ARIZONA -- Prior to retirement I was bombarded weekly by printed material by AARP advertising United Health Care. Since I knew I was moving from TX to AZ at the end of 2015 I signed up with UHC in October so I could start getting coverage from Jan 2016 when I started living in AZ. I contacted UHC and they gave me the name of a GP physician I could see. I saw that person for a diabetic checkup Jan 18, 2016 and was told they did not accept UHC insurance after UHC indicated he did. I incurred a bill of $247.
Month after month I contacted UHC trying to get them to pay the bill only to learn I had NO coverage since Jan 1 due to a mistake the person at UHC made when they completed my enrollment. It was after April before they recognized their error and made my coverage retroactive. In the meantime I settled with Honor Health Scottsdale for $197 and paid it myself given verbal assurances from UHC they would pay.
It is now July 10, 2017 and still no payment! In Nov 2017 my coverage was made retroactive to Jan 1, 2017 and I go back and forth with customer service. First I had to fill out a written claim and send it to one P.O. Box in Utah. I did that--no response. Then someone else at UHC said I had to sent it to a P.O. Box in CA. I did that too--no response and also no way to contact anyone by phone at their claims office. Then I was told I had to contact LifePrint since they paid out claims. I did that and they said, no, they don't do that and I had to contact UHC again. I did that and got a new case ID.
Then they said it was sent to the wrong group. I called again and they said it went to the correct medical group. Now I hear that they need more information. This is totally insane. The company is so big and nobody has the power to resolve claims quickly. After 18 months this has become almost laughable if it was not sad. AARP should drop UHC completely. I am 70 years old and do not know if I will outlive this claim at the rate things are going!
CONNECTICUT -- I called about my mom's insurance. I had cancelled it on MARCH 6 (She died March 4), but the person I spoke to did not follow through, and I was still getting mail about the policy. I explained all of this to a surly rep, who, instead of apologizing, insisted I never called (they don't make mistakes there!). She was screaming at me, so I asked if she could just go ahead and cancel, and she said she would (who knows, though?), then I hung up. She never said she was sorry about my mom's death, and she had a huge chip on her shoulder. I will never deal with this company again.
ARIZONA -- My plan that I pay for out of pocket, every single paycheck holds 0 exclusions for lab work. Regardless of the reason of the lab work, it is 100% covered. UMR takes it upon them self to decide what is approved or not regardless of the plan. Once denied they are requiring complete medical records. What is the point of offering 0 exclusions if you're going to deny claims?
I have called twice and chatted twice with reps and 0 can give me a reason to why the claim was denied. Not one single representative understands why and it's "strange". What UMR fails to realize is when they deny claims, the provider sends YOUR member an invoice for full amounts. Full amount invoices that go past due, extremely past due, to collections. Get your ** together!!! Your claims people need to check members plans before denying claims. I should have stayed with Blue Cross.
OVERLAND, KANSAS -- My son has Medicaid and he had an appointment to be seen by his dentist. We don't have dentists nearby that accept Medicaid so I had to schedule transportation services, considering that I'm disabled myself and that the facility where we had to go is an hour away. So I did, I called Medicaid and they booked the service for the right day. However, they called me back the next day to tell me that I had to book it through United Health Care and that's when my nightmare started. So I called United and they told me that because it was not a medical emergency, they couldn't book the trip, that it was too late.
I explained to Dotty ** and Becky ** that the delay was because I was not given the right information and that I couldn't reschedule the appointment for a near date, considering that they take forever to schedule an appointment for Medicaid patients. I also explained to them that even when it's not a life threatening event, my son has a real problem with his teeth and that he also had already a cavity but they just didn't care at all.
I'm taking my son out of United Health Care because they are actually United We Don't Care. All their customer service people are trained to not give their names and their service is all but caring. Very horrible and frustrating experience. That's when you see a different treatment when you're a disabled person who sadly depends on Medicaid. They just mean money.
TEXAS -- I signed up with this after not being able to find a doctor who took my Aetna HMO in the area. I was told there were many doctors who took this United Healthcare plan. WHAT A LIE! There isn't one doctor in this community who takes this plan. Most of the doctors they have listed for primary care are dead, not practicing medicine, or retired. So who do we trust? We can't trust United Healthcare to tell the truth about anything. The president needs to be slapped with a huge lawsuit and it will only happen when the customers take charge of their own care and expose United Healthcare for the frauds they are.
N FT MYERS, FLORIDA -- I was forced to sign up for Obama Care or face a penalty, so I did in February 2014. I paid my first payment to Insurance agent the day of signing up. The next two months, which were March and April 2014, I paid a for both months, which was $86.00, $43.00 per month. I got confirmation number and never thought about it again. Received my next nil, 0 ZERO Balance and continued the rest of the year paying the 43.00 per month with a monthly invoice that stated ZERO 0 Balance. Receive December 2014 invoice again with ZERO balance, I pay the $43.00.
After shopping around on marketplace with my agent, I changed my coverage for 2015 to BCBS. I was immediately cancelled by United Healthcare due to March and April's payment not being made. I had confirmation number but the account that I paid it from had not been deducted the premiums. I was NOT notified. My monthly invoice stated ZERO 0 balance.
I now have to pay back every penny to every provider. I am being sued by several. I pay monthly payments just to keep my Primary Dr. as I have been with her over 20 years. I cannot get them to understand or admit that this is not right. Please advise if you have any information that can help me. I have contacted a lawyer and was told that most lawyers won't take a case due to payments. Ridiculous. Thank You.
STOUDSBURG, PENNSYLVANIA -- Signed up for an expensive, (over 1,250 per month), plan with $250 deductible. It turns out the deductible is really $4,000. No expenses are applied against the deductible unless you have surgery! With them for two months, they dropped my main medication, **, was told to do an authorization, which was rejected and they never sent me notice. My doctor appealed and they dropped her! No way to contact anyone at UHC through email. I had great success contacting AETNA that way. Only contact is reps in the Philippines that have no authority to do anything.
MARKET PLACE, FLORIDA -- WORST, WORST, WORST experience ever! Here's my experience... (Personal information has been changed for my privacy). 2012 - Signed up for individual insurance for "Suzy " (female) with United Healthcare Golden Rule. March 2015 - Signed up for individual insurance for "Suzy " (female) with United Healthcare MarketPlace. - March 2015 - Marketplace plan was started, and month 1 paid. ID **. March 31, 2015 - Marketplace plan was terminated without communication to either Suzy or Stewart. March 2015 - No payment made to United Healthcare Golden Rule.
May 2015 - Suzy realized she never received an insurance card from the MarketPlace and could not log in to their website. May 2015 - Stewart (Insurance Agent) and I ("Suzy Anne " (female)) called United Healthcare MarketPlace regarding plan established in March. Response was that the plan never went through, and a new application was filled out over the phone. New application used the wrong name (Anne as the first name, as the surname, no mention of Suzy) and indicated insured was a male. Suzy paid $713.72 to cover the balance from April and May. ID **.
May 2015 - United Healthcare mailed Suzy 2 letters regarding outstanding balance of $38.62 and a period of 10 days to pay the balance. Suzy was out of the country and did not receive either letter. No communication was made via email or telephone to either Suzy or Stewart regarding payment issue or coverage termination. July 20, 2015 - Physician office calls Suzy regarding insurance had been terminated. ID **.
July 20, 2015 - Suzy and Stewart call United Healthcare, call was disconnected. Suzy called United Healthcare back and spoke with a customer service. She was advised her insurance had been terminated for lack of payment. Bank statements indicate a check for $224.11 was mailed to United Healthcare each month, yet according to the United Healthcare representative, none of those payments were attributed to Suzy 's account. According to the bank, they were all cashed. Suzy was advised to send an email and explain the situation. An email was sent (to email@example.com) and Stewart was carbon copied.
July 21, 2015 - Email from United Healthcare was received by Stewart that read "We will make the exception to reinstate without lapse with the additional $38.62 and the June payment of $262.73 for a total of $301.35. The insured can call and pay with a cc payment today or they can send a payment to us to be received by the close of business on 7/23/15, after that date we will not be able to reinstate without lapse."
July 21, 2015 - Suzy called United Healthcare, paid $301.35 and was advised her account would be reinstated. This reinstated her Golden Rule account from 2012 (ID **), not her most recent MarketPlace account. Suzy was transferred to the MarketPlace, however after speaking with someone and waiting on hold for more than 30 minutes, the call was disconnected. Prior to being disconnected, Suzy was advised that she paid $713.72 in May, and her account had been terminated at the end of May.
July 22, 2015 - Suzy called United Healthcare Marketplace to get reinstated. She was advised that her account (ID **) had been terminated in March. The representative advised a new application would need to be filled out. They found Suzy's name was written as Anne and she was identified as a Male. The call was disconnected before the application could be completed.
July 22, 2015 - Suzy called United Healthcare Marketplace to get reinstated. She was informed that there was nothing she could do as her insurance had been terminated. Call transferred to Tier 2, who sent a request to United Healthcare Case Management to reinstate insured. Suzy was advised the process could take 1 - 2 months. No record of May's payment or Golden Rule account was found. July 22, 2015 - Suzy called United Healthcare Golden Rule to confirm insurance coverage secured the day before (July 21, 2015). Her ID (**) could not be found in the system.
July 24, 2015 - Suzy and Stewart called United Healthcare MarketPlace to discuss coverage. Their system did not reflect calls from earlier in the week, nor did it correct the name "Suzy Anne" and "Anne." Service representative Lance advised call would be elevated to someone that could problem solve and worked on odd situations; United Healthcare MarketPlace should be in touch with Suzy in 5 - 7 business days with a resolution.
July 28, 2015 - Case management called and left a voice mail. Name (first name only) was not understandable. Did not leave a case number. Call was to informed me they had my case and would be working on it. July 27, 2015 at 6:20pm. Called number left on the voice mail (877-887-0441), no notes regarding case management, case manager or case number. Called number that called me (**), call was disconnected.
July 31, 2015 - The MarketPlace called to inform me my application has been updated. Marketplace has updated my application. Sent the application and a request for reinstatement to the UHC. Have to work with UHC to get reinstated. Has no information about payments, old policy ID number. At this point I have to work with the plan (aka UHC). Name and sex have been corrected. No idea who at UHC I need to talk with. Advised her that my policy got messed up because the Golden Rule and MarketPlace systems didn't catch the error in my application.
She asked why not, and I said it was because the systems don't communicate and neither do the people. She said I would need to work with the insurance plan. I asked who that was and she said the plan. After asking for clarification again, she said it was UHC. I asked which department at UHC I would need to talk with since if I called then and said, I need to talk with the Plan, they would think I sprouted a second head. She said she didn't know, she wasn't part of their company and doesn't know their departments. She doesn't communicate with them.
July 31, 2015 - United Healthcare called. Received a file from the MarketPlace on 7/15 showing termination should have been 3/31. As of today, UHC has not received anything from the Marketplace. If the Marketplace sent something, it will take about 30 days to process. July 31, 2015 - A letter from Golden Rule and check came in the mail today. The letter states that I am paid through July 31, 2015 and in fact overpaid by $224.11. The check is for $224.11.
Here are the issues: This payment was made through the website that we set up access to while on the phone with the Marketplace in May 2015. This payment was applied to my old Golden Rule account from 2012. I was dropped from the Golden Rule account in May for non-payment. The Marketplace won't show record of this payment. I also received a letter from the Marketplace that says I am eligible to re-enroll in January. This is the first communication I have received from the Marketplace.
March 2015 through current - Suzy never received any communication, a new card or an invoice from United Healthcare Marketplace. March 2015 through recent - United Healthcare Golden Rule has been charging Suzy for an old plan, collecting payments and not attributing them to her account.
Sent them: Bank payments for United Healthcare Golden Rule. May payment for United Healthcare MarketPlace
American Express payment for $301.35 for United Healthcare Golden Rule, made July 21, 2015. Total paid to United Healthcare 2015. Jan: $224.11. Feb: $224.11. March:. April: $224.11. May: $224.11 and $713.72. June: $224.11. July: $224.11 and $301.35. Total: $2,359.73. Marketplace premium: $356.56. Owed to United Healthcare for = $-35.85.
SALT LAKE CITY, UTAH -- I am so surprised to see bad reviews! I had this insurance in 2014 through my husband's employer and ended up needing a hysterectomy in December 2014. My husband's employer had already decided to switch insurance companies in Jan 2015, so I was in a time crunch.
I went on Dec 8th for pre-op evaluation, and my surgery was scheduled for Dec 18th. Unfortunately I found on from the hospital on Dec 17th that the insurance had not yet approved the surgery, because pre-approval had just been submitted by the doctor's office that morning, the day before my surgery.
I called the insurance company in tears to get this surgery done, as I was in pain, and I was told she would do everything possible to get it taken care of. I also stupidly disclosed that we would be changing insurance companies in a couple weeks and I didn't know what the coverage would be and I had already met my out-of-pocket annual maximum - a perfect reason for them to delay approval to not have to cover.
Imagine my surprise to get a call at almost 8:30 pm (well after closing time) to tell me it was all taken care of, I could have my surgery the next morning. Surgery was done, bills were paid, no problems. A few months later the anesthesiologist was billing me, saying my insurance didn't pay them. I looked at the EOBs, which said I owed them $0 due to network discounts, so I called and told the provider this. They said OK, no problem.
A few months later (after my coverage ended) I got a call from the anesthesiologist again saying I owe, and that they are not in network with my insurance. I called UMR and they got on 3-way call with me and the provider and told them they are in network. The anesthesiologist office said "I don't care. We are billing it."
True to their word they sent me to a collection agency. I told them what happened (Note this was almost a year later, long after coverage was terminated with this plan). I called UMR and they send documentation to the provider showing their in-network status with a copy of the contract. The collection agency continued to call and I continued to explain to them and they told me to call the provider, which I did, and they said they would look into it, which they didn't.
Fast forward to today, March 2016, 15 months after my procedure and the termination of my UMR plan - the collection agency said I need to send EOBs to show I don't owe the balance by the end of the day or my credit is going to take the hit. I called UMR with no ID, no active plan, and no benefit to them whatsoever and spoke with Natalie, a super sweet woman who looked up all EOBs for anesthesia (as they did not bill under their business name, but under a provider whose name the provider couldn't tell me), and she faxed the EOB immediately and waited on the phone to make sure I got it. I faxed it to the collection agency; game over - I win.
UMR reps were always understanding, helpful, accommodating and expedient. I know they say people are more likely to leave a bad review than a good one, but I believe this company definitely deserves credit for the assistance they provided me, and continue to provide long after my coverage was ended. I would recommend them to anyone looking for good customer service.
My daughter has seizures, and the original medicine she was prescribed (which UHC covered) caused bad side effects. She would turn into a different person for the first couple hours after taking her medicine. She was almost manic! As the medicine wore off each day she became depressed and mopey. Her school work was also suffering, and the teachers were asking us if there was a problem. She had previously been a good student and all the teachers loved having her in the class. This was at a low dose of the medicine, as the doctors were ramping her up to the normal dose for a child her size.
After discussing with the neurologist, he then prescribed a new medicine. The new medicine was the same as the old, except it was time release. With the new medicine she has gone back to her old self, and doesn't experience wild mood swings. Unfortunately, UHC will not cover the time release medicine. Because the time release medicine contains the same ingredients as the cheaper first medicine, they will only cover that medicine. We have appealed, with doctors and teachers writing letters to describe the side effects of the first medicine. None of this matters to UHC.
We will continue to pay the $650/month for the time release version. We are lucky enough to be able to afford this. However, I feel for those in the same situation who are being denied and can't afford it. We probably would take her off the medicine completely and risk further seizures if it meant going back to the first medicine. Prior to this happening, UHC denied my cholesterol medication. This medication had previously been allowed by Humana before my company switched providers. My specialist told me I was better taking an over the counter version instead of the medication UHC would cover.
However, he recommended I continue to take the non allowed medication. I did continue to take this medication until we had the issue with my daughter not being covered. At that point paying the monthly amounts for both was not an option, so I have discontinued the cholesterol medication. UHC has a well-earned reputation for not covering medical necessities. They offer lower premiums to companies, and then make up the profits by not covering items the doctors feel are important.