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.
PITTSBORO, NORTH CAROLINA -- This letter will be copied and placed on the webpages of all companies. My story begins almost a year ago. My husband (a Duke Internal Medicine patient) was scheduled for a follow-up colonoscopy after having multiple polyps found the year before. In the course of the year, my insurance changed and we secured Marketplace insurance with United Health Care. This was premium insurance, very expensive monthly premiums and a $250.00 deductible.
The provider's office did a referral, and here is where the water goes murky. Duke, at the time did not take the type of UNC insurance (compass platinum), so an appointment was made via the providers office with UNC healthcare. My husband called UHC prior to the visit to make sure the paperwork was in order and was told "the procedure was a covered 100%". He had the procedure, and received a bill. Part of the bill was covered but 2900.00 was not. Upon investigation per UNC, the referral was for a screening, not diagnostic and needed a new number.
The provider office said the referral did not need a number and would look into it. UHC said the referral was not correct as well. After multiple phone calls with all three groups and a lot of finger-pointing between companies, the bill was turned over to collections, and UNC will not return phone calls.
A customer service representative from Duke has also looked into the situation and told us today, everyone is blaming someone else. Here is the sad thing, all these companies advertise "patients first, patient centered care" etc. The patient should not be responsible for making sure referrals have a correct number, should not be responsible for making sure codes are correct. He did due diligence to make sure prior to the procedure that it was covered.
The final disservice and disrespect to the patient is making them jump through hoops to find out no one is accountable but him. $2900.00 may not be a lot to some, but it is a lot to us. Add the monthly expense of the insurance premiums, for what should be covered and this is shameful.
SALT LAKE CITY, UTAH -- If you can find anyone else to get your insurance through, do it! I have them through my workplace and they are TERRIBLE! I have never had an insurance company make you jump through so many hoops to maintain coverage. Every time I turn around I have to verify that I don't have any other insurance coverage. Now I have to send in a marriage certificate, copies of tax forms, "proof of ownership", and birth certificates just to prove to them that I have dependents. What the ** do they think I am paying them for? If I didn't have dependents, I wouldn't be paying their inflated rates!
If you have a claim, then it gets worse. They deny everything and then make you do all the work to try to get them to approve it afterwards. They will never contact you first regarding any information. No wonder they had to refund money because they made too much profit. They make their profit by failing to pay out for coverage you pay them for.
FLORIDA -- I had to changed to my husband's insurance since I retired. I have taken ** for undiagnosed chronic pain. I have pain in my right shoulder, my lower back mainly on the right side and pain in my right ankle. During a trip to Wyoming, I pinched the nerve in my lower left back and had horrible pain shooting down my leg. I have seen two specialists and had three lumbar injections and two nerve procedures where they burn the nerve connections. I take ** and ** for the pain.
Now United Health care is denying my ** because I don't have nerve pain due to injury to spinal cord. Also they state if I can't take a tricyclic antidepressant or ** I am legible for **. Guess what! I can't take either. And I have chronic nerve pain. Go figure.
USA, MARYLAND -- Coverage ended 2/28/15 with $0 premium balance due. May 2016 got premium balance due $60.52. Able to still go into UHC account to print payments made from 2014 - 2015 time of coverage. Found they changed payment amounts. Still had emailed payment confirmations also. Had to get CC statements to prove amounts. Called UHC. Talked to Jessica to tell her I am waiting for CC statements since I went paperless and it is almost 1 1/2 year later. Please note my account. "No problem" she said.
Next day Mark calls from UHC asking for payment. WTH!!! Both times I feel they pretended to note my acct. I spoke with James 7/18 to say I have proof payment made but amount changed. He informed me I can only and repeat only send my proof via email or fax! No mailing. WTH again.
I'm lost in words since I had reported them when we had them for making coverage a nightmare. State Attorney's Office short staffed and because I was no longer with UHC they could not investigate them. Bull. So I am hearing others having the same issues with not paying for script, need preauthorizations again & again. Saying they did not have payment when did. Now how many are getting premium balance due over a year later???
I started work with a new company that uses UHC. I live outside of their main area in the Northeast and when I used their website to look up providers I found none in the area. When I contacted them about this they told me the same thing. I cancelled the coverage and went on the very expensive COBRA plan available due to my old job. My HR department eventually gets to me and after further research finds that a different third-party website shows that I do have providers in my area.
It is unacceptable that their website does not work properly and that their staff is unable to provide the information I need to make my insurance choices. Their misinformation has cost me thousands of dollars, countless hours, and a fair amount of stress all while I've been trying to deal with a serious recent medical issue. If UHC is this terrible at providing simple information, I worry about relying on it for any serious medical issue.
WEST BLOOMFIELD, MICHIGAN -- I had a wisdom tooth that suddenly decided it wanted to come out and was poking through my gums. I looked online at UHC's list of dentists that supposedly carry my plan, and after 11 phone calls, only one actually accepted my insurance, within 30 miles! And that office told me I would have to have an initial consultation first, then they had to send paperwork in for approval, and that could take 10-14 days. And it will be another week before they can get me in for a consultation. So UHC finds it acceptable for you to wait at least two weeks in a good amount of pain, so they can approve a procedure that very obviously needs to be done.
I tried to contact UHC for help. I called at 9 am ET and the message stated that if I need to speak with someone, I should call back during business hours. But you can't find business hours anywhere on the website or on the message. And how is 9 am not during business hours? And this is just for the dentist! I cannot imagine trusting my health care to these people. Pray that you don't have any emergency that they have to take 2 weeks to discuss.
CORPUS CHRISTI, TEXAS -- First when I got approved on May 2016... I needed to get colonoscopy medical supplies... I got them all the way to October 2016! And I would pay a copay. Once November hit they started telling me that they weren't covered in my plan. Mind you I was getting them for May to October. No issues then for November and December. I couldn't get them do. I didn't. Then I needed hearing aids so I went to the ear Dr in November then it started. Dr is wrong. Wrong codes so they ain't covered. It was like that for a month.
Then December 20 insurance company sent a letter was approved. By the time the holidays kicked in the Dr was closed for then a week and another couple of days because of New Year's so I got screwed by this insurance company so I lost out! Cause for 2017 I had to change to a new insurance! It's not fair what these people were 2 months before saying it was out of network when in the beginning you were in network but they were still collecting my premiums! These people are jerks. I wonder how many did they do these to! They should get sued!
EVANSTON, WYOMING -- I am tired of dealing with the people at UMR. I am now receiving checks without EOBs which is fine. I do this with other insurances. But I have spent over 2 hours trying to download the EOBs. They have no record of the claim. So after all this time I have now spoke to 4 different people.
The first person (English was not their first language) would not listen to anything I had to say. He just kept reading from a script. Then he transferred me to the wrong line after holding for 35 minutes, the operator was unable to help me and transferred me again, where I again held for another 40 minutes.
I was finally able to speak with someone and she also could not pull up any information, by claim, check number, or member number. Apparently it is commonplace for them to send out checks with not entering them in the system. I deal with insurance companies all day, everyday, and this is one of the worst companies I have has to deal with. They are right up there with CNIC and IBEW, and EMI. I am tired of insurance companies outsourcing all of their jobs to other countries and having to fight to speak with someone that can understand and listen to what I have to say.
The absolute worst insurance company ever. I signed up with them on marketplace.gov. "ABSOLUTELY" pay for nothing!!! I HAD a $250 deductible and went several $100 the deductible and they said I had not met it. I spent many hours on the phone trying to get reimbursed for the several hundreds they owed me. My husband was in hospital for 4 days, they paid doctors, labs, blood work and physical therapy but refused to pay hospital bill. I got four different letters stating four different reasons why they would not pay.
Every representative tells me different stories. They keep telling me I am not responsible for the bill. They aren't paying, who is gonna pay it. Now I have collectors calling me... Why aren't all of us getting a class action lawsuit??? That is just one of the nightmares I have had with them trying to get claims paid... Do not ever get this horrible insurance, do yourself a favor. Get another healthcare insurance provider.