DENVER, COLORADO -- Can Secure Horizons Insurance Be Hazardous to Your Wealth?
In the Fall of 2008, I retired and applied for Medicare with Part A and B. The school district where I worked had several plans and companies that could be used along with Medicare for medical needs. I chose Secure Horizons part of United Health Care, and their most expensive policy. I contacted my doctor for a physical exam with normal blood tests. One additional test was a Vitamin D blood test to diagnose possible future osteoporosis as it ran in the family. Later on this Spring, flu-like symptoms required that I go back to the doctor again. She ordered tests for thyroid and gall bladder.
Then, the fun began. I began receiving statements from Secure Horizons insurance denying payment for many of the blood tests. I began dialing the laboratory, the doctor's office, and the Secure Horizons about the bills. The laboratory responded that this was the responsibility of the insurance company. The doctor's office submitted the paperwork twice and each time it came back denied. Secure Horizons played dumb and said it wasn't their responsibility. The doctor's office asked me to keep waiting, but this was hard to do when I was flooded with hundreds of dollars of bills for no reason. When trying to get help, a customer representative at Secure Horizons named ” Gigi,” informed me that her supervisor was on a “conference call” when I asked who the CEO was. I wanted to send him a press release. Her manager, she replied, could not get back to me for two hours. Needless to say, I found the CEO's name immediately on the internet. Is there a plot afoot at United Health Care/Secure Horizons to issue blanket denials on claims? (See note below regarding out of network gouging by United Healthcare). Deciding which insurance company will best meet your needs is difficult because there are so many unknowns. Even customer satisfaction surveys have their limits. However, leaving customers with more out of pocket expense is no the way to do business. Enough said.
Note:” Thanks to the New York Attorney General we now know that insurance companies were in fact, swindling members who sought out-of-network care. Several insurance companies, including United Healthcare, CIGNA and Aetna, have agreed to pay millions of dollars to settle an investigation into how they set the rates for out-of-network care. It turns out the provider rates the insurance companies were claiming to be "usual and customary" were much lower than what providers were actually charging, leaving patients to pay a much higher portion of the bill.”
Imagine what my problems would have been if I had ad a cancer diagnosis. Too scary to imagine.
A few weeks ago, we received a letter from Secure Horizons claiming that my elderly mother owes $528.00 in premiums. The letter did not state what the premiums were for. As I have medical POA, I called the company immediately upon receipt of the letter in an attempt to resolve the matter. I was told by the customer service representative that even though we had cancelled my mother's Dental Gold Plan almost 2 years ago, we are still responsible to pay the $32 monthly premium even though she had not received any dental services. In other words, they are refusing to release my mother from the plan even though she no longer wishes to continue her dental insurance! Secure Horizons claims they had never received any cancellation request from us, which is untrue. When I asked why they took almost 2 years to bill us for the $528 instead of issuing a cancellation notice, the customer service representative couldn't answer me, but instead responded by screaming. I also explained to the representative that since we didn't utilize their services, we owe them nothing. I further requested that they stop harassing my mother with phone calls and letters as their claims are unfounded.
Any other reputable insurance company would have sent a notice of cancellation long before this point, instead of trying to bill my mother retroactively for services never rendered.
Hopefully, "Secure" Horizons will heed my request to stop their harassment and shakedown tactics as they have no basis for their claim. According to some other info I found on the net, Secure Horizons has contacted over 40,000 members using similar strong-arm tactics.
Since this matter is still ongoing, I will update periodically with details.
In the meantime, seniors beware of this company. If this happens to you, fight them tooth and nail.
Update 7/21/11: Customer service was informed over 3 yrs ago. both verbally and in writing of our intent to cancel the rider. A cust. svc. rep. told me the only way you can stop these letter is to make the payments. My written requests have been totally ignored. This is clearly harassment!
DALLAS, TEXAS --
I sit here in a hospital room awaiting the discharge of my 74 y/o father. He had abdominal surgery and was diagnosed with cancer. Mind you he is a spry 74 y/o who is very active and has a strong constitution. I am not certain if we are taking him home or to a rehab facility. He is still in pain and needs assistance but some area director at Secure Horizon who has not met my father seems to think he can go home. I have also run into issues with several doctors who won't accept Secure Horizon because they are difficult. The road blocks this company has to utilizing the coverage are completely UNACCEPTABLE. The ratio of rehab facilities that accept Secure Horizon is something like 20 to 1. It was difficult to find a place that would accept his insurance and even more difficult to find a decent facility that accepted Secure Horizon. Thankfully this is December and I can change his insurance to Medicare effective the first of January so that we can go to world class physicians for chemo and radiation treatment. I have learned through this process that EVERYONE accepts Medicare but only a small percentage of the health care community take Secure Horizon
HOT SPRINGS, ARKANSAS -- I can't even imagine what the admin cost is for Secure Horizons Medicare Direct. Since enrolling in the plan in November, effective date 01-10, I have had a barage of telephone calls and, literally, at least one to two pieces of mail a day from them. Today (12/10/09) I received a notice that they were going to take my payment out of my bank account within a few days. I already paid my premiums for my current company though December, and the agreement was for Secure Horizons to be deducted direct from my Social Security. I called Secure Horizons and got a call center. I had to repeat everything 2-3 times. I was told to ignore the letter (unsure in what basis). They said someone would investigate and I would get a response within 30 days. I asked to fax a copy of their letter to them, and they said there "was nowhere to fax it." In other words, I was on my own. I think Secure Horizons is part of the problem, not the solution to rising healthcare costs. I've been to Canada and the U. K. many times and the people seem quite happy with their public healthcare system. I think people would be surprised to know how many Americans have moved to Canada for the healthcare benefits.
This is to the previous person who complained about calling Secure Horizons referral names to doctors and none took the insurance. Secure Horizons DOES mail out a booklet every year with all the doctors names, addresses, and phone number that indeed do take the Secure Horizons Insurance, and it's up to your primary care doctor to send you out to a Specialist doctor to take care of your needs. Next time you call Secure Horizons, try asking them to send out a current List of doctors for your use. Hope this helps you out, I know it's very, very irritating and frustrating getting the run around from the Insurance Company, I too am having Billing problems with Secure Horizons that seem like NEVER ENDING!!!
Amazingly horrible, Secure Horizons canceled my 87 year old father's coverage claiming he "moved out of the service area" when in fact he changed LOCAL care givers. For 8 weeks they said they'd "make a determination" but never did. Every time I called I had to start over. I was never able to speak to a supervisor. Week 8 they said they could not discuss his case unless I faxes a Power of Attorney. NOW they want this? It is really unbelievable what they put us through. How can they do this legally? And, yes, finally we are going to the Calif Insurance Commission and every other advocate group.
My advice: AVOID THEM at all costs!
VIRGINIA -- Since my wife and I enrolled with this health insurance company in late December 2008, it took my calling their customer support 5 times and a total of 45 days to receive our medical ID cards and on top of that, the cards have the wrong Primary Care Physician Names and Phone Numbers. The plan we enrolled in "Medicare Complete" with a Rider that is supposed to cover Dental, Vision, and Hearing for and additional $39.00 per month each on top of what ever they collect from Medicare. Since January 1, 2009 when we have gone to doctors and dentists, these people have done everything to delay paying their share and as of this date (February 25), it has cost us over $800.00 out of pocket even though it should be half or less. We too are stuck for another 10 months.
So if you see them advertised on TV as being sponsored by AARP. Do not enroll, RUN away from these people as fast as you can. They are the worst..
I am making a very long and aggravating story very short. My mother in law is currently in a hospital and needs a long term care facility. The problem is, we can't put her into one (even though we are private paying) because NO ONE accepts Secure Horizons by United Healthcare Medicare insurance (the medical staff gets paid through the insurance). We called SecureHorizons to get her disenrolled, because she entitled to do that if entering long term care. Well, it's been a month, and after daily phone calls to them, she's still on their policy. She is still in the hospital and I will be getting a big fat bill from the hospital soon because she is still there. You can't even keep a record of who you spoke to at Secure Horizons because they don't want to give out their names. Some way to do business huh? I have honestly never heard of such a thing. I have heard from other people that need medical services (surgery, etc.) that they are in the same boat. Their doctors won't take the insurance so they have to wait until open enrollment to get off this plan to get the necessary medical treatment that they need.
For anyone who is in the same boat as we are, I understand your frustration. They take advantage of the elderly.
PENSACOLA, FLORIDA -- I am a member of secure Horizons since last 6 years. I have been trying to collect my out of pocket expenses due to medical emergency when I was travelling out of country. I have faxed all the paper work to Secure Horizons Medicare supplemental plan's claims department ( 850 439-3202)at least 6 times and to customer service (850 435-2086) at least 4 times but each time I call to verify the status of my claim I am told they have no record.
Did you know that claims department is not allowed to talk to customers, that is what the customer service told me. I am now going to fax them the paper work everyday until someone responds.
I feel that they are purposely not responding so the time runs out and they don't have to pay my claim.
Someone has a better idea?? help. I am on social security disability and this has created a substantial financial burden on me. Thank you