UnitedHealthcare Vision Insurance

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I have had UHC through past employers and found it difficult to deal with their customer service representatives. In this situation, I went to my "authorized" eye doctor to get a new prescription and new glasses early this year (2016). During the appointment the doctor noticed some vision problems and recommended I have further testing done to determine if surgery may be needed. I was tested for blepharoplasty, a condition where the eye's vision area is obstructed by heavy tissue above the eyelid pushing it down. This causes poor night vision, progressive driver safety issues, headaches, squinting when in bright sunlight, and low quality of life due to poor vision. The original doctor referred me to a surgeon to confirm this was necessary to correct my sight. This was not solicited by myself, this was diagnosed by eye doctors and surgeons who found a genuine concern for my future eyesight.

In a letter received from UHC, the insurance company considers surgery on the eyelids to be "cosmetic" and will not cover "cosmetic" surgery under their policy. They further are denying the payment for the doctor appointment to the surgeon who confirmed the original diagnosis. UHC paid an expert to say the surgery was unnecessary. I believe the paid "so called" experts UHC uses are denying me coverage through this policy, through direct orders from UHC. I pay UHC a substantial amount of money for health insurance from each paycheck not counting the amount contributed by my employer. It is not fair that the exuberant fees I pay purchases only substandard coverage for my medical needs. Denying treatment is how UHC makes much of its money. UHC is unfair and greedy.

Because of Obamacare, I am legally bound to have health insurance. The insurance companies can charge high rates, cheat their customers and are protected and endorsed by Obamacare Federal Laws. Due to this unfair legislation if I had a life threatening disease or trauma I may not receive proper care through UHC. From the articles I have read, other complaints on this site, and through past experience with UHC, it is likely they would deny benefits in almost any case and let patients die. UHC appears to charge the highest rates and provide the least coverage for the money. I definitely do not want to waste any more time with them nor do I want to continue using them as my health insurance. I will be speaking with my HR person at my company to change health insurance carriers and will make my recommendation to the company to discontinue use of UHC.

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I spoke with three representatives with United Health Care Vision because they did not pay for a vision bill from an in network provider. When I asked to speak with a supervisor, it seemed that they just passed me on to another lower-level customer service representative. They stated that they were "paperless", but required that I write a letter to appeal their decision. Additionally, they stated that their name was "spectera(?)", but later one of the representative said that they were United Healthcare Vision. It seems very odd.

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I called to get a list of providers and was told of a doctor near me. The system changed or for some reason the MD did not show as in network and I paid out of pocket. I sent my receipts via UPS, requesting a signature. My package was received and signed for the next business day. It's been 17 days and nothing. I've phoned several times to check status and was constantly informed my package wasn't received. No one could tell me where or why and I had to start all over. The money I paid out of pocket a waste. I am canceling my vision plan - no accountability and no expedition for my claim.

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My employer offers voluntary vision insurance and I have purchased this coverage for the past four years at an annual cost of approximately $300. Each time I've incurred vision expenses, I've discovered that the provider I chose was out-of-network. This year I visited UHC's website to learn who was in-network and exactly what benefits I would receive. I had my contact prescription in hand while viewing the website and discovered that UHC offers contacts by mail for a reduced cost. I used a link on UHC's site to the contact provider and was required to acknowledge that I was leaving a UHC site. I arrived at a webpage that read "Welcome United Health Care Members". I made the selection of the contacts that would result in the highest level of reimbursement, 100% coverage for up to a year's supply.

I was surprised to find that I needed to provide a credit card for this purchase despite my coverage with UHC and the convenient link between UHC's site and theirs. If I have coverage for 100% of the selected contacts, why wouldn't the online provider receive payment from UHC? I called the number on the website and while on hold I listened to a message stating that independent ophthalmologists could partner with this provider to provide their patients with contacts and receive commission (kick back) on all purchases made by their patients. I thought to myself that UHC was likely receiving some kick back for my purchase but if I receive the same contacts for less cost with the convenience of online ordering, what harm would additional revenue to UHC cause me?

When the representative came on the line, I explained my confusion. Why must I use my credit card to purchase contacts that are covered at 100%? The representative explained that I needed to pay for the contacts and submit a claim to UHC. I accepted this as reasonable and paid $180 for a six month supply of contacts and then went to the UHC website to find a claim form. No such claim form existed so I phoned UHC and was instructed to use an out of network claim form and mail or fax the claim to UHC. They processed my claim as out of network at $105 of my $180 expense.

I went back to the web pages and on the last page of the contact provider's website (as you are paying), in a tiny font where you would normally find the name of the software/application used to write the website or find trademark details, there is a statement that the provider is out of network with UHC. So much for that convenient link on the UHC site and "Welcome UHC Members". But if that wasn't bad enough, I submitted the claim on 1/30/2014 and still have not received payment. Their explanations/excuses alternate from one call to the next. The first call is "We will issue (or have issued) a stop payment - we can see the check has not cleared. Here is a confirmation number for today's call".

On the next call, if it has not been 30 days since the previous call, they say "we have 30 days after the stop payment to re-issue a check. Please wait 30 days and call back". If it has been 30 days or more since my last call, their response is "I see record of your last call but a stop payment has not yet been issued. We'll do that now and issue a new payment. Here is the confirmation number for today's call".

I need an Explanation of Benefits to file an appeal of the manner in which they processed my claim - Out of Network. Interestingly, they've revamped the UHC website and there is now a clear disclaimer that the Online Contact Provider is Out of Network. Fortunately, I saved screen shots of the site as I experienced it - only disclaimer in a font of approximately 3 pts. and only on the last step of purchasing (not on a UHC web page). I suspect UHC is not paying vision claims to insureds and I'm certain that many more MEMBERS experienced the same deceptive link between the UHC site and the Online Contact provider. If they save $80 on every claim, plus make some commission on each sale, UHC is collecting quite the little bounty. Even better, from what I am able to tell they simply do not pay claims. I would like to find a class action attorney who needs Plaintiff #1 against United Health Care Vision Insurance.

Today when I phoned, I was escalated to a supervisor, Kyron, who asked if anyone has yet explained to me that UHC's recent system conversion is the reason for these delays. I pointed out to Kyron that during their conversion they continued to accept my premiums and therefore had an obligation to pay my claims. Kyron responded that his department just pays claims and has no responsibility for collecting premiums. Wow. Kyron doesn't split atoms in his spare time.

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Earlier on 7th of July '14, I called up United Health Vision Care for knowing my benefits for Out of Network. One of the Customer Representatives informed me by pulling up my account, that I'm eligible for total of $400 ($200 - Frame & $200-Lens). Now when I see my claim status it shows that paid by plan as $175.05 instead of $400. I called up today asking about the claim status amount. One of the representatives has again told that my plan is eligible for total of $400 ($200 - Frame & $200-Lens). When I asked the Representative - then how come only $175.05 paid instead of $400, then he transferred the call to his supervisor. Supervisor says that the information provided by their representative was wrong and my plan is only eligible for total of $200. Can someone please help me in this regard?

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I signed up with United Health Care in December of 2013. No Complaints with Services they provided. Until after a Routine Eye Exam. I tried to use my eyeglass discount at the Providers that UHC had listed in their manual. To no avail. I was repeatedly questioned - did I have vision care? Apparently I did as I was able to have the eye exam with no problem. I called UHC several times and of course talked to about 10 different operators (Because you get a different one every time you call) explaining the same issue which was I was unable to find a Provider who would allow me to purchase eyeglasses. I got the standard run around and excuses.

Same Problem AGAIN with finding a Dentist. I was told that I was covered for routine Dental exams. Contacted the Provider and made an appointment. One day before the Scheduled appointment I was contacted by the Secretary of the Dentist that she had contacted UHC for my coverage information and was told that I was not covered. I then called UHC and asked, "Was I covered?" and I was told yes. Called the Dentist office back and stated this to the Dental Asst. The day of the appointment I was called again by the Dental Asst. and told that I have OON (Out of Net Work) Coverage and they did not accept this plan.

It states clearly on my card that I have a PPO SNP Plan. I then asked for a list of Providers who take my Plan. I was given the same Dentist names and address who declined my plan in the first place. The excuse when you speak to the Representatives is "Well huh, that's odd because they are in our network." Maybe they are but they say they aren't. What does that mean for me? No service and not getting the benefits that I was promised when signing on with this Wretched Company. This is the only place to lodge a Complaint unfortunately as I have been told that they have no Official Complaint Department. I will never use them again and would not even recommend them to an Enemy.

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I had an appointment with an eye doctor for a routine vision exam because I believe, but not 100% sure that a representative told me that a routine vision exam was covered under my policy. Because the claim was denied, I requested that they listen to the recorded conversation which they allegedly did. I was told that the representative did not tell me that the routine vision exam was covered; and therefore, requested that I listen to the conversation. I was told that this is proprietary information that they could not share with me. I was not happy when the company I work for changed to United Health Care because I was told doctors do not like this company because they have to fight with them and consumers would have to appeal claims due to mistakes they make. I don't know if there are any laws or regulations regarding a citizen's right to listen to a recorded conversation and was told to file a complaint with the Attorney General’s Office.

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Without notice, UHC dropped two of our children, claiming they had another provider. Now, UHC has dropped my daughters, a twin, from the vision plan without reason. There has never been any contact from UHC to explain the changes or that they had occurred.

After discovering we were being denied coverage, a call was made and the children were reinstated for healthcare, but not vision. Nobody at UHC has any documentation why this is happening.

Expert Review

Cyril TuohyInsurance Contributing Editor

Cyril Tuohy, has covered the insurance industry for more than 15 years. He is an expert at writing about personal and commercial property-casualty insurance and covers life, annuities and retirement as a staff writer for a top insurance trade magazine aimed at insurance agents and financial advisors.    More about Cyril→

UnitedHealthcare, a top insurer in the United States, offers stand-alone vision insurance or as a “rider” to a United Healthcare dental plan. (Not all vision plans are available in all states.)

  • Plan options: UnitedHealthcare Vision offers a Plan A for glasses and contact lenses, or a Plan B for glasses and contact lenses.
  • Providers: Consumers with UnitedHealthcare can choose from a national network of eye doctors and eyewear retailers.
  • No waiting periods: Coverage kicks in within hours or days of premium payment.
  • Vision Benefit Rider: For an additional premium payment, dental plan members can add vision coverage to boost the value of their dental plan.
  • Best for Individuals, families and employees in search of stand-alone vision coverage or looking to add vision coverage to an in-force United Healthcare dental policy.

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UnitedHealthcare Vision Insurance Company Profile

Company Name:
UnitedHealthcare Vision Insurance
Website:
https://www.uhc.com/