, they could "discover" that the original claim was incorrectly processed and sudenly this person could be responsible for an additional amount of coinsurance (in an expensive surgery that could be hundredsa or thousands of dollars).

In my situation, it was just very frustrating to know that they were only paying lip-service to my issue. They had no intention of understanding my issue. I KNOW I owe 20% of the charge. I paid 20% of the charge and I don't think 18 months later it is ethical to reevaluate the charge thereby making me responsible for an additional amount for a claim that I had already paid in good faith. Times are tight economically for everyone right now. I had to pay the additional amount on my credit card and will now be paying on it for years instead of being finished with this claim from JANUARY 2007. Emotionally, I just feel abused and powerless. I had no choice but to pay and no additional options within their organization to appeal to.