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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!
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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!
United Health Care require participants have an annual checkup in order to avoid an increased contribution of $50 per month. This is not an issue. This year my primary physician Dr Debra ** of St Mary's Medical Center, Fairless Hills, PA prescribed blood work as part of my annual check up. As I expect is the case with 99.9% of the population you take in good faith that your doctor is familiar with tests that are commonly accepted by healthcare insurers. Not long after the tests I received a bill for $580. When I questioned this with UHC they told me that two of the prescribed tests were not covered. To this day I do not really know which tests were not covered!
I called the surgery of Debra ** & was told by the assistant there that one of the tests was for anaemia which is not usually prescribed as part of the annual check up, so indeed the issue began with Debra ** who should have either not prescribed these tests at all, or prescribed them separately from the annual checkup. Had she have done so then UHC would have paid the service provider. It's all down to the medical coding. I filed a complaint with UHC, Debra ** & service provider in copy. I received a letter to say IF my request qualified as a complaint they would inform me in 30 days. I guess if they disagree then they do not communicate at all because 45 days later I've heard nothing from them.
Debra **'s office accept no responsibility & have gone all wishy washy on the tests that do not qualify as part of annual check. The service provider have sent a final notice & it is beyond me why UHC & Debra ** can't sort this out between themselves as it is an obvious error & all boils down to the coding. As a consumer I'm put between a rock & a hard place. My next course of action, after this consumer complaint is a letter to my employer concerning UHC & engagement of a lawyer. Ridiculous situation that UHC could deal better with, communicate better on & be more understanding towards the duped consumer.
As a Healthcare Provider, I contacted United health care to inquire why a claim was not being paid. After 30 minutes of being transferred, the representative refuse talk to me stating HIPAA issue, then he hung up on me. I cannot afford to see members for free, and will now need to terminate my professional relationship with United Health Care.
I like UHC but their reps seem to be really rude or not the best people. I work as an agent. I'm informed and tell my customers how the plans work. Then, they call the idiots at UHC for some reason, and get a different story. This happens a lot. This time, my customer called a UHC rep who gave them the wrong information. They trust the stupid reps who aren't telling the truth and as a result, agents lose out. Every customer I've talked to who's talked to a rep isn't happy most of them.
United Health Care is untrustworthy, crooked and run after your money. I am not covered anymore with United Health Care. They just stop my coverage without any reason. I even put autopay but they are not taking money anymore. They have me about a year and half getting money from my monthly cost and my thought is I am insured when the truth is not. Now, it's my time to see my primary care just to meet him and the fact I am healthy is not really an emergency but I want to maintain my health status, so I went for checkup and I finally use my health insurance knowing I am covered. UnitedHealthcare has no purpose for you. They just keep you for a while getting you part of them because you are healthy. After all they get rid of you without giving information, warning in your mail, or call to fix the issues because they just can't but monthly bill they are so ALERT. They loved your money. That's all.
My primary care is running after me because I am not covered anymore. UnitedHealthcare I spoke is she said I got to call for Marketplace. Here you go again with marketplace when simple things they can't change. All I ask is help me out of my bill. It's really a small amount. If they can help since I am paying money for them over a year ago continually. They can't help. All you heard is "Sorry" which is meaningless. All I feel with UnitedHealthcare is untrustworthy, thieves, and bad feeling for them. I hope this company will not be able to survive anymore and I hope people will wakes up and leave this insurance company before they leave you with illness. My suggestion is don't even try to be part of them. So scary.
I have extreme pain from spine. Can't function, work, or even walk for several hours each day due to pain. Rush orders were generated for L4/5 laminectomy and excision of facet cyst last Friday August 26th, 2016 to have surgery on Monday, August 29th at 3:30. No food or drink since midnight. By noon UnitedHealthcare still had not approved. Sat in hospital waiting area with migraine, vomiting dry heaves, extreme pain and weakness.
Hospital tried to escalate with UHC and were told not possible. They had to cancel surgery and send me home until insurance approves or I had to pay over $11,000.00 immediately with no payment plan and dispute it on my own. There was no way to come up with money. Daughter had to take me to nearest food provider for chicken soup and pain killers. This is the most inhuman thing I could think of and even the Colorado Insurance Commission Office said there is nothing they can do since it's a self-directed insurance and UHC is a claim processor. I have horrifying pain and nowhere to turn.
I tore my meniscus, am in pain, and have been scheduled for one week to have surgery. With UHC you need to have your surgery approved before the surgery happens, otherwise they won't cover it. I didn't think it would be a problem - after all, I had a full week for them to get to it. Yet now I am having to cancel my surgery because they haven't gotten around to approving it. I have the impression they couldn't care less. I hate health insurance companies, and UHC is as horrible as it gets. The USA needs to wake up and get rid of insurance companies. What a stupid, inhumane system!
I've never seen such poor performance from a Life/Health Insurer, much less any Company. Do you know of anyone who'd take $1300 per month from a family of 4, clean health history, non-smoking, no pre-existings, and then look for ways to cancel their coverage? And if they can't cancel, they blame it on the whole state and pull out after you wind up paying over $10000 for coverage that no one here utilized and somebody else took advantage of. Dumbass, I'm footing the bill! I could go into detail about how they actually succeeded in canceling my policy (no notice, just termination - aren't they legally required to send a ** notice at least?) but I've got more important things to do. They are deceitful, plain and simple. The worst of capitalism lies in the private Health insurance market.
Unbelievably awful, keep double-checking that your payments were credited should you choose to deal with this company. They have lost my payment three times this year. It has taken proof of payment, followed by phone calls, follow up well after their stated 5 days of issue resolution because the insurance is still not reinstated, and repeat multiple times in a loop until you get someone competent from their accounting department. How can they continue to lose payments and THEN still not reactivate within their 5 days following proof of payment? And customer service can't keep the problem straight nor find out what is going on. They have not gotten the problem correctly documented ANY of the three times when my payment was lost. My insurance plan is fine, though I haven't used it for anything serious. That's the only reason I have given them 2 stars vs. 1.
There is no point rehashing my experience with United Healthcare. I've had the same experiences that have been reported here. I call every few weeks and, each time, our claims are first approved and then denied for a different reason. During the last call, I asked to speak to a supervisor. I couldn't speak to anyone at United Healthcare, because UHC has no customer service representatives. All inquiries go to one or more OUTSOURCED call centers that have no affiliation with UHC. Their job is to stall, or bounce the caller to yet another outsourced call center.
And, if you are unfortunate enough to have a mental health claim, you are told that another company handles these for UHC, which in turn has its own unaffiliated call center(s). Get ready for more denials when the mental health claim is accidentally-on-purpose sent to the medical division and then, in the shuffle, your information Is lost, and it's up to you to prove the treatment was officially approved by UHC in the first place.
I may be assuming too much, but it seems to me that this is all quite purposeful. The premiums are high, and United Healthcare continually denies legitimate claims. We pay roughly $800 a month for our coverage, and the Federal Government adds another $400 to that. UHC then pays out $100 for medicines and basic doctor visits. It's a pretty good return on their end. Meanwhile, we must deal with tremendous amounts of added stress during a time of crisis. At this point, and after innumerable phone calls, I don't believe that my family's bills will ever be paid. The Healthcare Exchange -- which was supposed to serve the public -- is looking more and more like a back-door bailout of the insurance companies. Exasperated, tired of fighting, and tired of being had.
Useless garbage. Cannot get a PCP appointment anywhere in New York. Nobody takes this garbage insurance. It is a waste of money. I will wind up paying for my primary care appointments, examinations, and tests. The worst! Con artists. Criminals, just taking the money and doing nothing.
Without a doubt UHC is the "WORST" health insurance company on the planet. I laugh at the inflated and bogus reviews plastered all over the internet that say they are "The most admired insurance company" LOL! Sure they are but by who? Big Investors? I'll bet they are since they are raping over 50 million customers in every crack and crevice they can find. As a Type1 Diabetic I know the health insurance industry very well and this one is a solid cheater. Beware of the harassing phone calls that have no end. The BS "nurses" so they claim that are there to use your information against you at every turn.
If you have to use this POS company DO NOT give them your phone number or use the phone at all. Only communicate through the Federal Mail system so that you do not give away your information and that everything is documented. Beware of OPTUMRX! Instead of sending the name brand medicines you are paying for they will send you piles of "sample boxes" for you to pick through and claim that meets the needs of your prescription. The St. Louis based employees are nasty to deal with and they are rude and argumentative. That's what you get when you hire cheap uneducated and unskilled labor from the bad side of town. Stay far away from United Healthcare!
I have a special needs son who needs PT to be able to function. I called member services as well as the PT company and was told my son had 20 visits paid and no pre-authorization was needed. They did not pay any of the first 9 and now have discounted the last 5. Due to this, the PT called again and was told they did not need authorization. United still will not pay and when I called they stated that the PT company didn't fill out the correct paperwork and will not be paid. When I asked how do I fix this they said PT needs to call and submit the right paperwork.
I explained they will not see my son anymore and I was told that's not their concern. They would not look into this, they would not talk to member services, they would not call the PT, they would not give me any paperwork or any help. I have called twice. The first time I could not understand the person very well. I was told I would be called back after they reviewed the account as they saw there was an issue. When I called the second time is when the above happened. They have stated they will no longer provide individual health plans next year. I have to wonder if this is why they will not pay any of my claims. They also are denying medications. Worst customer service and benefits. Do not pay as the plan states.
United Health Care Company Information
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- United Health Care