After losing my dental insurance from work I felt it would be worth checking into getting a family dental insurance policy. Humana is a well known company right??? I called the company representative on August 19th 2011 and this is what happened: In a very high pressure sales pitch about how great the policy was the representative told me that their in-network providers provide discounts of 28% for many procedures including crowns, root canals, and so on.
The discount services were effective immediately. I asked if a specific dentist we just started seeing was an in-network provider. The representative stated "yes". I said - "So, the discounts you stated will be honored by this dentist?" He replied that "they would be honored by this dentist." I signed up. Wow was I wrong. I talked with the dentist after I got off of the phone and guess what? They do not give any discounts to patients for HumanaOne.
I cancelled my policy which was not in effect until September 1st 2011 (full two weeks before coverage was to begin). Oh the nightmare run around begins. You have to email the company to cancel, you can't do it over the phone. I emailed over ten times - no response. Then I finally get an acknowledgement of my email to which I could not reply. It just said they received the email from me to cancel, nothing more. I emailed again. I finally get a letter stating my insurance was cancelled as of September 1st, no mention of my refund.
I called the company on 9/27 to find out that I have to write to their grievance department to try to get a refund but they would keep $35.00 no matter what. The representative did not tell me this either. Now I am told that this is their service fee. What service? I was given false information about the policy coverage and discounts, given the run around to cancel the policy and given a huge run around about a getting a refund. Stay away from Humana's service!
LEXINGTON, KENTUCKY -- My wife and I both had part D coverage last year through Humana. When the 2011 update book came out it was next to impossible to figure out what if any changes would affect our prescription expenses. So I called Humana customer service. Went through all of our prescriptions one by one with the agent and was told only one of our prescriptions was changing. One of my wife's was moving from tier 1 to tier 2 changing the cost of that prescription from $7.00 to $40.00.
Come January, what a surprise we got when we went to pick up our prescriptions. The truth was the exact opposite of what we were told. For each of us only 1 prescription was staying the same. So in total 2 prescriptions stayed where they were on tier 1. The other 9 were moved from tier 1 to tier 2, meaning a $40.00 copay for each of those 7 medications.
Basically the Humana Agent out and out lied to keep us paying for insurance with them. Now we pay them a total of 86.00 a month for prescription insurance and they cover about $70.00 of our prescription costs. When you're on SSD income is limited enough without the people who are supposed to be helping you lying to you and adding to your cost of living expenses.
When I filed a complaint with Medicare about this a Humana agent called us trying to tell us nothing had changed in the co-pays. Their only answer was to give us a phone number, our doctors could call an petition for a tier exemption. I think you all know pretty much were that one is going. Now the question we are facing is do we give up prescriptions and suffer the consequences or do we give up eating.
LEXINGTON, KENTUCKY -- In late April of 2007, I applied on behalf of myself and my then 8-year old son for health coverage with Humana. I received my first letter acknowledging my application on May 2, 2007. The underwriting information originated from Waukesha, Wisconsin. I signed the agreement effective May 1, 2007, and at that time I was 49 years old.
In that same packet of information that I signed and faxed back on May 2, I read in the "Additional Information" pages the underwriter's comments regarding the health status of me and my son, **. The comments regarding my health status were based on a thorough checkup and revealed no abnormalities.
Moreover, the only medications I had taken in the past 24 months were penicillin as needed for dental work. The comments regarding my son were based on a normal school checkup in 2006, and the only medications he needed were miralax (over-the-counter) and antibiotics for an ear infection. No additional medications were needed within the last 24 months prior to our signing with HumanaOne. The whole point of this rendition is to establish that we were, have been, and still are, healthy individuals with no history of excessive filing for insurance benefits.
My "conditional receipt" was for the initial monthly premium of $247.98, applied upon approval of the policy. Again, I am still referring to the May 1, 2007 effective date and the May 2 packet of information faxed to me and then faxed and mailed back to them. I received a letter from HumanaOne dated May 17, 2007 regarding an "application update". In it I was told that my application was approved with modifications, and that I had two days upon receipt to acknowledge the modifications by my signature.
The modifications in the form of an amendment stated that my monthly premium would be increased to $343.90, and the reason given for the "rate up" was "due to body build". I was already committed to this plan, so I signed the amendment effective June 1, 2007. This represented a $95.92 increase from my conditional monthly premium four weeks earlier. Curiously, I had the same "body build" those same four weeks earlier.
In 2008 I noticed that my monthly premium had increased from $343.90 to $390.68, with no prior notice and no reason given. I called and spoke with an individual in the system who could only tell me that the reason was due to me turning 50 years of age (like I really had to be reminded). I accepted that and informed my husband that the automatic debit would show an increase every month by $46.10.
In 2009 I again noticed that my monthly premium had increased from $390.68 to $443.94, indicating a monthly increase of $53.26. When I called to ask why I was told simply that I was a year older, and that each year the premium would increase due to that.
During the past 24 months I have not submitted a single claim for myself. Please see the documents submitted by hard copy to show this. During the past 24 months, I have submitted four medical claims for my son, (doctor's visits) which totaled $278.30. Of that total, HumanaOne paid $20.09, consistent with our deductibles. Also during the same 24-month period, I submitted claims from prescriptions for my son totaling $91.02. The plan paid $00.00, but consistent with the agreed upon deductibles.
My point is this: my medical and prescription needs have been zero for the past 24 months, yet it is my increasing age that supposedly triggers each yearly premium increase. My son's claims have been for normal causes for a boy his age, and not significant by any stretch.
My complaint is the rising monthly premiums assessed each calendar year with the reason being my age. My age has not contributed to one cent in claims and thus not one cent in cost to HumanaOne. I will inquire with appropriate authorities to see if this falls under insurance abuse or age discrimination without cause. I am a housewife and my husband is the sole source of our income. These ever increasing monthly premiums, assessed each year, impact my family and seemingly for no acceptable reason.
I was enrolled in a Humana Supplement beginning 01/01/14. On 10/15/14 I received a notice from Humana, raising my rates for 2015. At that point, Humana had paid $20 in costs for me during 2014. I located other insurance, equally good, for much less money. It was secured on 10/27/14. I contacted Humana to dis-enroll as of 12/31/14.
For the next 3 1/2 months I have been arguing with Humana. On January 3, they drafted the money for January from my account. I complained. Three weeks of daily calls and arguing passed before a check was finally issued on 01/28/14 to reimburse me for the money they had drafted. However, by the time the check reached me, I also received a call from Humana accusing me of inappropriately getting a check from Humana for money I actually owed them. The call was accusatory and threatening.
On 02/06/15 I received a letter from Humana stating that my application for supplemental insurance was being denied. It went on to say that, in my application (that I had never submitted) I had agreed for them to use my PHI to complete and underwriter review. That was a lie and a HIPAA violation. Finally I sent out letters to the Ethics board, the insurance commission, and the Board of Directors at Humana as I have all of the communications as evidence of this fiasco.
Sure enough, I received a letter dated 02/10/15 saying that they were disenrolling me, effective 12/31/14, followed by a second letter, dated 02/11/15, saying that my application for supplemental insurance had been denied, based on the fact that I had provided them with permission to access and use my PHI to facilitate underwriting review and based on the information they received, I was being denied coverage.
At this point, it is clear to me that the denial letters are punitive, a way to punish people who disenroll from their coverage. They are clearly violated HIPAA regulations and should be prosecuted for those violations. Further, the company functions in an atmosphere of the most uncaring, ignorant, disrespectful, dishonest employees imaginable. I will not be satisfied until Humana is publicly prosecuted for HIPAA violations and publicly humiliated for the way they do business.
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.
ORLANDO, FLORIDA -- HumanaOne sold my wife and I a policy that we were told included pregnancy/prenatal coverage. 2 months into it, we find out that NOTHING is covered for pregnancy by HumanaOne and that they don't even have a contract with any OB/GYN provider for discounted rates. We told the sales staff that pregnancy coverage was something that was important to us, being in our 30s. They told us it would be covered. HumanaOne will tell you ANYTHING to get you to sign up with them, and then exclude basic things like pregnancy coverage. Avoid them like the plague.
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 "outpatient 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.
I work for a company who offers Humana CompBenefits 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 "customer 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.
PITTSBURGH, PENNSYLVANIA -- My complaint is against Humana and its sales associate **. My parents are paying monthly on a policy that is supposed to cover my mother's prescriptions. The above mentioned agent 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 lied to them just to make a sale. 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. ** 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.