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Humana Is An Insurance Company Straight From Hell!
Posted by Larry4mo on 11/12/2012
MONETT, MISSOURI -- My wife had an accident 14 months ago where she broke off her good teeth from her gum studs from a serious fall. She suffered in excruciating pain for many months while we submitted numerous appeals because Humana said "dental" was not covered (all initial appeals are ruled upon by Humana paid people). Humana continuously blocked us from receiving medical attention on every point!

Finally we got to the Federal Court of Appeals. The judge ruled fully and completely in our favor, stating that if an accident caused the damage to her teeth it cannot be considered routine dental, and also that we had an Advantage Plan (Humana Gold) with expanded coverage. The judge proceeded to outline to Humana why they never should have denied us medical coverage in the first place!

Our doctor said Humana always refuses coverage in an array of medical claims routinely in an effort to not pay out money for necessary medical claims. My doctor said after some people filed appeals and got turned down they gave up before making it to the Federal Courts, which he said eliminates 95% or more of the appeals! (It takes up to a year or more to make it to the Federal Courts). The Federal judge instructed Humana to pay for our medical treatment 5 months ago. So far Humana refused to arrange or pay one penny! I called the judge's clerk and asked how do I enforce the judgment? I was told they didn't know of any way to enforce said judgment! While my wife continues to suffer we will have to dig up the money to pay for a private attorney to sue in civil court!

Note: You cannot sue Humana for pain and suffering, punitive damages or even attorney fees because the Government gave them immunity. So what do they have to lose by not paying?!! Humana is an example of a company that will let you die for the sake of pure greed (their stocks have reached all-time highs on the NYSE)!
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Posted by nikalseyn on 2012-11-12:
This is good to know about Humana. We will tell people of your experience with them at our senior meetings. This is the time of the year when seniors can change their ins. plans and to know of actual experiences people have can help people make informed decisions.
Posted by gardener07 on 2012-12-01:
thanks - I was considering Humana - am a senior and getting my Part B reset right now. Good info!
Posted by uchu on 2012-12-01:
This is exactly why the good ol' US of A is dying a slow death at the hands of insurance companies...shame.
Posted by Robertr Wilson on 2012-12-04:
Not so long ago HUMANA provided a complete health care plan that was used as a secondary with SOCIAL SECURITY. After a while, HUMANA DUMPED THEIR POLICY, ANYBODY REMEMBER THIS?
Posted by ok4now on 2012-12-09:
Maybe Obama Care has a provision to help. Don't hold your breath. This is an absolute disgrace! Has corporate greed taken precedent over helping an insured customer? Then this customer as a last resort is forced to appeal this to a Federal Court? How pathetic, shame on you Humana. If it was your child who needed medical help would you be so quick to deny this claim? I don't think so.
Posted by kathy on 2013-04-25:
Sorry to hear. I'm having similar issues with them. It's been 7 mos and nothing. I called Medicare and issued a complaint thereby them launching an investigation. Also, contact your local Congressman, you can issue a complaint there too. If we don't stand up for our rights-we won't have any. Good Luck~
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Humana One Dental Is a Scam
Posted by Leelee2295 on 09/02/2009
I am not offered insurance with my employer and am in desparate need of dental services. I found a plan through then that gave a list of services I could receive at a discount rate and it was in my budget so I signed up. I had to pay a $35 application fee and a monthly premium of $15.10. They had a large list of providers in my area and I was very thankful to finally have great coverage.

Then the terror begins. A bunch of the providers on their list had disconnected phones and were no longer in business, some said they never signed up as a provider for the plan, and others were so terrible I did not stay for the appointment. It would have been cleaner at the health department.

I had not utilized coverage so I called to find out what to do to cancel the policy. I was told I had to email to cancel and that was the only way, so I did. Next, I get an email back stating they received my request and it would be processed within 7 days.

I wait and still nothing in my account so I call back and am told they never received my email. Not only did they not rectify the problem immediately I was told that the application fee was not refundable. They then made me email them the original email I sent and the confirmation email they sent me! So again, I did.

A week later they tell me they are processing it that day and that it would appear in my account within three days. I waited another week and called them back. They told me I had to wait longer and that it is an issue with my bank. I had to tell the lady to "stop patronizing me and open up your ears to listen. There is obviously a problem somewhere. You are customer care so HELP ME! She told me she would like into it and call me back.

At the end of today, she returns the call only to tell me that they did cancel the account and processed that, but for some reason it had not been placed back to my card. She assures me that it would be refunded today. Yah! I told her I would talk to her again next week when they again drop the ball.

Enter into a policy with them at your own risk!
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Dangerously Crooked Company -- Avoid At All Costs
Posted by Jj73 on 02/26/2009
DAYTONA BEACH, FLORIDA -- I have had the most alarming experience with Humana One. For years I have been paying premiums and not really using the insurance except for once a year doc visits and prescriptions. Then I had some dental trouble and consulted with a representative about whether I would be able to get a procedure. She told me how much money there was available and it was enough. I got the procedure -- probably totaling about $1,300 to Humana (I paid that much in co-pays since dentistry is about 50%). That unleashed a chain of events that is only getting worse. First Humana refused to pay the claims saying I'd been "terminated." So my dentist is all upset. But I'd consistently paid my bills to Humana, and Humana was paying for monthly prescriptions well after I'd supposedly been terminated. They must have conveniently, retroactively terminated me somehow -- but then apparently reinstated me right after the procedure, since I'm now current with them. THEN -- here's where it gets really bad -- Humana reached into my bank account and attempted to take out $1,900, an amount they have yet to explain. This caused an overdraft -- at first I thought it was some sort of online fraud. I was very alarmed and assured by the representative it was a grievous error. Then I was told by another representative that I owed Humana this money. Which of course makes no sense.

They still haven't told me why they felt compelled to do this. I distrust this company so much that I am considering changing my bank info lest they try it again. They were not authorized to go into my account, period. It was all very terrifying. I am quitting them as soon as I resolve the dental mess. What if I became ill with cancer? I think I know what would happen. Getting any treatment out of this company would require a legal battle for which few have the resources (because if they did, they'd have real insurance). I chose Humana because it was cheaper than COBRA. Should have paid the extra money instead.
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Posted by Anonymous on 2009-09-01:
Welcome to the "real" world of insurance. They keep taking your premiums and then fight like hell not to pay anything when it comes up. Capitalism at it's finest. They don't care about their customers, only their stock holders.
Posted by Lynn on 2012-05-17:
I came here to see what other complaints there were out here regarding their dental coverage. I will take this further and complain to the right places.
Posted by Stacy on 2013-02-18:
Horrible company! when I signed up there were several dentists in my area to choose from...3 months later I finally receive my insurance cards and NOONE will except their plan. They keep charging me monthly! Very Shady!
Posted by Ms. Clark on 2013-10-28:
I have been considering Humana Part D, but after reading these reviews I will stay as far away from Humana as I can!!!! I am having a similar experience with Dental Select still taking money out of my account all the while they have cancelled me. Very frustrating!!!!!!
Posted by Al on 2013-11-07:
I just got off the phone with Human DHMO. The rep actually told me that "Human does not keep any records of my dental procedures." Apparently, if the dentist is "in-network", there isn't any paper trail or record maintained by Humana. Unbelievable!
Posted by Have to Complain on 2014-03-14:
Humana is ridiculously bad. I have already had to complain to my state insurance board about their vision plan. Now, I have to do the same thing regarding their dental plan.
I chose a costly plan based on the benefit information they provided to ehealthinsurance stating that they cover bridgework with no waiting period.
Waiting period? They now claim it isn't even a covered benefit. Period. Nothing on the ehealthinsurance website excludes it, and nothing in the Humana plan documents says that it is excluded.
Humana out and out lied about the coverage on the ehealthinsurance web site, and didn't include any information on their own website indicating that bridgework was not covered. According to ehealthinsurance, there is nothing they can do to make Humana honor their obligation.
To top it off, I am contractually obligated to pay this ridiculously high premium for no useful coverage at all for a year! I guess I have to honor my legal obligations, but they don't.
I am done with Humana. If they turn out to be my only option, I will work with my dentist to see what can be done with no dental insurance. Frankly, if the medical community would make its services affordable, I would do without insurance completely.
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Humana one is a rip-off
Posted by Lucy1 on 07/31/2007
KNOXVILLE, TENNESSEE -- I feel it is my duty to tell of the gross incompetent and deceitful nature of the Humana One. My first claim was while I was out of town in California - I called the 1-800 number and was given 3 doctors I could see. The first one was an emergency care in a Longs Drug store and had been closed for months - the other was in another town 45 minutes away - when I got there I was told they would not see me they were not seeing any new patients . The next office was now over 1 hour away I had given up hope considering I was in a taxi.

Then I was going to have my physical - ALL of the doctors on the Humana One site did not take Humana One anymore - So I called the customer service and had them find me a doctor. They found one 45 minutes away - and so I go - only to find out that a pap smear is not covered. So I have to pay 250.00 for a women’s wellness exam. I was something I asked about when I signed up for my coverage - please be aware that they have not paid for any of my 2 doctors visits - so I paid 2,000 for insurance that has cost me over 400 in doctors charges- I shudder to think what would have happened if I had a medical emergency that was very expensive.
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Posted by trumania on 2007-07-31:
Health care in this nation is very bad. Things like this happen all the time. Check out the movie SiCKO.
Posted by runaway on 2007-08-01:
Health insurance is awful these days! One suggestion is to call when they refuse to cover something (after checking your policy, of course). Many times they use flimsy excuses to deny a claim (my favorite was "we didn't know if you were still employed there"), but once you call and question them, they will suddenly cover it. They are hoping most people won't take the time to call them and will go ahead and pay it.
Posted by superman15 on 2007-12-21:
You're right, Humana does not have a strong footprint in California. They are more of a regional company being strong in the south and midwest. You should look into stuff like that before traveling, really all the health insurance companies have weak AND strong networks depending on geography. Getting sick/hurt on a vacation is a pain. I got sick on a cruise ship once in international waters, wow was that a pain.
Posted by Kenny48 on 2009-02-05:
I too have Humana One and have not yet tried to use it. They charge me $180 a month, and I still have a $7,500 deductible. I have to use their plan doctors, but have not yet picked one. As with you, I find most aren't taking patients or are no longer in the program. I was just looking at my policy, and came to realize I have no idea what they actually pay for. It is some forty pages of gibberish. The only amount mentioned anywhere is what I must pay them each month, and how much my deductible is. So in other words I have to pay them $2160 a year and still meet their deductible before they pay out anything. I got this insurance because out of three I had a choice of, here in Florida they were the least expensive. Now I realize they aren't providing me with much. I got this to keep from being "cleaned out" in case of a medical problem, but I can see I am being cleaned out by Humana!
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Beware of the Prescription Plan Thru Wal-Mart
Posted by Marvallous on 09/26/2012
WEST PLAINS, MISSOURI -- I had By-Pass Surgery and my wife thought we "Had" to have a prescription plan. She purchased the Humana Plan. They did not inform her that there was a $300.00 deductible. We do not use $300.00 in prescriptions a year and, we had a drug plan with the hospital where my wife works. Asked Humana for a dis-enrollment. They agreed to dis-enroll us on 07/31/2012 and sent us a letter of confirmation. Approximately 1 and 1/2 months later I received a phone call from a "Collection" agency, stating that Humana had turned us over for collection.

We had NOT received any statement, bill, or any correspondence from Humana since the letter of confirmation. We never used their plan and paid 9 months plus 2 more to the collection agency. I did complain and got a phone call from Humana, apologizing for the mix-up, but the damage to my credit was already done. I had prior to this a 780 score. Don't know now.
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Posted by mcarthurdw on 2012-09-28:
1. check your credit
2. If it affects your score contest it, get the fact that it was an error in writing from Humana, and include it with your letter contesting the credit report.
The sad fact is that all Health Insurance in the good old USA, is over priced rubbish. I pay over $10,000 a year for BC/BS for my wife and myself and the co-pays are still insanely high.

I wish you a speedy recovery
Posted by j.c. harding on 2012-09-28:
When we signed on with Humana for drug Ins the cost was 6 change a month, after the first year the cost more than doubled for each of us to over $15.00 each per month with no advanced notice. They have poor customer service. My advice, deal with someone more reliable!!
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Humana will not return calls or pay for policy covered expenses
Posted by Kayl bagwell on 10/02/2007
Our daughter went to ER 6 months pregnant with bladder infection. Labor started tried to stop no good. Admitted to hospital. Insurance denied all. There is coverage for pregnancy complications and ER visits if admitted. Beware of there policy.

Kayla Bagwell
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Posted by Sparticus on 2007-10-02:
Great... we have a Humana individual policy... I wish I lived in Canada or France...
Posted by Jillian Barclay on 2011-01-29:
I have read hundreds of consumer complaints on Humana and have worked for many years in the health field. They are one of the most difficult to deal with. Please, if you have trouble with any insurance company, get in touch with the insurance commissioner in your state. Most will already have a file on Humana and will usually help you file a fraud complaint. Also, consider contacting your state assemblyman (not federal Congressman) and asking for individual help. The state govt is usually much more helpful than the fed. and faster. So sorry-wish I could help all of you. I am a patient advocate and this is the type of work that we do. Think about contacting a patient advocate in your state. We fight for the consumer against ins cos- most states have many to choose from-alot provide free services. Look for the free ones first.
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Don't enroll In Humana Comp. Benefits
Posted by Allisa on 09/16/2010
I work for a company who offers Humana Comp. Benefits as dental insurance. With my policy, I needed to select a provider. I called Humana in April 2010 to select a location near to my home. At that time, Humana did not have the correct address for me, so choosing a location was difficult. They had me living in a town that I have never lived in. Once I selected a provider, I began getting my dental care there and consequently receiving bills stating that Humana was covering nothing. I then made many phone calls to Humana speaking with many different "customoer service specialists" who told me that they could not help me because selecting a provider now would not take effect for a month and a half and they would not make that provider coverage retroactive. I asked to speak to supervisors, was hung up on, or was left on hold for long periods of time (i was on hold once for 16 minutes). I finally got the opportunity to leave a message for a supervisor and requested a call back. No supervisor has yet returned my call. It is now September and I finally reached a decent customer service agent who checked with her supervisor and made my dental provider active since May 1st, thus covering my services there.

I feel that I was misled by Humana. I would not recommend this insurance provider. They don't cover much anyway, but being lied to, hung up on, and left on hold is not acceptable.
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Posted by Alain on 2010-09-17:
Can your company's Human Resources department (or whomever handles insurance for the company) give you some assistance with this problem?
Posted by Phillip on 2011-06-07:
Humana stated they would pay the lifetime of $1500 for my sons ortho. I paid my part and they paid the first 750. now after talking to several customer service reps, and being placed on hold for long periods of time, they say the ortho entered the wrong code. They have since resubmitted the code they told them and still they say it is the wrong code. However when they EOB came back humana had the wrong code on the EOB. We are still going round and round and now I am going to be left with the bill until this is resolved. The first chance I get to get away from this company I will!
Posted by Jessica on 2011-12-06:
I work at an orthodontist office and I am treated the exact same way. Constantly hung up on, never given a straight answer, I've even been told "we just don't know". I had 2 brothers same treatment, same codes, filed the same way and the company was paying two different amounts
Posted by Matt on 2013-10-04:
Compbenefits provided me with a list of in network approved providers. I contacted a number of these dentists and they related that they do not accept Compbenefits due to difficulties receiving payments. Other listed providers were no longer in business. The few remaining either had negative ratings on the internet or were located very far from home making them nearly impossible to get to. This inaccurate list (bordering on fraud) caused me use a dentist who is out of network. Compbenefits then used a mystery formula to exclude a large portion of the bill and then paid half of the remaining portion. When I asked them how they compute this formula they related that it was based upon a geographic average. I then asked to see the averages as well as the geographic definitions. I was told that they could not provide me with any of the requested information. I asked for a supervisor, placed on hold for a while and then was told that no supervisor was available but that one would return my call.
Nobody ever returned my call. I called again, this time asking for a supervisor rather than going through the whole process of explaining again. After a lengthy time on hold I reached a supervisor and related the above. This time I was told that I was probably given the wrong list of in network providers (I was well aware that the list is inaccurate). She further related that I was given inaccurate information in regards to the formula used to compute excluded amounts. She related that it is neither based on averages nor on geography but instead is a contractually driven formula agreed upon by the City and Compbenefits. I again asked to see the formula that dictates portions of bills that are apparently arbitrarily ignored. I was denied and directed to contact the city with any further questions.
Questions I would like answered. How do they decide the portion of the bill that they choose to ignore? Is the figure based upon industry standard prices? Geographic based averages? Or compbenefit profitability model driven by denying payments? How can I find in network providers when compbenift either deliberately or negligently fails to maintain accurate and current lists?
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Plan not as sold/advertised 2011 or 2012 - Beware
Posted by Itjiggles229 on 09/28/2011
After checking out this plan because of drugs listed on their formulary and on Medicare's Find-A-Plan, I signed up in August. However, in checking the "Drug Guide" as they like to call it the drug is listed - however, it is not covered. First person at Humana I spoke with said not covered and I'm on Medicare's site showing me that it is. So I was confused when the 2012 Formulary arrived and it's listed in Humana's "Drug Guide" as covered. So I again called Humana and asked about the drug and was again told that they had the latest up-to-date list and the drug is NOT covered. This was the Customer Service for members 1-800-281-6918. Not being satisfied I called the non-member's number for prospective members 1-800-706-0872 which is the Sales Office. Rep looked up the drug and said yes it is covered how much it would be, etc. When I told him I had checked and the member office told me it was not covered he just transferred me back to the same people I had already spoken with regarding the drug. Sales office and Medicare saying one thing, but in reality drug is not covered. So what the agent tells you will be anything but the truth to get you to sign up only to discover you will pay full price for the drug. Check it out for yourself. Humana could care less and continue to sell misrepresented policy.
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Posted by londonwitch on 2011-11-03:
Call Costco either locally or their warehouse, believe me you will save monies. I have a drug that Walmart told me would cost $266 for three months, Costco told me I could get it for forty three. Turn them over to the Insurance Commisioner in your state and the BBB
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Watch Out! Drug Formulary changed 2011
Posted by Chakar99 on 01/06/2011
I urge all seniors who subscribe to any of the Humana HMO/PPO Medicare plans to quickly obtain a copy of the NEW drug formulary. Nearly all analgesics, especially Class II controlled substances have either been dropped altogether or raised to tier 2; the former $7 copay is now a $42 copay for the unsuspecting seniors on fixed budgets. Many other popularly prescribed medications for seniors have also been dropped.

There was ABSOLUTELY no warning of this. We found out when we attempted to fill our monthly prescriptions. There is no price break if you use their in house mail order pharmacy, "Right Source" either. And be very very careful that your prescription for inhalers is written with instructions to use up the canister each month; otherwise you will be charged a two or even three month charge for that single canister! It happened to us.

They even made me pay full charge for pre-operative lab work and the anesthesiologist's required ECG because they were done on an "out patient basis" the week prior to hospital admission. NO MORE SURPRISES FOR US FROM THIS "FOR PROFIT" health insurance company established by a former US senator and his family.

Next year we will NOT be with Humana again.
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Posted by Skye on 2011-01-06:
It's not only Humana who have made changes, without notifying policy holders. It's terrible, and I'm afriad only going to get worse.

So much for healthcare reform.
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Big Brother HMO
Posted by Eimken on 03/09/2012
SAN ANTONIO, TEXAS -- My mother was recently involved in a auto accident and taken to a icu trauma in San Antonio. After 12 days in icu her drs. recommended a LTac facility. Humana Gold Plus "reviewed" the Drs. recommendations and disagreed with their request. She was moved to another floor to wait until her chest tubes can come out before Humana will let us know what they will pay for. My mother is in a 3 person room with chest tube, broken hip, open wound, 6 broken ribs, heart problems, broken femur and instead of getting the help that a LTac would be able to provide, she is stuck waiting, against the Drs. advice, for Humana to see how she progresses. I, her daughter live 200 miles away had to return to work after 12 days,(she is stable, just not getting well enough to stand or get tubes out) I offered to pay for transportation to Houston, where I live so that I could be there daily to assist in her recovery and help with decisions. Humana refuses to move her even though the Drs. say it would be best for her to get the care a LTac offers and to be with family. Humana is keeping her there and making all decisions as to what care she is receiving based on what they will pay for.
My mother pays a good amount to Humana as a replacement for her Medicare thinking that she would receive the best of care. Humana has taken away her right to participate in the decisions of her health care. I would encourage anyone with parents that have Humana Gold Plus to examine other options. Even the Drs. and hospital staff have told me that their hands are tied and they hate to see people come in with Humana because they know they can not give them the level of care that they need. Medicare is a much better option. Do not let your parents be in the position that my mother is in. Helpless and at the mercey of a review panel deciding what is best for her.

sad daughter 3/9/12 12:02PM
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Posted by clutzycook on 2012-03-09:
This story is weird for two reasons. One, was the accident her fault? If not, why isn't the other person's car insurance paying for this. Two, hospitals are EXPENSIVE whereas LTACS SNFs are cheaper by comparison. There's gotta be more to this story.
Posted by jeff on 2012-03-09:
You must fight harder and advocate for her survival.. Remeber , it's cheaper for Medical insurance companies if when they believe the problems are potentially terminal, that we die as quickly as possible. They are a business.. Health and care don't belong together. At the end of the year only profits matter not who you killed to get those profits. Insurance for medical care is immoral .. Look at the rest of the civilized countries. Follow the money.. Fight hard for your Mother
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