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!!!
TEMPLE, TEXAS -- They are a nightmare... First I called after my surgery to see if I could get some hand therapy... Duh they did not have a list of therapists online in my area. I asked to go to such and such place to see if they would cover and they had no idea. They told me to ask the hand therapy clinic if they take my insurance. The place said they did. Then I went to the hand therapist and about 10 visits in I call my insurance company to see how the bills were being paid. Guess what? Now they said I have to go back to my regular doctor to get an ok to see my hand therapist. I went back to my Dr who approved my hand therapy and started therapy and Humana paid all the visits.
Then I found out I had to go back to my regular doctor and get an ok again because it had been a couple of months. My doctor approved 60 visits which should be covered. I called Humana again to make sure everything was ok and they told me my visit would not be covered, but then assured me they would get on phone and try and get it covered. I went back to my surgeon who wanted me to continue therapy and again called Humana and they referred me to another company who makes the decisions.
This company I never had a contract with by the way and they told me I would have to get the Dr notes faxed over to them to have my visit today covered. I called the OT clinic and they had no clue so I recalled Humana who called my OT clinic or so they said and they told me that the OT clinic agreed to call me when they faxed over the notes.
Three days later no phone call so I called Humana who told me to call this other company because they did not give ok just this company. The company told me that I would not need to fax over the notes even though someone else in the company told me to fax it over... So today I have an appointment and I have no clue if it is covered... Get rid of Humana. It sucks... Oh by the way the last person I talked to stated they probably said all this to get me off the phone Thanks a lot...
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.
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. :(
My wife who is suffering from multiple sclerosis has not been allowed to refill her Betaseron for more than 15 days. The reason...Humana is reviewing her medication. How long does it take? Humana doesn't know. In the meantime, Humana did send her temporary medication.
Today, after being on the phone with Humana for 3 hours and been transferred from one employee to another, with no luck, at the end up talking to a manager there by the name of Deanna (conversation-ref. # **). This manager informed me that I cannot file a complaint over the phone about my dissatisfaction of the customer service at Humana and the only way to file complaint about an employee of Humana is in writing to the grievance department.
In the meantime, she advised me to take my wife to the ER to get her Betaseron shots or to go buy it from my pocket. (To whom doesn't know. Betaseron is not a medication that you can buy from a pharmacy.) Now February is almost over and we could not get a refill. We use to get the Betaseron from Biotech, but this month Biotech informed us that Humana did not allow them to refill it because they want the medication to come from Right Source pharmacy only. The patients should stay without medication until Humana finish their review of the medication. This what you should expect when you sign up with Humana.
LOUISVILLE. KY -- I am a 56-year-old woman who has Humana Medicare. I had a six-way bypass and my surgeon wanted me to go to a rehab facility for a few weeks. I live in a tri-level home with 2 small children in the home and no one in the home to help me with my recovery. I spoke with the benefits section and was told I had coverage for rehab for 20 days at 0 copay and then 156 dollars a day.
After 3 days of waiting for approval finally they called the rehab facility I was suppose to go to and said I was declined. They said my age I should be able to go home. They didn't take my surgeon's expert opinion that I needed to be in the facility. Humana wants your money but does not want to pay for you to have the services you need.
CINCINNATI, OHIO -- DO NOT BUY HUMANA RX INSURANCE! Humana has a cheap monthly charge that they use as a come on. However, there is first a $320.00 deductible to be satisfied. Then, their drug costs are way out of line. For example: I've had to pay $22.00 for a 30 day supply that my previous carrier charged $4.00. I've had to pay $117.00 for a 30 day supply that my previous carrier charged $40.00. They move what are Tier 1 Rx with other carriers to Tier 2 to be able to overcharge for what is clearly Tier 1.
I suffered a complete breakdown in communicating with them. They tried to contact my MD using the wrong phone and fax numbers. Both correct numbers were clearly written on the Rx. Furthermore, I was given two different fax numbers that my MD was to use to contact RightSource. Again - DO NOT BUY HUMANA RX INSURANCE!
LAS VEGAS, NEVADA -- A CLASS ACTION IS OVERDUE AGAINST HUMANA. They fail to honor approved services and/or agreements. On April 2014, my Dr.'s office requested additional trips for me so that I could see a physical therapy in addition to my primary care.
These trips were approved and I've been going to my appointments, however, I called the transport co. on 8/12 and was told that Humana voided all trips for the rest of this year. I called my Dr.'s office and was told by the nurse that trips already approved are good until the end of the year. I have sent 3 e-mails to Humana and all I get are evasive responses.
In addition, on 8/12 I rec'd a Notice of Denial of Payment from Humana for my transport to the therapist even though they have the order for this service from my Dr. Because of the numerous complaints from thousands of patients, I ask that an attorney files a class action on our behalf. In the meantime, I reported them to the BBB.
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.
VIRGINIA -- I applied to join their network as a provider on December 23, 2014. The customary time is 60 days if you have everything. Humana reports it takes 120 days. It is Sept. 9, 2015 and I am still not approved. They haven't sent me anything either. I called over ten times and sent 5 emails. Two escalations and two supervisors and still nothing. They have cost me business by not putting me on their panel. I am very angry that it has taken almost 9 months. I can see why they were bought out. They can't provide customer service. I can only imagine what the clients go through.