Humana’s earns a 1.4-star rating from 337 reviews, showing that the majority of policyholders are dissatisfied with health insurance plans.
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customer service
Really difficult company to deal with. I recently signed up for Humana/ Compbenefits dental plan through my credit union. I sent in my first premium as instructed in Nov. 2010. In December they double drafted me which left my account $2.00 overdrawn and my payment was refused. The bank in turn charged me a $29 OD fee. (Had they billed 1 month as they were suppose to by contract I would have not incurred this cost) So by January 2011, I was in the hole not only for 2 months premiums but also an additional $29 fee assessed by my bank. I am fully disabled with MS and am confined to a wheelchair. My budget is limited and allows me only enough each month to pay for necessities. I deposited my monthly premiums as they were due and was never aware there was a problem with my account until March when I broke a tooth and needed to actually USE the benefits I thought I was paying for. My account with Humana had been closed since January. I contacted Humana and was told that even though THEY created the problem, they were not able to correct it, or return any of the money that I lost due to THEIR error. I was told if I wanted to be reinstated that I would not only have to absorb the cost I already incurred but ALSO give them an additional 4 months premiums to catch up to May 5th. I tried to compromise by saying, ok, let's forget about the initial money that I am out of pocket and let's start this over. "Can I give you a check today to start this over effective May 5th?" That seems fair, right? NOPE! They expect me to pay them for 5 months premiums on a plan I didn't have access to on top of already absorbing the cost of the original malfunction which they admit was totally their fault. I have been through several customer service reps. Each one has been individully rude, uneducated and very UNhelpful in this situation. I've had better service at the DMV.
deceptive practices
After buying glasses for myself with Humana insurance and buying glasses for my sister in law without insurance I was shocked to see that I had to pay more for the same glasses with the insurance than she had to pay for the glasses without the insurance. I tried to cancel the insurance and was told I was locked in for a one year contract and could not cancel the insurance. This information was never given to me at the time I applied for the insurance and I believe this is an immoral and deceptive practice. Beware of any dealings with Humana.
fraud, theft
Humana has been charging me for something I never ordered, nor needed.
This is but a very small portion, representative of the several years that I have dealt, unsuccessfully, with humana... I would switch companies in a nano - second, but sadly, tragically, for many — they're all the same.
(That physicians have allowed themselves to be "owned" and manipulated by hmo's is a mystery to me,)
Although these messages are meant to be confidential, I just copied/pasted the latest useless exchange with this fraudulent company.
I have removed identifying info
*my annotations*
Hello,
The ppo plan should never have been active! I was charged for something that I clearly did not want or need and most of all, requst. You forgot the part about crediting my account. This is the third year in a row that this "reputable" company has perpetrated this fraud; it needs to be corrected.
Thank you,
— original message —
From [protected]@securemail. Humana.com
Date wed 03/23/2011 06:21:11 pm
To mg.@humana-odcs.com
Subject re: re: re: billing [#]
Dear,
Thank you for your recent inquiry submitted through the humana message center.
Your enrollment shows the ppo plan is not active.
If you have further questions, please continue to use the message center or call our customer care department at [protected]. If you are speech or hearing impaired, call 711.
Thank you,
Pam j.
Web customer care specialist
Humana insurance company
— original message —
From: mg.@humana-odcs.com
Date: 3/21/2011 2:34:51 pm
To: [protected]@humana.com
Subject: re: re: re: billing [#8]
A partial answer — was the ppo canceled on 01/01/11? I am being charged for this. I need to know that the erroneous charges have been removed.
* as is their custom, they completely ignored my query in their response — in fact they have ignored it for three years, charging me for something I did not want — or need*
— original message —
From [protected]@securemail. Humana.com
Date mon 03/21/2011 06:16:19 pm
To mg.@humaana-odcs.com
Ssubject re: re: billing #]
Dear,
Thank you for your recent inquiry submitted through the humana message center.
Effective 01/01/2011 you are enrolled with humana gold plus h24 (Hmo) effective 01/01/2011. No premiums for humana gold plus h248 (Hmo).
*yet, they are still trying to collect*
*yet, they charged me for another plan, that I informed them numerous times, that I did not want or need*
You can file an appeal. Humana will accept written appeal from a member or an authorized representative expressing dissatisfaction with humana’s adverse determination. Mail your written letter of appeal to the following address:
*an appeal is useless — I did that and it "could not be found"*
Humana insurance company
Attn: grievance & appeals manger
P. O. Box 14165
Lexington, ky 40512
Please include a description of your request for the reconsideration of the processing of the claim or desired benefits. You will also need to include your member id number, group number, patient's name, date of birth and supporting documentation within the letter's content.
If you have further questions, please continue to use the message center or call our customer care department at [protected]. If you are speech or hearing impaired, call 711.
Rose
— original message —
From: mg.@humana-odcs.com
Date: 3/18/2011 4:18:21 am
To: [protected]@humana.com
Subject: re: re: billing [#]
3/17/11
This is the 3rd year in a row that humana has extracted money from me through manipulation and trickery.
In numerous phone conversations, for the last three years, I have repeated that I have gone to an hmo and yet humana erroneously charged me for a ppo, despite my verbal — and written — requests to cease and desist. These are not mindless mistakes — this is theft — more of what the countless online complaints describe.
And here it is, year three and it's happening all over again.
I will be adding my humana [redacted] to these many consumer sites. You can fool all of the people some of the time...
— original message —
From [protected]@securemail. Humana.com
Date tue 03/01/2011 04:03:25 pm
To mg.@humana-odcs.com
Subject re: billing [#]
Dear ms.,
Thank you for your recent inquiry submitted through the humana message center.
This issue has been forwarded to our enrollment department for review. If you need to contact us in the future about this issue, you may use reference #428. You do show active on both plans at this moment, the hmo and the ppo. Please use your hmo id card for any medical costs.
Thank you for contacting humana to receive guidance when you need it most.
If you have further questions, please continue to use the message center or call our customer care department at [protected].
Alissa f.
Web customer service representative
— original message —
From: mg.@humana-odcs.com
Date: 2/26/2011 9:09:24 pm
To: [protected]@humana.com
Subject: billing
Hello,
The ppo plan should have been canceled as of 12/31/10 — in fact, I never chose it; should have been on the hmo all along.
Thank you
Rita kelley
The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.
The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.
The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential material. If you receive this material/information in error, please contact the sender and delete or destroy the material/information.
I have just found out the same as above. What a scam. They told me on the website when I went to pay I was not a client after I had been paying for 6 mos. My Debit card was stolen and I had to change it. They could not take the $22.00 out of my bank so they contacted me in a letter. I tried to pay online then by phone.the same thing. .When I got a hold of a person they said the digit was wrong not a 9 at the end but a 3.. Wow, They are trying to call me back now, three times. This just happened. I could hear that it was so weird in th woman's voice. You would think I would learn and check the internet scams before I send money. I feel so foolish.
bad medix d
Humana walmart medix x plan is awful they dont send drugs on time they overcharge and you have to wait a month to get credit 180.00 dr wrote prescription for drug they wouldnt fill it said needed preorthorization my dr did this they still wouldnt they denied the claim. I spoke with nurse at my drs. Office told her tell your friends to stay away from humana. Oh thats old news they over charge the always deny preorthorization. We have
Known how bad they are for a long time
customer service
I own a small medical practice in Kansas. About 5 months ago Humana abruptly stopped paying my patients' claims. Repeated calls and emails to my designated local representative went unanswered. Finally after numerous calls to the national organization Humana determined we needed to sign a new group contract. I was given a reference number and told to expect a contract in the mail. After 1 month no contract, and a repeat call to the national company resulted in a new reference number and instructions to call back in 1 month if the contract doesn't arrive. I still can not reach my local representative by any means-all emails and calls go unanswered. In the meantime my patients wait to see me for appointments and surgery, as I am unable to see them until the situation is resolved. If this is how they treat physicians, woe to the patients.
The complaint has been investigated and resolved to the customer’s satisfaction.
Friday11-8 I called to change my pcp after talking to 2 people I was
told that I could not go outside my ipa/group of doctors which to my
knowledge there are about 4 docs in that group. What caused the
problem is that they said there were no docs closer than 35 miles.
This was the first time I had heard that I was not allowed any choice
of pcp's listed except for the ones in the steingard group.
Talking to a 3rd person she said I could change and so I selected a doc
in my area but did not know if that doc was taking new patients so I
had to wait til Monday to call and see if they were. The person I
talked to at humana agreed to call me Monday at 10am and do a
conference call with the doc to see if he would take me as a patient.
The conference call was necessary because there was so much
disagreement as to whether I could select a doc outside of the ipa.
Monday came and she did not call so I called humana and for 4 and a
half hours I was shuffled from one person to the next even hung up on.
Many saying I could and many saying I couldn't choose a new doc.
Transferring me to the humana spokesmen who ran the ipa part. Them
saying I could choose a doc outside of the steingard group and
transferring me to another person to carry out that request only to have
the transfer-to person saying that I could not choose a doc despite
what the ipa rep said. This went on for over 4 hours. At the end of
that time Someone there said they had set me up with the doc of my
choice. When I went to make an appointment with the new doc I was
asked if my new doc would be retro to nov 1st or dec 1st. So I had to
call back humana and they said I was not showing with a new doc but I
was still with steingard. So I was so totally upset with the futility
of all the hours I spent with them. After again being transferred
around I was supposedly set up again with the new doc, Kevin Cleary.
The next day I was concerned that "was I really set up with the new
doc". So I called Humana again, it being Saturday 11-16 and was told
that I was not set up with a new doc, sheesh! So this person again
attempted to set me up with doc Cleary. I told her I did not believe
her after going through this 3 times and not being successful and that
I would call back later to see if it was really true. I did call back
later and was told finally that I was showing with doc Cleary effect
12-1 and was given a ref. number of [protected]. Later I couldn't
help thinking that this guy was just trying to appease me. After all
what could I do about it? Nothing had worked so far. So I have an
appointment 12-3 with doc Cleary, will it be so? If it is true that
if you choose an ipa group of docs that you have no choice of the other
docs listed as pcp's then why offer them? Ipa's has been a terminology
used for years but with a different meaning than what Humana seems to be using
it as or at least what some of the Humana reps seem to think it means.
The need for an immediate doc or even a few months away seems a dream at this point. The reps really need good training so they all agree on what they are doing and saying.
What do I do next? I have no idea and I am fearful that I do not have a new pcp and I was told 4 times but it turned out to not be true. What would you do to resolve this problem when all calls to Humana were to no avail?
bad customer service and plan
I am a coding specialist for a Eye doctor in rural Missouri. I have had numerous people call in and complain because there is a Out of Network deductible for their services rendered by our doctors. We explain to our patients ahead of time that we are not providers but we can bill their claims out for them and everything is subject to their plan. Come to find out there aren't any In Network doctors within 65 miles.
I felt especially bad for a couple from the town I live in that we have been seeing since 1996. This patient has to have test ran every 3-6 months to monitor a condition for his eye (he only has one, and now has glaucoma in his other eye).
Anyways, I spent an hour on the phone and I found out there is a waver that the parients can fill out to get their claims processed as in network if there isn't any In network docs within 30 miles, so we did all of that and got an authorization for all backdated services and through the end of the year. Now about 2 months later and 9 calls and 4 hours + on the phone with people that can't help me I am still stuck! I have spoke with Supervisor after supervisor that promice the moon and all I get is rejections and duplicat claims.
I finally called the patients Insurance agent to inform him that the insurance that he sold these people was not something that is working for them, started to explain all the problems with In and Out of networks and he and said "People hear what they want and he has been selling this insurance for 5 years" well Mr Gary I want to let you know that this poor guy with only one eye has been coming to us for a very long time and you should ask more questions and "qualify your customers" before you sell them a useless insurance plan!
BEFORE YOU BUY HUMANA - CHECK TO MAKE SURE YOU HAVE DOCTORS IN YOUR AREA! HUMANA IS NOT THE SAME AS MEDICARE!
fraud
My complaint is against Humana and its sales associate Dennis Gabauer. My parents are paying monthly on a policy that is supposed to cover my mother's prescriptions.The above mentioned associate met with my parents in their home approximately 3 months ago. He explained to them that my mother's prescriptions would be covered and that she would not end up in the so-called "donut hole" for a long time. I am not sure if that is what happened or if this associate just lied to them just to make a sale. Maybe he was told this by Humana Inc. just so that he could lure more people in. Either way my mother's prescriptions have not been covered and they total over $500. a month. My parents are in their 70's and do not have the income to pay for her prescriptions so my mother has considered just not taking them. These medications are life sustaining. I have spoken to Mr. Gabauer and explained to him my mother's situation. He told me at that time that he remembered my parents and he also remembered telling them that my mother's medication would be covered. He told me that the company should cover them and he could not understand why they weren't. He told me he would get back to me the next day after he checked his paperwork. He did not get back to me, however, he talked to my mother the very next day and told her the same thing. He admitted to her that he remembered her situation and that he did state to her that her prescriptions would be covered. He also stated to her that he could not understand what the problem was. When I called him the day after that he returned my call to tell me that he has been told he is no longer allowed to discuss anything with myself or my mother. I do not understand what is going on. It seems that either the company itself is either trying to cover something up or just rip off elderly people. Since my parents have paid for months of coverage that they never got but were promised, I feel that they should be reimbursed the total they have paid. I also feel that since my mother has had to pay full price for her prescriptions, that the company promised would be covered but lied, she should be compensated monetarily for the amount that she had to pay due to the company's lies. I am going to contact the Office of the Inspector General of the US regarding Medicare fraud to file a claim. I will do whatever it takes to get to the bottom of this. I also will contact whoever I have to so that this will be settled in a manner I feel is appropriate for my parents.
trick
I have this brain condition which also involves my eyes. I have been going to the same eye doctors down the street since I was a little kid. THEY are the ones that discovered my brain condition and they have all the tests, medical equipment, and prescription writing abilities to take care of it, but Humana says I can only go to them for glasses and check ups but anything involving the condition I have to go all the way into the city to the main campus for a guy to do all the same tests my local eye place did. Which never works out because I always end up late even when I leave hours (HOURS) earlier than necessary because I'm not familiar with the area and they always give my slot away and refuse to see me for another three to six months. No kidding. If this appointment is so unimportant that it can be put off for so long then why have it at all?
Well anyways, it's been over a year since I had my last eye exam and I really need new glasses. So I made an appointment with the people down the street but after I gave them my credit card and the new temp gave me the receipt I realize she charge me more than they normally did. We came to the conclusion that she accidentally charged me for a special eye test that I do need, but could no longer get there because it is connected with my brain condition. She seemed to be having trouble getting the extra amount off my bill, so a full time worker came to help and as soon as she came over and saw my Humana card she said they no longer took Humana. It sparked a big debate with all the workers there weather they did or not (It was so funny, them not knowing if they still took my insurance).
Finally someone got on the phone with Humana and they figured out that if you go to any out side place of Humana (which my eye place was now considered as), the card would still work and act like it accepted Humana. However, you have to pay up to 3, 000 dollars each year first, then after you have paid that full amount Humana would pitch in a fraction of any costs that came up after that. So the lady that called Humana explained to me that the bill I initially got would have just gone toward the 3, 000 dollars and I would have gotten a bill for the rest later. I almost let the bill go at first thinking that it had been a long time since I had that special test done and should really get it, luckily I anticipated that that might cause me problems through Humana and decided against it. I had no idea what problems I would really be stopping! And its good to know that thing about places accepting the card even if they don't actually accept Humana. Now I'm paranoid every where I go though.
Also, on a personal note, after I had finished catching up with all the lady's that work at my eye place, and turned to go, I nearly wanted to cry. I had been going there since I was a little kid...now I had no reason to go back...
I did find out that because of a recent change in the insurance I wont be eligible for it anymore in a year and a half, but in the mean time I have a question for anyone that reads this. Where is the list of places that do take Humana because I've looked and looked but I can't find it!? Any help would be much appreciated!
You can't believe what they tell you...they told me that my Dr's office is in network but now they are denying the claims, saying the office is out of network...and they are not very nice about it. I took this off of their website today and my Dr's office assures me that they are indeed in network, but it's like talking to a wall! Humana is right and every one else is wrong! And their so-called customer service is the worst I have ever dealt with. I'm getting rid of them as soon as my contract is up!
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Physician Details
Perry County Family
Practice Inc
Network:
HumanaChoicePPO (Medicare PPO)
1625 Airport Rd
New Lexington,
OH 43764
County:
Perry
Phone: (740)
342-5158
Fax: (740)
342-7393
oh brenda, love you
wost service experience
I have had terrible experience with Humana Medicare Coverage. I have Humana Medicare insurance and the first four years did not have a problem. My diabetes is controlled by an insulin pump and I never had problems getting supplies. Then all of a sudden without notice they canceled my supplies. My doctors have faxed them several times and also talked to personnel there several times about my situation. When I called customer care to inquire the person was really rude, and told me that he couldn't help me, and to call back later. The Dr office said that they all kept getting the run around by Humana. What I don't understand is that If they were going to stop the insulin pump supplies for what ever reason, why didn't they send me a notice? That would have at least gave me enough time to make other arrangements. They cancelled my supplies altogether without a warning. In the past, they would send letters out if there were any changes. This time there were no letters sent. The medical supply company that I used, informed me that Humana just all of a sudden made a mid-season change. Because of this, there was nothing I could do to get my medications and medical supplies. I know that Humana is getting paid to cover me because Medicare is paying them 110 dollars every month for providing insurance.
If any one reads this and if you are considering Humana, especially if you have a life threatening diseases, PLEASE do not use Humana! I had to go back on insulin shots which my body is having a hard time adjusting to, especially on a short notice. My blood glucose levels have been going crazy 300- 500 until I can find the right dosage. This puts my health in jeopardy. By the grace of God, I know that I will get through this. I just want to warn others before it happens to someone else. I also have a brother with Congestive Heart Failure who also uses Humana Medicare insurance, and they have stopped paying for his necessary lab work and medications. Please beware of Humana!
The complaint has been investigated and resolved to the customer’s satisfaction.
In 19 years of dealing with insurance companies...I have only given up three times...2 with Humana and 1 with Aetna. Humana's customer service is worthless. If it is not the most basic request they can't tell you anything (Ya know, if I had a basic request I could figure it out myself...I need someone who can help fix the complex problems). The biggest issue, the people you are talking to have absolutely no understanding of the American Medical System so they don't have a clue what you are talking about. I once spent 30 minutes going around in circles about copays vs. percentages. Patient had $40 copay but she was charged a percentage. So I'd ask them why are you charging a percentage you just said she had a copay. "Yes. Patient has a copay of $40.00" But you charged her a percentage. "Well "x" was billed, "Y' was allowed, patient is responsible for "Z"" (Then on to the next charge). THAT IS A PERCENTAGE...NOT A COPAY..."Yes, patient has a copay of $40.00." GRRRRRR
I have been on the phone with Humana for almost three hours today. I have Humana through Medicare and nobody can tell me where I can get my insulin pump supplies. They finally emailed me a list of 300 companies they have contracts with for durable medical equipment. I've called 20 if them so far and most are not good numbers or numbers to other companies than what is stated. I have two infusion sets left and have no clue how to get my supplies. If anybody knows, I would greatly appreciate it. I hate Humana!
CCS Medical might be the answer
I am starting to feel Humana is doing that to me. I have been getting the run around. Humana is so used to charging the Medicare Part D, that they are overlooking the Part B for DME supplies, therefore creating tons of additional stress for it customers. I hope Humana can get it right, I feel like they are ripping off medicare.
I just signed up with Humana Medicare and should have checked here first. My plan went into effect on October 1. They still don't have me in the Silver Sneakers System. Multiple calls to them produce no results. I have been a member for all of 3 days and am finding that their Customer Service and their systems are nonexistent.
I had Humana as a Medicare Supplement as of 01/01/2010 and cancelled it by calling them in December of 2010 to disenroll and cancell my automatic deduction from my SS check in December. A few days ago I got a letter from a collection agency that Humana is filing a collection against me for $465 because I had the insurance carry over in January. When me and my insurance agent had called to fix the problem they told us ok and it would be taken care of. It wasn't. When my agent called again 2 days ago they said I called to change my Credit Card information. I never called them for anything except to cancell my policy and my SS deductions for January 1st, 2011.They never got a credit card from me at anytime so how would I change that if I had my premium deducted from my Social Security Check each month and if I did pay with a credit card why would they bill me for something that should have been paid for with said card? This is an on going battle with this company and no one seems to care or one person doesn't know what the other is doing. THEY DON"T CARE. Like the person before me said, if you are considering to buy "any kind" of Insurance from this company DON'T. They are the worst people to do business with and they just don't care about anything you have to say and if you prove your case they come back at you with another excuse. Customer service doesn't esist here. Stay away, far, far away from them unless you like to be treated like your an iot and you don't matter.
no one to make my eyeglasses
I am a member.my name is Janet Whelpley.my ID is H59025533 I recently had cataract surgery with implants.I cannot find an eye doctor to make my glasses.I need reading glasses.Humana gives one pair of glasses a year after cataract surgery also.Can you give me a optician in Okeechobee that I can use.I have made calls to the names in the phone book.And noone takes Humana that I have phoned.Please look into this for me I dont know what to do ext.Give me a name please.
Thanks Jan Whelpley
total rip off
I got a HumanaOne policy and soon after it started I was told I needed back surgery. Humana told me it was covered, and Humana told the doctor it was covered. I had the surgery. Now Humana has decided NOT to cover it. They will not say why and they will not give me anyone to talk to about it. this will cost me more than $20, 000 in hospital and doctor bills. Humana hangs up one me when I call about it. if I ask for someone in charge, they put me on hold for 30 minutes or more and then hang up on me. THESE PEOPLE ARE ### AND LIARS AND CHEATS. STAY AWAY FROM HUMANA ONE. THEY HAVE RUINED MY LIFE.
Your story is outlandish.. the reason for any denial is clearly stated on your Explanation of Benefits which you can also view on their website and no I don't believe they keep "Hanging up on you". Health insurance companies monitor their calls and if you got hung up on, it would not happen several times as you erroneously claim.
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not paying bills and unauthorized bank withdrawals
Humana has jacked me around ever since I signed up in Mar 2009. I'm constantly on the phone trying to straighten out there mistakes and incompetent billing. I was on the Humana Advantage Plan because it fit my budget and I didn't see doctors very often. When I had to get a colon operation I had to call in to Humana for a "Waiver" to go in Network providers and Hospital. No problem except that it took numerous phone calls by me to the providers that sent me unpaid bills and humana denying payments. The operation was in Aug of 2009. Humana didn't notify me of processing the bills nor did they notify the providers billing office. The providers change so often I can't keep up with whose in network or what. I call Humana every time before I see a doctor to confirm of in network authorization. Some doctors offices excepted Humana without checking which plan I was on. I had no way of knowing whether the provider was excepting the correct plan. It was very difficult to make contact with humana to get a customer svc rep to assist me with my dilema. Cust svc was very courteous and patcient to say the least. But to talk with the source of the problem dept. Forget it. It happened again on 12/04/2009. I had a hand fusion. To this day humana still hasn't finished paying my bills. I'm constantly still on the phone with them. Sure humana corrects the mistakes but why do I have to notify them and babysit them. I'm worried all the time the doctors billing office will turn me in to the credit bureau because of late payments. Now, I tried to change plans so I can eliminate the Co Pay and all the hassle of waivers by changing to the F type Plan. 264.00 dollars a month just for peace of mind. Oh yeah...forget it. They screwed that up to. I decided to just return to the humana advantage plan because I pretty well know there game, I thought. After numurous calls and more issues concerning plans, disenrollments letters etc...I knew nothing about because their agent forgot to inform me, the Humana F type plan that was cancelled by me in Mar before the deadline? They decided to withdraw 524.00 inwhich I gave no authorization from my bank account. That's 2 payments for Mar and Apr this year inwhich I am not covered by the F type plan is in there pockets. I contested the unauthorized withdrawl but humana did it anyway. This is now still pending and if at all I recieve those 2 payments returned to my account won't happen for 4 weeks. Interesting how Humana takes so long to pay legitiment bills but can withdraw your bank account overnite. It's been a nightmare for me with this insurance co to long. So, without saying...I've learned my lesson. I am now in the market for a reputable co. I'm also filing in small claims court. This is a pathetic situation. The Advantage Plan is not an advantage. Believe me. I'm sure some of you out there are happy with your plan. I guess I was in the right place at the wrong time.
benefit payments
Tow claims 1 for a dental check was done out of network, the policy provide for 50% reimbursement it paid for less than 40%, and I had a routine physical, covered under the policy, the doctor recommended a shingles vaccine, recommended for people over 60, Humana would not pay for. $194.
The complaint has been investigated and resolved to the customer’s satisfaction.
No space for my complaint, name: Arthur John Greer, address 801 North Hillview Drive, Milpitas, CA 95035, SS#[protected]. phone; [protected], my complaint is as follows: Failure of Northern California Kaiser Permanente Northern California to process Medicare Part D prescription drugs benefits for Senior Advantage members who have dual coverage that is I am covered by the City of San Jose Retirement Health Care Insurance and by Medicare Part D prescription drugs benefits. Therefore my out of pocket Co pay to the Kaiser Pharmacy for prescriptions covered by Medicare Part D should be paid by Medicare. Kaiser Permanente Southern California collected the out of pocket costs of prescriptions covered by Medicare from Medicare ; however Kaiser Northern California doesn't. I would like a refund of all Co pay collected out of my pocket by Kaiser Permanente Northern California.
claims
I changed jobs and Human said I would get a packet for a State of Continuation on my health coverage. I filled out the information to continue my health coverage and sent it in. Humana received the packet four days later and told me they could not process my application until they received the premium payment. I sent them the premium payment and now almost...
Read full review of Humana and 1 commenteverything
I'm beggin anyone who has had problems with Humana to email, call, or send a letter to me stating your complaint and any supporting information you have about your complaint. I have made a decision to dedicate my "free time" to organizing a "front" against Humana. While words do not hold water by themselves, nor do individual complaints, I believe it is possible to have a group of persons large enough to attract the media. If I could acheive this goal, Humana would be forced to respond to a "newsworthy" story. I'm offering all of my time to deal with this. However, it will go nowhere without your help. Please email me, [protected]@yahoo.com, write me, 46 lottie's lane, nellysford, va 22958, or call me at [protected]. thankyou, jenny schmtiz
The complaint has been investigated and resolved to the customer’s satisfaction.
My complaint has nothing to do with my primary care physician or specialists. My physician (and a lot of other physicians) have to work so much harder with the insurance companies to get the benefits their patients believe they are paying for. My complaint...HUMANA. Medicare & the rising costs of prescription's and health-care. (Thank you Obama)! Last year I paid $ 7.00 for a 30 day supply of Quinapril. It was a tier one generic prescription of Accupril. Today (switched to a Humana Medicare Ins.) I paid $36.98 for the same prescription. When I called Humana, I spent at least 45 min on the phone...mostly on hold...and was told that my tier one prescription was now considered a tier 3 (because someone decided it should be) and the cost would be more. When I asked what the preferred brand would cost, I did not get an answer. All of my prescriptions are now 4 to 5 times higher in cost. Hard working tax paying Americans no longer matter. READ THE FINE PRINT. GET A WRITTEN COST FOR EVERY PROCEDURE FROM THE INSURANCE COMPANY AND THE PHYSICIAN. AND THEN PAY ONLY THAT. SEND THE BALANCE OF THE BILL TO MR OBAMA.
Agree 100%. Our experiences with Humana Gold Plus providers and some specialists have been nightmares! Humana means high risk for YOU as the patient. It is true that the doctor is paid a certain amount of money, just like this provider states. We confirmed this with a Humana representative. If you want sub-standard care and want to take chances on your health and life, then Humana is the plan for you. If not, get out! The only way to successfully survive Humana is to get referrals to qualified specialists for treatment when needed. Beware of the specialists as well and make sure they are reputable and not influenced by the Humana pay scale. Both the primary and specialists in the Humana network are very likely to care more about the dollar than about your health. If you are stuck with Humana for the moment and have a health condition or symptoms, don't give up until you get the appropriate diagnosis and treatment. You may save your own life.
TIP OF THE ICE-BERG. Run, Run, Run as fast as you can away from this insurance. I am a healthcare provider in Florida-TAKE MY ADVICE- keep your MEDICARE- Do Not Sign up for this plan. Its a full risk plan for doctors. That means Humana pays a doctor a certain amount of money to look after you. Full risk- They pay for most tests, medications and most procedures. As you can imagine that's a good incentive to order less tests, use the cheapest medications and to cut costs. The money they don't spend on you they keep. Humana usually contracts with doctors that care more about the bottom line and not your health. I have seen people die, have strokes and become riddeled with cancer because of these greedy doctors and this criminal insurance company.
Little secret- most doctors just write off the c0-pays from medicare and never send you to collections. You will never have a problem seeing a specialist or getting an appointment. If you value your health and life stay as far away from Humana Gold Plus as you can.
violation of hipaa laws
Wife called Humana to ask questions about health insurance rates, etc. I recieved a message 2 days later from Joshua an underwriter wanting me to call him back. I called back, and after going through 3 peopole who wanted to know my policy #, I finally reached him. What about "I do not have a policy with your company" is so hard to understand. I was cut off while on hold twice as well. I finally reached Josh, the underwriter, he begin to name off Medications I was on 5 years ago and wanted to know what my exact diagnosis was to be on the medication. Well actually he told me that the medication was for depression and also for anxiety and that he needed to know which I had been diagnosed with. Well my reply was that it was to help me stay calm while dealing with people like him who pull my medical records without authorization. I checked with my wife and she had signed nothing allowing them to view my medical records. I was unaware of everything except for the fact that Josh had left me a message and I was returning his call. I then called back and asked for a supervisor and told him the situation and how I was unhappy that my medical records where pulled without me authorizing it. As well, Joshua never verified who I was other than the fact that I told him my name when I called. The supervisor told me they had every right to pull my medical records because my wife had requested rates. I told him shouldn't I have at least been notified or at least got a call to make sure my wife and I were still living together. His was response was that they are not required to do that, and even said that they would just charge my wife with insurance fraud. The part that got me the most was when the supervisor told me that they had a system that pulled up the persons information who was calling based on the phone #, so they could tell if the call was the person they said they were. So I asked him what # I was calling from. He gave me my wife's # . Funny, I was calling from my work phone with my wife 20 miles away. I guess he thought because I have a southern accent that I'm stupid enough to believe something like that from him. With all this said, I just want people to be aware that Humana basically does what they want how they want. Even after all this, the supervisor tried to convince me to buy the policy...I told him he must be out of his mind. They seem to find the path of least resistance to stay legal instead of making any kind of effort to ensure the privacy of thier customers. I will stick with Blue Cross Blue Shield.
The complaint has been investigated and resolved to the customer’s satisfaction.
No way man. Insurance underwriters are highly paid folks. Humana does not put one to work when someone "asks about rates". Not only do they have to have a signed application to get a release for the records, they have to have a signed application to know you are serious about buying insurance before they spend any time and money on your file. Additionally an underwriting supervisor is not in sales and would not try to "talk you into buying a policy". Reading between the lines here, it sounds like you got denied by Humana for taking a drug associated with mental health. And yes, it is not fair, but if you are on a crazy med your chances of getting private health insurance are not good. Glad BCBS approved you.
I find your story hardly believeble and that's not a HIPAA violation. He was speaking to you about yourself.. how is a violation?
fraud and cheating
Your insurance coverage details are outlined in what is called your 'certificate of coverage'. Surely you can access this from Humana's website. No, it is not available on the web. I called Humana and was told they would not send it to me. Tiffany told my husband that she could look up our plan to reference our certificate, but it would take a couple of days.
This was one of many calls where we were told something different each time we called. I have Humana Healthcare from the city I retired from, and I moved to a rural area. I was able to find a doctor on the plan. He is not close to a lab and has permission to send his lab work to the Hospital two miles away, to be tested in their lab. It was categorized as lab work only. It was a blood test on blood drawn at the doctors office... $15 co-pay and $10.00 lab work. Oh, No! I was charged an outpatient Hospital deductible of $100.00. By Humana's definition... an Outpatient is treated at the Hospital and confined for a period of less than 23 consecutive hours.
When I argued that I was never physically at the Hospital, and therefore did not fit the definition...I was told that 'My Blood, which is a part of me' was there...so I had to pay as an outpatient.
My husband needed a stress test and went to a Cardiac Clinic in a Larger City that was In-Network, so we figured we were safe. Wrong! One of the employees that was on the bill, was not In-Network. This place had over a hundred employees. We have Tiffany on tape saying that it is the patient's responsibility to check each and every person, at the facility, who could possibly be involved in your treatment... prior to treatment...even if there are hundreds. It doesn't say that in the certificate either. This company makes it nearly impossible for you to find out what your coverage is, and then changes the wording in the agreement to find a way to deny coverage or get a larger deductible.
My husband and I have spent countless hours dealing with this company, on more ridiculous issues than I can relate here. I do have tape and documentation, though...for every claim. We are currently in the appeal process and if The City did not have a contract with Humana, I would not use them.
I definitely do not recommend them to anyone and I feel sorry for the Seniors who think Humana's Medicare Plan will help them.
The complaint has been investigated and resolved to the customer’s satisfaction.
Please tell me why this is an ALLOWED and ACCEPTABLE PRACTICE in the UNITED STATES OF AMERICA! Please what can be done NOW! The people of this country have become so weak and passive.
Your insurance coverage details are outlined in what is called your 'certificate of coverage'. Surely you can access this from Humana's website. No, it is not available on the web. I called Humana and was told they would not send it to me. Tiffany told my husband that she could look up our plan to reference our certificate, but it would take a couple of days.
This was one of many calls where we were told something different each time we called.I have Humana Healthcare from the city I retired from, and I moved to a rural area. I was able to find a doctor on the plan. He is not close to a lab and has permission to send his lab work to the Hospital two miles away, to be tested in their lab. It was categorized as lab work only. It was a blood test on blood drawn at the doctors office... $15 co-pay and $10.00 lab work. Oh, No! I was charged an outpatient Hospital deductible of $100.00 By Humana's definition... an Outpatient is treated at the Hospital and confined for a period of less than 23 consecutive hours.
When I argued that I was never physically at the Hospital, and therefore did not fit the definition...I was told that 'My Blood, which is a part of me' was there...so I had to pay as an outpatient.
My husband needed a stress test and went to a Cardiac Clinic in a Larger City that was In-Network, so we figured we were safe. Wrong! One of the employees that was on the bill, was not In-Network. This place had over a hundred employees. We have Tiffany on tape saying that it is the patient's responsibility to check each and every person, at the facility, who could possibly be involved in your treatment... prior to treatment...even if there are hundreds. It doesn't say that in the certificate either. This company makes it nearly impossible for you to find out what your coverage is, and then changes the wording in the agreement to find a way to deny coverage or get a larger deductible.
My husband and I have spent countless hours dealing with this company, on more ridiculous issues than I can relate here. I do have tape and documentation, though...for every claim. We are currently in the appeal process and if The City did not have a contract with Humana, I would not use them.
I definitely do not recommend them to anyone and I feel sorry for the Seniors who think Humana's Medicare Plan will help them.
Humana Cheats people. After paying 420 as monthly premium, Humana says the coverage does not have gynecology treatments and have 1000$ maximum benefit per year... Also they do not tell people that they don't cover pregnancy and related procedures... Cheat...cheat... Cheat
Humana is correct about the in-network thing.. that is your responsibility to verify every provider's in-network status.. they aren't going to reimburse the provider above the maximum reimbursement limits because you didn't do your homework.. it probably is in the certificate, but if not it's common sense that PPO and POS plans work that way.
Oh, man, Humana seems to remain the worst company anyone has been involved with. I, too, have kept careful records regarding Humana. I think I have over 40 phone calls--- actually, I think it is closer to 63 phone calls to Humana. I have hundreds (really, 100s) of paper claims and papers regarding Humana that I have docuemented. I am so frustrated, as it seems you are, as to how I can ask the same question to several different persons within one hour and recieve the same answer. I hope things will go better for you than what they have for me. Jenny
unauthorized billing
I had a medical procedure done late last year while covered by Humana Health in Louisville. In three phone calls to Humana, I was told my co-pay would be $25.00. However, when I received my Statement of Benefits outlining a $500.00 co-pay, I immediately made and specifically documented my third call to Humana informing me again of a $25.00 co-pay. On denying my appeal, Humana documented a false date and false information of my first call, and Humana would neither acknowledge nor deny my third call. Because Humana has maintained their stance on my calls, I have complained Humana in my case had been dishonest with me.
The complaint has been investigated and resolved to the customer’s satisfaction.
Humana changed my pharmacy plan and increased my premium from its original $17 a month to $62 a month without informing me or obtaining my consent. Now they tell me if I drop the plan during the non enrollment period I will be penalized when I obtain coverage (from an honest insurer) during the next enrollment period for the rest of my life
This can’t be legal!
Well I work for a health insurance company (I'm not going to say if it's Humana) and it sounds to me like you have a misunderstanding of how health insurance works. FIrst of all, you are always told that you cannot be guaranteed benefits or amounts until the claim is actually received and processed. Secondly, $500 is not a co-pay amount (it might be a co-insurance amount which is a vastly different thing), but it would be very unusual to have a $500 co-pay for anything.
I'm begging you to send me an email, letter, or phone call about your Humana complaints. While indivdual complaints do not harm Humana, a united front of many persons could make a difference. I plan on publishing an article about Humana. But, my article will not "hold water" unless I have persons to back up the problems with Humana. This means that I HAVE to have your help. Please email me (jtbirdiusrex@yahoo.com), write me at (jenny schmtiz, 46 lottie's lane, nellysford, va, 22958), or call me at [protected]. Please take a moment of your time to help me. And please contact anyone else you know who has had problems with Humana and encourage them to contact me. My effort to attempt to hold Humana responsible for their actions seems futile, but I couldn't live with myself if I didnt' try to do something about the company. Again, I'm begging for your help. Please don't let me down. jenny schmitz
fraud and cheating
About six months ago, my husband's company switched from United Healthcare to Humana health insurance. The first thing I did was go to Humana's website to make sure our family's doctors - my son's pediatrician, my OB/GYN, and our family dentist - were in Humana's network. I really liked all of our doctors, I'd done a lot of research to choose the best ones, and I did NOT want to change.
My son's pediatrician was the only one that didn't show up on the network list. I called their business office to see why they didn't take Humana. They said they used to take it, but had a very hard time collecting from them. They said Humana had a habit of automatically paying the doctor less than the agreed-upon amount for a service, and then making the doctor's office jump through hoops to get the rest of their money. They said when they did pay out, it took forever to get a check, and often required multiple claim submissions. And they said Humana refused to pay for what the doctor considered to be routine care for a child, including some vaccines and screenings, and that they nit-picked every chart in an effort to get out of paying for care. They said their relationship with Humana got to the point that it wasn't worth it anymore, so they dropped them. And as disappointed as I was, I can't say I blame them.
So I went to Humana's website and found a pediatric clinic that is in their network. I went there and I hated it. It was clearly an inferior facility and inferior quality of care compared to my previous doctor. And I was even more frustrated when, a month or so later, I got a bill in the mail for $104 from the doctor's office. Apparently Humana had paid only $34 of my son's 15-month well-child check-up. I called Humana to tell them there must have been some mistake. They said they only paid a small percentage of the claim because I went to an out-of-network doctor. I said, 'No, actually, the only reason I even know that doctor exists is because I found them on YOUR website.'
After putting me on hold for more than 10 minutes, they came back on and told me the clinic I had gone to was in-network, but the particular doctor I saw was not. I asked them how in the world I, as a consumer, am supposed to know that just because a clinic is in-network doesn't mean the individual doctors are. After much, much, much back and forth, they agreed to resubmit the claim and pay it. They acted like they were doing me the biggest favor in the universe, and kept stressing that this is a one-time ONLY exception they were making for me. Gee, thanks jerks.
Not long after that, my husband went to see our family's dentist, which was in-network. Humana paid for his entire check-up, no problem. He didn't even have to pay a co-pay. Two weeks - yes, exactly fourteen days - later, I went to the same doctor and got the same check-up and x-rays. When I finished the appointment and went to check out, the office manager informed me that I owed them $280. I informed HER that I had dental insurance - here's my card, which I've already shown you when I came in.
She said, 'Oh, I guess they didn't tell you we don't take Humana anymore.' I said, 'What are you talking about? My husband was just here two weeks ago and you took our insurance THEN.' She was very nice, but she told me they had been in contract negotiations with Humana for months and couldn't reach an agreement. The dentist had requested a small and routine increase in fees, and Humana had bluntly refused. She said the amount they were willing to pay would not even, in some instances, cover the dentist's costs. I told her I refused to pay, since they should have told me when I walked in and showed them my card that they no longer accept Humana.
I called Humana to protest and got nowhere. They said it was my responsibility to know whether the dentist was in-network. Apparently I should have checked to make sure the dentist was still in-network just before I walked out the door to go to the appointment. Checking before I MADE the appointment wasn't good enough. So now the $280 is in limbo, with me, the dentist, and Humana refusing to budge.
After the dentist incident, I thought it might be wise to go back to Humana's website and make sure every doctor in the state hadn't dropped them. I was especially worried about losing my OB/GYN. I had established a great relationship with them during my first pregnancy, and I felt comfortable with the thought of future pregnancies knowing I would be in their good hands. So when I pulled up a list of in-network OB/GYNs in my county, my stomach dropped.
Not only was my doctor not on the list anymore, but there are only three doctors in my entire county that take Humana. And I don't live out in the boondocks, I live in Raleigh! For comparison's sake, I went back to United Healthcare's website to pull up a list of their in-network OB/GYNs in my county, and got a message that I would need to narrow my search criteria because my search had returned more than 300 doctors. THREE HUNDRED. Humana offers three doctors, none of which is less than 40 minutes from my house, and only one of which delivers babies at the hospital closest to me. I called my OB/GYN's office to find out more information about why they dropped Humana and... well, by now you can guess what they said.
Last week, I woke up in the middle of the night with horrible lower abdominal cramps. I started to get worried that it was something serious, since I very rarely have any abdominal or gynecological issues. Then I thought, 'It'll be okay, because if this still hurts in the morning, I'll just call my gynecologist.' And then I remembered that, thanks to Humana, for all intents and purposes I don't have a gynecologist. Or a dentist. Or a pediatrician. Or any good alternate choices available that DO accept my insurance. It was a terrifying feeling. I guess this is what it's like to not have any health insurance at all.
So we're shopping around for a health insurance plan that we'll have to purchase out of pocket. It will cost a lot more than we pay for Humana through my husband's company, but we're willing to pay for peace of mind.
The complaint has been investigated and resolved to the customer’s satisfaction.
Humana has deleted my ID number and I have been a member for 2 years. There is no one in Humana who is willing to correct this error and I am unable to continue to receive medical care. The customer service reps. are supposed to fix these problems butthey act as if they cannot fix the problem. How does this happen in the United States?
"Well" is unfortunately a 4 letter word at Humana. It appears to be a problem within, which of course, affects their services. In their training, they teach "perfect service" - however, the caliber of nurses and staff is "terrorist-like", and if an employee shows signs of applying "perfect service", the employee experiences horror stories, and may be threatened with sharp cutting objects. It is common for a Humana employee to appear to brag that they may be the next "terrorist".
I was not able to use Humana's insurance. Although I paid for it to start at the beginning of the month, it was not ready, so I could not receive the medical services that I required. Many Humana members are in the same boat. The insurance applications are not processed on a timely basis, so even though you have paid for the insurance, you cannot use it. If Humana took the time to steer their employees away from terrorism, then they would have more time to process the applications promptly. The health care industry is in the hands of nurses and other staff who behave like terrorists - Humana is probably the worse example of such decay.
White humana employees be like...
In Dec 2010, my daughter needed her wisdom teeth extracted. Our family dentist referred us to a Dr. Fish, a specialist in Chandler, AZ. Upon entering the office, the receptionist asked for my insurance card. I handed it to her, and asked that their office pre-determine my out of pocket costs for the services. She said I could talk to the person that handles their insurance claims. After the Dr. finished the initial examination, I also mentioned to him that I would like to know what my out of pocket responsibility would be. He said that would be available from the insurance person. Finally, I was sitting at the desk of the insurance/financial person, and again requested to have a predertermination of my out of pocket costs. She said they don't offer that service, but they would invoice my insurance company and everything would be all right. Two months later, I started to receive billings for the total amount of the work. I called the office and was told that they were "out of network", and that I was now responsible for all charges. I told them that I had asked 3 times during the initial visit to predetermine my costs, and was refused. About one week later, I called the office and without telling them who I was, asked if they accepted SecureCare Dental insurance. The receptionist immediately responded "NO". I am convinced that the insurance person knew all along that we would not be covered, but didn't want to turn away our business! I told them that I would be willing to pay exactly what I would have been responsible for had they been in-network, but they refused to budge. I would expect to experience unethical treatment from a used car lot, but not from a dentists office!
Physician Finder Plus - MyHumana
Other Providers:
Physician Details
Perry County Family Practice Inc
Network: HumanaChoicePPO (Medicare PPO)
1625 Airport Rd
New Lexington, OH 43764
County: Perry
Phone: [protected]
Fax: [protected]
This is my Drs office...how can they say it's out of network?
I am having the same OUT OF NETWORK problem with Humanna. Have only had their PPO since 03/10. I verified that our Doctor and his office are in network. Now, even though most of the customer service people that I talk to assure me that my Doctors office is indeed in network and say they will resubmit the claim and get it paid...nothing happens. Some of them are down right rude and tell me that my Drs office is billing wrong or that it is up to me to file a dispute. If the customer service people can't figure out whether or not some one is in network...how the heck do they expect me to know? I'm stuck with them until Nov. then I'm switching to another company. People warned me and I should have listened but they were so nice when they wanted my business.
Your account is riddled with half-truths and no-truths.
You, as a member, are always responsible for verifying a provider's network status regardless of what is was 2 weeks ago or an hour ago... plan changes happen all the time. The here-say you heard from a doctor's office about their dealings with Humana are just that - here-say. And no, dentists are the real greedy ones here.. they make more than enough to cover their costs and they don't ask for small increases.. they ask for outlandish ones.. so Humana was probably wise to not renew their contract with your dishonest dentist.
Wow something similar to your dentist visit happened to me with my eye doctors. I have this brain condition which also involves my eyes. I have been going to the same eye doctors down the street since I was a little kid. THEY are the ones that discovered my brain condition and they have all the tests, medical equipment, and prescription writing abilities to take care of it, but Humana says I can only go to them for glasses and check ups but anything involving the condition I have to go all the way into the city to the main campus for a guy to do all the same tests my local eye place did. Which never works out because I always end up late even when I leave hours (HOURS) earlier than necessary because I'm not familiar with the area and they always give my slot away and refuse to see me for another three to six months. No kidding. If this appointment is so unimportant that it can be put off for so long then why have it at all? Well anyways, it's been over a year since I had my last eye exam and I really need new glasses. So I made an appointment with the people down the street but after I gave them my credit card and the new temp gave me the receipt I realize she charge me more than they normally did. We came to the conclusion that she accidentally charged me for a special eye test that I do need, but could no longer get there because it is connected with my brain condition. She seemed to be having trouble getting the extra amount off my bill, so a full time worker came to help and as soon as she came over and saw my Humana card she said they no longer took Humana. It sparked a big debate with all the workers there weather they did or not. (It was so funny, them not knowing if they still took my insurance) Finally someone got on the phone with Humana and they figured out that if you go to any out side place of Humana (which my eye place was now considered as), the card would still work and act like it accepted Humana. However, you have to pay up to 3, 000 dollars each year first, then after you have paid that full amount Humana would pitch in a fraction of any costs after that. So the lady that called Humana explained to me that the bill I initially got would have just gone toward the 3, 000 dollars and I would have gotten a bill for the rest later. I almost let the bill go at first thinking that it had been a long time since I had that special test done and should really get it, luckily I anticipated that that might cause me problems through Humana and decided against it. I had no idea what problems I would really be stopping! And its good to know that thing about places accepting the card even if they don't actually accept Humana. Now I'm paranoid every where I go though. Also, after I had finished catching up with all the lady's that work at my eye place, and turned to go, I nearly wanted to cry. I had been going there since I was a little kid...now I had no reason to go back...
I did find out that because of a recent change in the insurance I wont be eligible for it in a year, but in the mean time I have a question for you Lloyd, or anyone that reads this. Where is the list of places that do take Humana because I've looked and looked but I can't find it!? Any help would be much appreciated!
I'm responding to the woman that lost denist, ex. Humana is famous for choosing not to act in accordance with their actual documentation they said a client in the mail. As far as I have been able to tell, the company makes money upon the premiss (I can't spell) that persons will not notice the actual cost of their appointments. I hate to say it, but the bulk of persons on medicare are not familiar with computers. They expect to recieve the benifits they pay for. I am a mere thirty-one years old, but due to disability, I am on medicare. I currently have seventeen pages docuemented regarding Humana and the number of times I have called and submitted claims. Spending much of my life in situations where I felt helpless, I am determined to expose Humana's reckless actions resulting in a higher profit for Humana. Please let me know if you have a way to educate persons about this company. For once, I am not fueled by anger, but am determined to help persons make the correct choices about health care. Please call or write me, jenny schmtiz, jtbirdiusrex@Yahoo.com, [protected].
price/prescription approval, etc
My husband and I have worked for the state of Ky. for 13 years (for me) and 14 for him. He was also a member of the Army Reserves for this entire time. He recently retired instead of rejoining for 4 more year until he is 60. When I was working we cross referenced and our payments were maybe the most expensive was 40.oo a month for both of us and our daughter and son. I never had a complaint, NEVER until just the last couple of months. We had Tri care and of course I was not out anything for surgeries, medications that were prescribed we 3.oo and no more than 22 if they werent formulary. I want to get in touch with the head executive of the comany and find out what I need to do in order to make this affordable. 400+ dollars for my husband and myself is totally unrealistic.
I went to get my effexor refilled. I have been taking this medication for 6 years. I have never had to pay anymore than 29.00 for this medication, My husband went to have his Cozaar refilled, same story, the insurance company has to decide if this is the right thing medication for the doctor to prescribe for us, so it needed to be preapproved before we could get it. Okay it was approved and it was something like 165.00 WITH the insurance. Now let's add a minute. I am paying 400+ a month. I am now paying premiums at the doctors office anywhere from 10-20 for that. I have no other insurance such a dental or optical with it, just strictly medical. My husband's blood pressure was in the stroke range, and the drug store could and would not give him enough meds to get him by to see his doc to have them changed. So I have wound up in the emergency room, I have had to see a gastronologist and he would not even treat me for the other things that need to be treated because without the Effexor, my abdominal problems would not respond well to the medication. so I have been down in the dumps. I have isolated myself from all my family and friends, they get on my nerves, and I can't stand myself so I just dont want to bring them down with me. I want the CEO headquaters comepany, I also want to bring this to thier attention. I will be mailing out several letters to senators, and other folks who think they are much more important because they do not have to worry about insurance when they are older. Just to let you in o n what has been going on since we had no medication while waiting on Humana to say it is okay to have them or not, My husband has had a blood pressure of 157/116, I cried, been to the emergency room because my stomach was cramping, so, i still thought what a waste of time I am spending in an emergency room taking up space that others with life threatning injuries may need, simply because it is easier than waiting on my physician to get into his office, so he can order me something that my 450.00 a month premium insurance is not going to pay for supporting people in Ky who have no health insurance, but I think it is unfair when we pay that kind of money, and the welfare system gets better care than we do. Prison life is good for insurance.I worked there for 13 years, I KNOW beyond a doubt if something is NON FORMULARY for the inmates, a stroke of a pen when it is presented to our Dept of Corrections Medical Director of the state who by the way is a Mental Health Doctor a bona fide Psychriaist who used to work at the Ky State Reformatory as an on staff Psych MD. I will be submitting letters to everyone that I can get through to, this is highway robbery, this is why people cannot afford insurance and go on welfare so their kids can be covered, but what happens when that parent becomes so sick he can no longer take care of his/her children, because he cannot afford the insurance for himself, or the medication for himself. I would appreciate if you could send me other addresses, so I may get this out there. I f not that is fine I will find them on my own. I know this is going to be a long drawn out process, but I can be a patient person when I beleive in something.
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Really difficult to deal with. I work at a dental providers office and simply wanted information regarding a patients benefits and co-payments. This seemed to be a bit to much for the benefits department, the claims department and the financial department. I asked for a supervisor several times and was never connected. I was transferred 6 times, the last time to the medical department and was told after 1hr and 14min and 10 sec that i would need to be transferred again to dental . I am so frustrated .
Humana Compbenefits is a scam. I picked this dental plan that was offered by my employer only to find out that Humana and all of the dental providers worked hand in hand to scam the consumer. I recently took my family in for their routine check up and dental cleaning. Each individual I took needed crowns which cost $500-$600 for each crown. What a coincidence I needed one crown, my older son needed a crown and my youngest son 17 needed two crowns. When it was time for our cleaning which was free. We needed deep cleaning which for my son was $50 extra but myself was $200 just for a cleaning. I advised them that I just wanted th routine cleaning offered for free which my insurance company would pay them. Instead I was told that if I did not select the deep cleaning that I would get no cleaning because they would only do the services that they recommend. I complianed to Humana who told me to choose another provider. All of the providers under the plan had the same ideology. You either pay what we tell you or you get nothing. Last time I checked this is called blackmail... So, to sum I am paying for this health insurance plan every pay period that I cannot use because in order for me to use the plan I have to pay for their overpriced dental care. Instead I have been going to other dentist without using this insurance plan and paying less for my dental care. I got a dental cleaning along with x-rays and check up for $60 per person. I am writing about this experience in hopes that someone will read this before making the mistake I made. Humana compbenefits is a money making scam at the consumer's expense. Don't fall into the trap about their low cost premiums because once you go to their dental providers they will tell you that you will need services that are not covered and you will be charged high cost for dental work. You will still be paying the premium to Humana but will not be able to use the coverage. You are better off finding a honest dentist and paying honest prices.
I am OP's wife. I would like to add my frustrations to this thread. I have been a member of Humana compbenefits for a year now. I second the opinion that they are poor quality. I originally went with them becuase they offered discount rates to credit union members. Upon receiving my start up letter (One page that says welcome, visit our site) I logged in to their website. It is extremely difficult to navigate. Logging in takes you to your benefits page. Once you select your plan # it directs you to choose a new provider. If you try to use any other function, it directs you to the Provider Only website of which customers have no access. In order to get back to your plan, you have to re-log in. Regardless, I have other complaints. The first provider I chose - Staff was friendly on the phone. The day before my first scheduled appointment my selected provider killed 3 people in a DUI accident and was arrested. I contacted Humana to ask them to waive the 30 day waiting period for changing providers which they did accomodate. I was seen by Dr. Gargasz at Downtown Dental quickly however, when I arrived at the office I was greeted by a customer that was dirty and not wearing any shoes. He appeared to be intoxicated. I made a quick comment to the receptionist about him and was informed that is normal there. I was told" You should have seen the one that was in here earlier, he was high on Oxycontin" apparently that customer informed them of their intoxicated state and was still serviced. At this point although I was nervous, I didn't have much choice. I needed to see the dentist to troubleshoot a loose crown. I waited over an hour and finally made it to the back. I was met by a lady that covered her mouth as she yawned before she told about how late she was up the night before. After about 20 attempts to get bitewing xrays, I had to position the plate myself for her. She left the room and I was left for another half hour or so. Then the dentist came in. He was a young stud (he thought) and had a very full of himself attitude. I mentioned the reason I was so rushed to see him was becuase of the other Dr.s DUI involvement. His response was "It can happen to any of us" and continued over to his computer to look at my xrays. At no point did he look in my mouth yet he came up with an estimate for over $5000 worth of reconstructive procedures that I needed. I just had all my metal fillings replaced 2 years before so I know it was very impossible to need that much work. A new crown maybe, 5k worth of reconstructive work is ridiculous. I told him I would need to think about it. I received my cleaning and left (which by the way was nice. The hygenist should seek employment somewhere else. She's a rarity in this office)...6 months later- I am scheduled for my routine cleaning so I go ahead with it. I informed the staff 2 weeks before my scheduled appointment that I have lost a small bit of one of my fillings (eating candy) and can it please be addressed at my appointment. I was told no problem, we'll put it on your chart. I took time off work and went in for my cleaning/ filling. When I arrived, it appeared empty with the exception of 1 lady in the waiting room. I was called to the back and had my cleaning then was told I was all done. I said wait, I need to get my filling fixed still. I was then told that if I wanted to be seen by the dentist I would have to wait until all the other people were taken care of. I said ok, "How long do you think that will be?" I was told the guy next to me was next and he had been there since 9am (It's now after 1pm). I asked the receptionist if it would be ok to leave if it was going to be a long time (I live 3 miutes from the office) and they could call me with a 5 minute warning. This appeared to be no problem and after confirming my number I was on my way. I received my call at 4:30pm. I was told there were still people there and that they would not be able to see me. Where did they hide all those people if they were so busy? I mean seriously, it's a small office. Aside from the service, let's talk about cleanliness. Although the office did have all the proper plastic covering, I'm not sure they change them after each person. The blue tape on the overhead light was splattered and the headrest sleeve was quite worn. When the assistant came in, she put on gloves then reached for the light, typed a little on the computer and wrote some stuff down with a pen that had been rolling around. After all of this she attempted to come at my mouth with those gloves. Are people aware that gloves are there for MY safety...not hers. I couldn't believe she wanted to put her hands in my mouth after touching all that dirty stuff. Anyways...I feel a little lighter now, thanks for listening to me vent. Hey Humana----> get it together. I called Humana to ask about reviews for their providers. I was informed they don't screen them and that it's my responsibility to "do the research" The next research I do is going to be for a new dental plan.