United HealthCare Services
Reviews and Complaints

In short it has been a nigtmare. Customer service is horrible. I have extended coverage through Cobra now since I was laid off on June 1 and my benefits technically ended June 15th, 2010. I am waiting to have a gastrectomy and pre approval was submitted 6-9-2010 prior to benefits ending. United Healthcare via Sedgwick CMS is now denying it based on coverage termination, however they received the submission from my doctor prior to benefits endidng and the letter clearly states this, the letter dated June 24, 2010 from them which denies the surgery based on criteria, is also wrong. This is their response...
"Rationale: Based on the information provided, the member does not meet all the extensive and rigourous Plan documentation criteria for coverage of obesity surgery(BMI.35 with significant comorbid obesity-related health condition, for at least 2 years; documented ongoing active participation in comprehensive weight loss program for 6 months within the past 2 years), and the proposed bariartric surgery is not covered."

The administrator for United Healthcare and my employer Sedgwick CMS sent me an e mail with the coverage information and criteria, this is not what it states. With my doctor we made sure all the criteria was met.
Aetna Insurance has approved the surgery and has the same criteria, I had had the same situation with Aetna attached is a copy of their intital denial and also the approval after documents were sent. What is difference with Aetna they were polite answered all my questions and expedited it immediaitely. United Health care continues to give it's people the run around.
They reviewed it and sent a denial within the coverage period. I have extended benefits via Cobra and they continue to say that they will not reconsider the surgery or an appeal because I am not covered and until the monies show up in their account they will not consider reviewing it. BAD FAITH if you ask me.
I have spent 2.5 hours o the phone today going from division to division, they place me a hold AND THEN DO BLIND TRANSFERS! Please help. This again wa s reviewed within the policy period and the appeals should be considered as such other than that United would be acting in bad faith. I have attached copies of everything

My complaint is against United Healthcare and how they deal with subscribers. I have logged over 5 hrs of telephone communication with United Healthcare in a 2.5 week period (from 4/20-5/6). I have been misinformed about information in my account and am enraged with UHC's Care Coordination Department, Appeals Department, and Benefits and Eligibility department.

United Healthcare needs to improve both its voice networking system, making it easier to navigate from one department to the next without having to repeat all of the same initial subscriber information, and it needs to improve the quality of their customer service agents, both in terms of their communication skills and knowledge of UHC's system.

With the high cost of proscriptions we are asked to us mail order to save money and help with the cost. I have just had my first mail order done. and it has cost me over 2 -1/2 the cost of getting filled at walgreens or any place with a 30 days. It would have cost me 35 dollars a month for my sons medication that would cost me 105.00 dollars to buy at walgreens for 3 months. Having the mail order filled it cost me 240.00 dollars and when I call to find out why they tell me they just fill the order and take money. never to ask if they can use anything to help save money I give them my phone number which they could have called to ask any questions. I think that this is a very big mistake and they should be held responable for the over charges. Without first contacting at least for the first orders. That way there would not be any bad surprise when the proscriptions come in with a bigger bill. I would like to see something done to protect everone from this. All first time mail order should be informed what it is going to cost before the proscriptions are filled. the same way walgreen or any other company would fill proscriptions.

thank you
Edward Snelling Jr
Phone [protected]

Our child was admitted to an inpatient intensive care unit. United Healthcare has weekly "doc-2-doc" calls with the treating physician. We were just told by UH told that our doctor recommended immediate release and that further coverage would be denied. Amazingly, this is at best a misrepresentation of the conversation. At worst, an outright fabrication of the truth. Almost needless to say, we are fighting to ensure our childs healthy recovery, but are woefully inexperienced in the insurance process and understand that we are up against this country's most notorious health care provider, who has a national reputation for mistreating its customers. Since we were not a party to the conversation we can't say for certain what was said by our child's doctor, but are trying to insert ourselves into the process to make certain this does not happen again. I have owned my own company for many years, but fortunately have not ever placed my group coverage with UH. Thank ###ing god for that sliver of good luck. Too bad Congress - Democrats and Republicans - can't muster the intestinal fortitude to correct this problem. We're on our own out here.

Generates TONS of red tape to collect payment for services rendered, COVERED by patients plan. One excuse after the other, the patient doesn't have benefits, once you spend an hour on the phone. Miracle, they have benefits, the claim should have been paid, then they send it back for reconsideration. Which then responds with a request for more paperwork. (They had paid the claims in prior years, after several phone calls years, only delaying payment for MONTHS.) Now they're two and have years without payment. We've had to TERMINATE patient. And now the PATIENT is responsible for the bill. So when you get angry with health care providers, now you know where the problem lies.

I just started getting long term disability and no one told me that I had to pay for my insurance out of pocket, the month of november I only recieved 400.00 dollars toward my long term disability. I am submitting a request a review Barbara Mackey 2419 school st Rockford Il [protected]

I called the office of the Georgia Insurance Commissioner to find out why United Health Care was sued for $750, 000 by the state of Georgia. The investigator told me it was because they would not pay for claims in the time period specified by law. He also told me this is the second time Georgia has had to sue the company. United Health Care was sued for the same thing about a year ago for $2.8 million. This is the company AARP is advertising on TV as the company senior citizens should get for their supplementary to Medicare. I am glad I called my office of Insurance Commissioner, maybe you should also before you buy insurance.

Since becoming a member of United Healthcare about 31/2 months, I have been denied, at least 5 times, medication that my previous Insurer has paid for, without question. They farm out prescription services to Medco. I have followed their procedures, and still they make me change to a cheaper medication, even though my doctor thinks he is prescribing what is best for me. Their job is to "be the judge" of what you get. If your plan does not cover what your doctor thinks is best for you, you and your doctor have to follow an appeal process. They will spend hours and hours on the phone, just to keep a patient from getting something they don't want to pay for. They will send you an authorization, or an appeal form, but by this time, you have already left your doctor's office, and are waiting at your pharmacy, then gone home. Sometimes you can get your meds, and sometimes you just have to deal with it. If they are so worried about their bottom line, they should be cutting better deals with the pharmaceuticals, but they already do that, don’t' they? Or maybe raise their rates. Oh, yes, they have done that too. They even want me use a pill cutter to cut my one med in half, just so they don't have to buy both dosages. Since most of the competing healthcare insurance companies have been gobbled up by Aetna, United and others, their simply is not as much choice for employers to shop around for quality, affordable plans for their employees. Period. If members of the U.S. Congress had to deal with a fraction of this hassle, they would be changing the law in a New York minute! Keeping people out of the hospitals by the use of drugs already is a proven approach for everyone. Why keep that medication from us, so that we get sicker, and risk an even bigger claim? The answer is that they know we have no one in our corner, as they do in Washington. I urge people with issues of abuse of power, and denial of service to let their thoughts be known, or it will never change. I also urge anyone who is trying to buy health care insurance, to find out all the details you can before you sign up, because after that, it's too late...

As a provider of vision care, this is the worst customer service I have had to deal with, upon calling multiple times and being transfered to multiple locations, incl. India, where they can hardley speak english, I had to finally tell the patient I can not get through to claims and he is just going to have to pay my company direct. Lost in the healthcare mayham. I feel so sad for these siniors who get taken advantage of.

United Healthcare fails to approve payment of medical claims. Same claim has been submitted with all necessary paperwork and forms numerous times. These claim involves a second insurance plan that is considered primary. EOB's from primary have been submitted, but everytime they conveniently misplace one of the documents needed to complete the claim. They will not accept a fax while I am on the line with them so that it can be associated correctly. I am requested to resubmit the claim with all documents again, only to have United Health misplace some other document. It's a never ending thing.

I have a son who receives "covered" Occupational Therapy and Speech Therapy weekly, and for the last entire year, United Healthcare has HABITUALLY processed the claims incorrectly and/or unbelievably slowly.

The 1-800 agents are rude, incompetent, and the "claims appeal" process is a joke. I literally call them on a weekly basis and get no clear direction on how they want the bills to come/how I should file. For my company, we only have a year to appeal claims and United just runs the clock out on you.

Additionally, the pharmacy coverage is laughable. Btw, I work for a mid-size company (approx 26k employees).

I contracted with UHC to sell their Medicare Advantage products (Secure Horizons and Evercare). These plans are under the jurisdiction of Medicare, or CMS for short

UHC had not paid me over $8, 000 in commissions dating back to Nov/Dec 2008. Their managers lied, stating that CMS did not allow such payments until CMS released an "approved" list of Medicare-eligibles. Medicare ha been very late in providing such a list, but, according to CMS, this is absolutely not true! CMS regulations state that they MAY, but are NOT REQUIRED to, withhold, that they MAY pay, and later reverse or charge back commissions if plan enrollees later turn out not to be approved by CMS.

To add insult to injury, UHC has FAILED TO RESPOND to my complaint letters, even though I sent the last one by certified mail, and I received confirmation of their receipt and acceptance of my letter - what kind of a flakey business is that ?!

In addition, no one would believe how much trouble agents had with UHC's computer system called "onDemand", which agents were supposed to use in tracking enrollees. Likewise, their agent support system was ATROCIOUS - I have copies of over 40 unanswered e-mails to their PHD )Producers Help Desk), and when I sent copies to the local managers (Tucson, AZ) I got no replies from those "wannabe's" either.

I recently filed a $10, 000 lawsuit (the maximum in Justice court in Arizona). It is standard practice in the insurance industry for agents to get paid first year commissions immediately when a case is approved, and then charge an agent back any "un-earned" commissions, if and when a policy is cancelled or lapses during the first year. I am convinced that UHC rips off agents like this nationwide; they must make tons of money off the interest on agents' monies that they decide to keep in their own bank accounts so long. The Arizona Insurance Department fined them $364, 500 for, among other things, "violating state laws governing ... timely payments to providers"; evidently UHC tried to rip off doctors and hospitals, etc. and now they seem to be trying to rip off agents nationwide in the same way. Based on my experience, in my opinion, this is a very bad company for agents to deal with.

If you have been an agent with UHC and had similar experiences, it sure would be good to hear from you.

United Health Care is by far the worst health insurance company in the United States. It is by far the WORST Company I have ever tried to deal with. Just recently I had to have an MRI. My plan states that I have a 90% coinsurance. So when I received the bill I thought that it was a mistake that they only covered the procedure at 80%. You may think that’s not so important, but for an MRI that was over $200.oo dollars extra out of my pocket. I called them and found out that they would have covered the procedure at 90% if I had obtained the procedure at another felicity. But since my doctors office had the machine on site and there deal with United Health Care was different. That was all the coverage I was going to get. My problem here is that my deal with United Health Care was for 90% coverage and that is what I pay for each month out of my pay check. Now I have to be an expert not only at my own deal with these people but the deals of every medical felicity I have anything done at. How could a person possibly win at this game?

My plan states that Preventive care is covered at 100%. So naive person that I am, I went to my Gynecologist and had my yearly pap and mamo. This being the first preventive care I have done this year, I assumed it would be cover at 100%. Well guess what. They paid $91.00 dollars and billed me for $571.00 dollars. There explanation is that I have exceeded by plan yearly maximum for preventive care. These people just all should burn in hell. They are definitely scam artists and I am stuck with them for the remainder of the year. Is there anything I can do about it? Please help.

Be carefull with this health insurance. I called the cust. service # & went over my benifits. They said I was covered except a 20.00 copay. Okay / I went to the doctor & yes the vist was paid except for the 20.00 copay I paid. The problem was the blood work they said was covered wasnt & I got stuck paying the whole thing. I tried calling the cust service but & even told them the name of the person I spoke with that said it was covered. They didnt care one bit. They said they were not going to pay for the lab work. I makes me mad - I have insurace for what? I need my blood tested every 3 month because I have diab type 2. - There reps are not trained worth anything & if they dont know good luck!

After dealing with insurance claims for several years now, UHC is definately the WORST in paying for claims. When confirming benefits their representatives NEVER tell you if a pre-determination is required on particular claims, therefore dozens of claims get processed and denied because their lack of explanation. Also they have come to the conclusion that although your benefits state IV Sedation is a covered benefit, they DENY it every single time its submitted. I have thousands of dollars in unpaid claims due to UHC, and the consequence is that the patient gets stuck with UNPAID claims and high bills even though they pay their monthly fees for this ridiculous insurance company that does not even care for covering healthcare expenses. It should be named United HealthSCAM!

While being insured with Golden Rule/United Health Care, I have had nothing but problems. I started my insurance coverage on Feb. 23, 2009, and my husband went to the doctors March 9, 2009 and they would not cover it. Then I went to the emergency room on May 31st, 2009 and my copay(which they call deductible) was $100. I was formally told by Golden Rule that was all I would have to pay $100 if I were to go to the emergency room. Well my final bill was $581.00 that Golden Rule would not pay. There answer was "We are sorry that you were not informed of how your coverage works." DO NOT DO BUSINESS WITH THEM! You might us well not have coverage!

My surgeon and I both received a letter from Medica - United Health Care that stated that I was approved for an open roux-en-y surgery that was good from [protected]-2009. I had said surgery 02-16-2009. The insurance company have paid for the surgeon fees, anestesia fees, CT scans, x-rays, labs, etc. I received a bill from the hospital for $47, 000. The insurance company investigated and their conclusion was that this service (the surgery) required pre-approval and that I did not have approval for this surgery, therefore I am responsible for the bill. Luckily, my surgeon had his copy of the letter. I faxed it to the insurance company and followed up with a phone call. I have not heard back. If someone scams an insurance company, they go to jail. An insurance company tries to scam a paying customer and what?

Several Explanation of Benifits indicate that the submitted claim was not paid because the physician was out of network. I've been with this Primary Care Physician for several years. I checked their directory of In-Network providers and he does appear on the list. To submitt an appeal you have to print and complete a form, then send it via postal mail. In this day and age of modern information systems you would think that United Healthcare could provide this service online. I would guess that they are trying to delay as long as possible having to address the complaints.