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.
UnitedHealthcare is the worst insurance I have ever had. They are denying my blood pressure medicine. I then sent an appeal for which they also denied. Telling me what medicine I should take as they obviously know more about my health than my physician. They do not mind signing the $600.00 a month check though.
I am not asking for something frivolous. I am asking for a blood pressure medicine I have been on for 5 years. They are also denied a diabetic medicine a co-worker takes. I will have paid out of pocket $4420 for an insurance that has paid $0.00 in health benefits to me. At this point I am in no benefit from keeping this horrific excuse for a health insurance company.
I do however have some recourse. I am an IT Director. I will make it my mission to post this same response on message boards, blogs, websites anywhere there is public viewing. You are a disgrace. Denying medications that people need to survive to prevent strokes, heart problems, Diabetic coma. I suppose all of these would cost less. Well you would just deny those claims as well.
UnitedHealthcare CEO Stephen Hemsley took home over $66 million in 2014. UnitedHealthcare made $157.1 billion. Yes that is billion. I suppose denying claims and medications are a good business. I am in the process of appealing with the Illinois Department of Insurance. This should give them a little more time to pocket a few more dollars of mine. Mr Hemsley needs a new yacht. I will try and keep from having a stroke as I cannot pay for my medication. Go look at their Facebook page. There are numerous subscribers getting their claims/medications denied.
HOUSTON, TEXAS -- Well I am paying for UnitedHealthcare over 2200 yearly and I cannot even find a family physician here in the Houston area. Shame on the House of Representatives, shame on Congress, shame on all government official whom endorse this scam for Americans! Yes, UnitedHealthcare has move their operation overseas to the Philippines and the list of doctors within the provider listing is only for Core 1 patients who works for private company or has coverage with spouses. The providers listing was never updated and never will.
When I need to see a family physician for an severe ear infection and flu, I contact 10 doctors listed within the provider listings and I was given the same answer, "WE DO NOT ACCEPT MARKETPLACE GOLD CARD HOLDER OR OBAMACARE RECIPIENTS!!! I call back to Marketplace and spoke with a very nice representative and I told her my dilemma, and how I need to see a family physician, and she politely stated I need to wait until open enrollment.
Well, you know what to hell with open enrollment and to hell with this Marketplace - ObamaCare useless coverage which is the biggest scam in all history of USA! And who is going to send notification to the top dogs and make sure this issue is address? NO ONE because NO ONE cares!!! Stay away for Marketplace insurance -- bottom line and that is my three cents! No rating for Marketplace and UnitedHealthcare -- Negative rating (-100)!!!
I signed up for the $400/month bronze plan with prescription savings plan... once I signed up for that plan, I then found out it doesn't cover mail order prescriptions, or most prescriptions in general. I called for assistance and basically was told, "sorry we can't do anything..." I basically was lied to or tricked prior to signing up for this plan, and now each time I call it's basically "too bad for you". Also, while applying it asked for my pcp, so I put their name in. Have been seeing this specialist for years now. They put some random doctor as my pcp. Never heard of him.
Was told I cannot change it to a specialist, has to be pcp.
So now I guess I have to go see some random doctor. I don't know to get prior authorization for some of my medications. Which makes no sense, because in the end the health insurance is basically paying for a random doctor when I have my own. I can't wait 'til next open enrollment so I can cancel! I am in the healthcare field, and I make sure I tell everyone about my problems with United Health.
UTICA, NEW YORK -- My first experience with the company. It is the plan our NEW company has. So much for the take over. "The Best Benefits" offered the employer says. Using supplies for the past 9 months to correct an issue that had been diagnosed by my doctor. The doctor stated it could take 6 weeks could take several months. One insurance company covered the supplies and the new insurance company wants to classify the treatment as something else and deny covering the supply. So much for Advocating 4 ME!
PHOENIX, ARIZONA -- Was given referral from primary care Dr to see dermatologist. While there Dr found spot on back. He removed and sent for biopsy. Now United Healthcare is refusing to pay because besides a referral I now need a preauthorization. In other words I needed to go back to primary care Dr so I could go back to dermatologist and spend another $50. This insurance company is the worst. Never had this trouble with any other company. Can't wait till January so I find new insurance.
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.
NEW YORK -- Essentially, United Health Care is a fraud, starting with the bogus name they use on your membership card, "AARP Medicare Complete." They're not Medicare at all!! They are just "affiliated" with them so they can legally use their name, just as they do with AARP. It's all about marketing, NOT giving you great service. Their sales representative promised me that I would be able to use all my own physicians, which was a [bold face] LIE. You can only use those on their private list, and that's for only simple, cheap "health" procedures.
When I went to use them to cover a recent minor surgery, I was shocked to learn from my doctor that I had been turned down!! Why? Because when I had asked all of my current doctors if they would accept Medicare, they all agreed. One catch... none of them accepted United Health Care!!! Get it? they have nothing at all to do with "real" Medicare, only the right to use their name!!!
Here's how United Health Care rips you off.* One month before you turn 65, they FLOOD you with their advertising materials, all of which look "official." Then there fast talking phone reps make you believe that you're getting a "good deal." You THINK that you're being covered by Medicare, but you AREN'T. The additional fact that they also use the "AARP" logo in their ads gives you even more reason to believe that they're a "good deal," when the only thing they're good for are basic, cheap office visits.
Should you need even minor surgery like I did, if you doc isn't on their extremely limited list, your shit out of luck. The fact of the matter is, the phone representative totally lied to me when I asked him if I could use my own doctor. You can't. Thankfully, however, in two more months I'll be able to cancel my membership with this clip joint and sign-up with the only one I should have in the first place... original Medicare.
TENNESSEE -- My father needed to have a CT scan per his doctor to make sure that his cancer (has been cancer free since 2000) had not come back. His claim was denied by United Healthcare. The reason stated was "You have cancer in your nose and throat area. You have neck pain. You have a sore throat and pain in the roof of your mouth. Your provider suspects spread of "cancer" to your brain. Your provider asked for a CT scan of your head/brain with and without a dye called contrast."
The letter goes on to explain what a CT scan is and what a MRI is and then states that "cannot be done for medical reasons and you have a brain function problem such as mental confusion, change in vision, slurred speech or a new severe headache."
My father receives this notification and is devastated!!! First of all, he went the doctor with throat and pain in the roof of his mouth. He NEVER complained of headaches, mental confusion, change in vision or slurred speech. He contacted his doctor and the head nurse called back and apologized over and over again since the information that was sent to him was a LIE!!! She confirmed that no one in the doctor's office provided that information to United Healthcare. It appears that someone that works at United Healthcare falsely added this information/LIES to his records so that the medical services requested would be denied.
I am sure this is not the first time that this has happened to customers of United Healthcare. Please do not use United Healthcare for your medical needs because they falsify medical records so they do not have to approved medical services or items. How many others has this happened to? Who can help with this type of fraud?