AUSTIN, TEXAS -- My Humana policy became effective February 1, 2015. I've been using Beconase since 1989 for my allergies. Each year, I get samples and try the new nasal sprays on the market, but I always go back to the tried true nasal spray that works the best for me. I live in Austin, Texas, the Allergy Capital of the World, and I have pollen allergies. We are currently in the worst season with cedar still going strong and elm and oak starting up. This is the most difficult time of year for me as far as my allergies.
1) Humana Step 1 STALL TACTIC - Decline the request immediately and ask for additional info. Then, when the doctor responds to the request (my allergist submitted the information they requested, explaining why I need this drug I've been using for 27 years).
2) Humana Step 2 STALL TACTIC is Rejecting the information and closing the claim.
I am not clear how many times Humana will decline and reject before they will finally do the right thing - not even sure they will ever do the right thing. But it means that me and my doctor are in for some truly frustrating periods while we continue to try to get this eHealth company provider to do what they're supposed to do for their insureds - to fill the prescriptions the doctor prescribes and says are needed.
Today's Humana can't hold a candle to the old Humana... That company provided healthcare coverage. Today's Humana works very hard NOT to provide the coverage they're contracted to give. Please don't make the mistake I made. Humana is not the company you want or need. Choose Blue Cross or UnitedHealthcare instead!!!
Today Saturday at 2 pm Pacific time, I tried to return a call we received from RightSource phone number (855) 250-7660. The representative who answered my call, his name is Kelli, refused to honor the power of attorney that they on file have from my wife to me (Conversation record ref # **). He said, "this medical power of attorney allows me only to verify address." Why people make medical power of attorney to spouse? This Humana is been nothing but headache. They are going to give me heart attack. You out there learn from my suffering.
COLORADO -- I found out the hard way that every time you speak to someone there you get another answer so make sure you receive everything in writing and believe nothing. Sorry to say but I have serious doubts about the integrity of this company and total love my agent which is why I continued with them this year. But will take a hard look at others for next year.
LOUISVILLE, KENTUCKY -- Because Humana decided not to keep Promedica hospitals in network I lost the Doctor who saved my left foot 8 times and now I am losing the Doctor who is treating me for bladder cancer. I thought insurance was about the patients and not egos!!
IDAHO -- Major "Bossy" issues and multiple minor issues: Humana sent a mailing telling me I should sign up for Humana Medicare Rewards program, then receive 4 preventive services and they would send me two rewards cards!!! What??? I'm not interested in signing up for anything and they should not be asking me to. I pay for Medicare MedAdvantage health insurance for insurance coverage, not to be part of a whole "bossy manipulation" of my life. I never agreed to let them persistently invade my privacy in whatever ways they deem necessary.
Their continual pressure to call them, to "sign up" for something, to do something for them is annoying beyond words. We all know by now that trendy "rewards programs" are never, ever free -- we always end up paying something for them. In this case, the insurance premiums are expensive in relation to their limited pool of medical providers (which is shrinking), and covered services and prescriptions are limited and continually changed. This insurances truly sucks the big one and I dropped it during open enrollment this month. I regret that I ever signed up with them.
Another annoying issue is I have received so many "robo-calls" (the phone rings but only a recording is there) asking me to call back if I can capture the multiple digit calling code before the call is disconnected. I only found out who was calling when I redialed the caller ID number on my telephone. Forget the long code -- I missed all but the first 3 numbers and they only said it once. Dumb!
When I called back, I was told several times that they were replying to a call from me -- that was a lie. The calls were coming in so often, I had to block the telephone numbers so they would not ring through because obviously they did not take me seriously when I told them to stop calling me. Oh, and I won't go into the surly customer service representative right after I signed up.
One service they have repeatedly pushed on me over the last couple of months is a home health assessment visit by a nurse practitioner employed by one of their "affiliates." I am healthy, fully independent, and highly mobile and will not allow such an intrusion into my home and my personal privacy. I have firmly said no multiple times per sales call but they persist. The last time I was quite blunt and used frank language to get them to "hear" me.
One week after my last refusal, here comes a high pressure, full-page letter from Mr. Painter, Chief Medical Officer, Health Guidance Organization, pushing the service on me (with all evidence that he probably sold used cars at some point) and telling me an appointment specialist will call me to schedule an appointment or I can call them to schedule it. What??? What part of "n-o", no, do they not understand?
Humana is not making good use of the monies paid by Medicare to provide health insurance and there is obviously a corporate mentality that they have the right to invade privacy to push their own agendas. Only buy insurance from this company if you want an "elder sister" to tell you what you need, when you need it, how much you can have, and if you don't mind intrusive, unsolicited telephone calls and letters from them to push their own gimmicky agendas. Even my primary care physician's practice is fed up with them and they have opted not to renew their contract with Humana.
During open enrollment, I canceled this joke of insurance and switched back to a reputable insurance company who at one time provided the employer's group health insurance where I worked. They have decades of experience in the field and respect individual privacy. They do not waste money on foolishness like Humana does. I won't even talk about all of the mail Humana buried me with. Pure wastefulness.
SPRING HILL, FLORIDA -- I turned 65 in Apr 2014 and made the mistake of signing up for the Humana Advantage Plan. For the past few months I have been treated by one of their PCP. He diagnosed the pain in my hip as arthritis. I keep telling the PCP that the pain was excruciating and that I could not put any weight on it. When I went for my appointments they would come outside to the vehicle and bring me into the office in a wheelchair. His answer to my pain was "We will up the Meds". Was taking Hydrocodone 10-325 for the pain. The pills did nothing for me as the pain persisted.
I finally had enough of the pain and called the nurse at Humana. After explaining my situation she told me to get to an Emergency Room within the next 4 hours. (The only intelligent person I talked to at Humana). After having blood work, x-rays, and scans done at the ER, they recommended I see an Orthopedic Surgeon with 2-3 days. They didn't tell me what was wrong other than I needed surgery to correct my problem. I called my PCP as soon as I got home. Was told that they would have to get records from ER before they could do anything. Left message to have PCP call me.
A week and 1/2 went by, no call from PCP. I called PCP and he stated he didn't have any records from my visit to the ER. I looked up the surgeon that the ER recommended and called him. He is in the network but needed a referral from PCP. Called PCP and they refused to refer me to surgeon. They would only refer me to a surgeon of their choosing, another doctor in their group.
Now the problem, do you really think I would want a doctor in this group of doctors to perform major surgery on me? They misdiagnosed my problem as arthritis when in reality the top of my femur bone was collapsing, thus the severe pain. For 2 months I endured this horrific pain and now I have to have a total hip replacement… a major surgery. I do not trust any of these doctors in this so called group.
I called Humana and was told I have to do want the PCP says even though my surgeon is in the network. The office girl at my surgeons office got the records from the ER and called Humana arguing that they were in the network why couldn't they see me. Humana would not allow it.
When I signed up for Humana back in March I was told that I could go to any doctor I wanted as long as they were in the network. I was never told about PCP's with their own group of doctors. So I am unable to walk. Can only sit or lay down. I do have a walker and a scooter (which I paid for out of my own pocket $1200) so I can get around my house as I live alone.
Instead of getting this operation done and over with before Christmas I now have to suffer and wait until January when my new Insurance and PCP go into effect. And yes my new PCP will refer me to my surgeon. As far as Humana is concerned they lied to me when I signed up with them and their PCP should be kicked to the curb. Stay away from HUMANA!!!
INDIANAPOLIS, INDIANA -- HUMANA insurance company a cesspool of lousy customer service, disrespectful reps and supervisors who are poorly trained and give you any answer off the top of their heads, right or wrong. Appeals department is the slickest, most sleazy part of the whole latrine. Is Humana Insurance a paragon of honesty?
Had all medical tests done by my 'network' surgeon then met with an insurance agent who changed me to Humana. I made sure my surgeon was also a 'Network' surgeon with Humana (specialty: cataract surgery). Guess WHAT? When I attempted to schedule surgery, I was told by his office manager that my HUMANA NETWORK surgeon has no place where HUMANA has certified my NETWORK surgeon to do surgery under NETWORK PRICES!!!
I wrote letters to them, made 20+ hours of phone calls in 2 weeks to poorly trained HUMANA reps who crudely & rudely gave misinformation! (Meanwhile my right eye has deteriorated more!) I spent hours typing an appeal letter to HUMANA with a painfully broken finger that required complicated surgery. HUMANA had DENIED the routine pain RX written by my highly trained hand surgeon, the senior partner at the biggest hand clinic in the US!
The appeals woman called me much later and started loudly speaking over me (she WON the trophy for rudeness in my 63 years), then told me if I said another word, she would hang up on me—which she did anyway. (I was tempted to go ahead and hang up on her, but then realized if I did so, she would note it as my fault.)
Another representative told me that my doctor is NOT a surgeon. I said "What? His specialty is CATARACT SURGERY!" He told me authoritatively several times my doctor is not a surgeon,( which would surprise the med school where he teaches surgery!) (So TIRED of their games after spending 20 plus hours on the phone the first two weeks, with both true and false answers about a network site for my actual cataract SURGERY!)
Got a letter back from HUMANA saying they would explore the matters from 'within' but could in no way ever let me know the outcome. In other words, again I got an UP YOURS from Humana! (They even had a doctor listed in their book as a network doctor, but she left family practice to do research 23 months prior!)
They blame the doctors for HUMANA's mistakes in Humana provider directories that they have printed! Anyone surprised? I consider having a NETWORK surgeon with no NETWORK place to get surgery done, to be deceptive advertising! Before switching to Humana, I even asked my agent if I would have any problem getting the surgery done with my network doctor (since I did not trust insurance companies) & she said no one she knew ever had a problem. (SURE, NOT IF YOU WANT TO PAY OUT-OF-NETWORK PRICES FOR A NETWORK SURGEON TO DO HIS WORK!!!)
KENTUCKY -- My story is very long and I will log it later. My mother had two strokes and required 3 hours acute rehab care and Humana Medicare denied our choice because they told us there were other facilities (1 and 2 star rated) that could do the same. No thanks. So we fought back and are still fighting.
What I wanted to get across to all of the Humana screws is to lodge your complaints with the Better Business Bureau. The BBB must answer all complaints and currently Humana has an A+ rating. That's right AN A+ FRIGGIN' PLUS. That's got to change and with the help of all of us and by spreading the word, it can quickly change to a C or D and then, they will be in hurting status. PASS IT ON.
MEDFORD, OREGON -- I spent several days going over my prescription list with a representative to ensure Humana had all the information they needed to price my first Medicare approved Prescription Drugs or Part D insurance plan. I accepted the plan and terms and it went into effect January 1, 2012.
The first time I went to the pharmacy to pick up my medicine for Parkinson's disease, the prescription was filled for 24 days when it should have been for 30 days. The pharmacist told me it was Humana's decision to restrict their coverage to 8 pills per day and not the 10 pills per day as prescribed by my doctor. I went around and around with Humana and finally a representative told me she put an override order on the restriction and assured me the problem was fixed.
Next month the same thing happened. I asked about the override placed the previous month and was told it was a one time only override. The representative I was talking to told me to take the prescribed amount and come back for a ten day supply to carry me into the third month and everything would be resolved by then. It was not. In fact Humana informed me they were no longer covering the medicine in my plan - we are talking about the number one medicine prescribed to Parkinson's disease patients. I gave a copy of the letter to my neurologist and he managed to convince Humana to reverse their decision.
I also have diabetes and early in the year, my doctor gave me a prescription for insulin prefilled cartridges or "Pen injection system". I could not afford even my copay so I asked for an alternative lower cost system and was prescribed for the same medicine in viles that would load into syringe needle for my injections. My copay for this system was a third of the cost of the pen system.
Last month a new prescription was written by a different doctor who mistakenly wrote it for the pen injection. The amount Humana quoted the pharmacy was much lower than the previous quote. My wife was picking up the prescription. She was unaware of the mistake. I was out of insulin and used the pen system since my wife paid for it.
Now we are in the eleventh month of the plan and I have just entered the gap coverage or "doughnut hole" and now I pay full price for all of my medicine. The prescription cost in the pen system for one month is more than $275.00. I called my doctor and asked to have my prescription modified to the vile and syringe method. The pharmacist told me the injection method was changed but the price remained the same.
I called Humana and this time had two reps and a supervisor involved. They reminded me I was in the donut hole and expected to pay the full amount which by the way was over five hundred for a month. I asked why was the price quoted 275.00? From that point on all they were focusing on was why their own company quoted a discounted price and told me the only price they had on my insulin was the vile and syringe system. Well this is open enrollment time and as of January 1, 2013, I will have a new plan in place. I only hope I can make it that far without my medicine. No change, not resolved. :(
Oh my, where do I begin! Words that come to mind - deceive, misdirect, allude, conceal - a thesaurus may not include all the words! Alluding to drug coverage that in reality is negated simply by the average person's non-medical knowledge. I believe Humana uses this to their benefit. Likely the worst customer service representation in the medicare insurance industry. I feel deceived by Humana's promotion of varied programs that are touted as saving money. Actually, if you become ill most likely you will pay far, far more than you anticipate. Website and paperwork is over the top complex.
For the most part your annual medical needs change year to year. Humana appears to counts on this by fine lining specific drugs for coverage. Never belief Tier One will cover your new generic drug as most likely it will not! Or that the antibiotic you need will be on their list of covered drugs or that that new drug that has been FDA approved for your new/old condition has any coverage at all even prior to the "donut hole" or with a physician's written, faxed approval in addition to the prescription.
Just because the drug company states its generic has no influence that Humana will cover it; has to be on a small Humana 'preferred' generic list that seems to be nowhere out there in cyberland. I find medicare drug coverage plans in general (other than and including Humana) are no replacement for what you had through your employer or what you became accustomed to with the standard insurance industry. Humana creates paperwork your physician needs to fax to them to get a basic long time FDA drug approved for you. After that you relax. Don't do that!
You can never speak with the same person twice as they have no extensions; just a hundred or so phone employees (by their admission) that have a list of rote answers Humana has given to them. You can talk in circles for as long as you desire but more than likely your questions will remain unanswered after you hang up. Humana has surpassed the credit card industry in this tactic.
I thought all I had to be concerned about was the medicare 'donut hole'. Oh my, was I wrong! When the pharmacist stated the insurance carrier said 'no coverage' I was in need of a respiratory drug for a severe case of the H1N1 flu. At $700 I wanted to cry. I changed carriers to Humana to save $20 a month on the premium. Now I have several $45 a month GENERICS on a Humana's Enhanced PDP policy!
I learned today it is far, far easier to get a direct question answered by knowledgeable medicare phone staff than contact Humana. The irony for today is medicare advised me that Humana statements made to me regarding medicare were incorrect; a medicare grievance is being issued! It won't save me from having to continue to pay until I am free to change carriers. However, Humana may be getting their hand slapped by medicare. AMEN.