SOLANO COUNTY, CALIFORNIA -- United Healthcare takes over your Medicare makes decisions on your medications above and beyond your physician's recommendation. The pharmacy Optum RX has denied 2 of my 90-day supply medications informing me that the 90 day of each of these 2 medications were all I was going to get for a year supply and all refills are denied. My physician has appealed this decision and it was disapproved.
I am going to appeal the decision once again but these actions are causing undo stress and anxiety. I am retired and my insurance is through Calpers I had to change plans because my previous Blue Shield Ins. hadn't signed a new contract with my physician's medical group Sutter Regional. I feel sorry for anyone that has to deal with this insurance co. I wouldn't even give this company one star. I cannot wait till open enrollment and get my Blue Shield back. Someone needs to look into an insurance company that defies a physicians diagnosis and prescriptions. I writing this because if anyone is considering United Healthcare they might do a little research first.
NORTH CAROLINA -- I have United Healthcare Medical Insurance and I live in an area of NC where roughly 80% of all medical providers are associated with Carolinas Healthcare Systems. United Healthcare did not renew their contract with CHS and I realize that both parties are at fault for letting negotiations fail, but we PAY UHC for their coverage so I think they owe us a little consideration when deciding not to do business with the company that provides the vast amount of care in our area. All of UHC's customers in our area (about 80,000 people) now have to find all new doctors.
For me that means new Gen. Practice physicians for myself and my spouse as well as new pediatricians, new dermatologist, new OB, new Orthopedic, new neurologist, etc. etc. The list goes ON and ON. The kicker is that we can no longer even go to Urgent Care in my area. So if my child gets sick or hurt over the weekend I have to drive him 2 towns over or into South Carolina for help. That's right, I'd have to drag a sick or hurt child into another town or possibly another STATE. That's the kind of care you get from United Healthcare, so beware.
KANSAS CITY, MISSOURI -- Since I became self-employed on 2013, I've been using United Healthcare. I thought this is the only one available for Individual Coverage. I have a balance in my deductible in 2013 and in 2014. But both years, I received an increase in my premium. The increase was timed when the open enrollment is already closed. That is not good business practice. I wasn't happy for getting a $90 increase last year.
This year for 2015 coverage, my premium is raised from $386 to $452 for an individual. I don't have a family and it's ridiculous to pay $452 per month. I got the letter when the open enrollment is no longer available. I understand that there will be increases but they should do that during the open enrollment so people has a choice to continue or find another provider. The moment I can, I will move to a new provider and I will advise anyone I know who's using United Healthcare to change provider.
SALT LAKE CITY, UTAH -- UHC has become the ABSOLUTE worst company for Health Insurance. They say they cover medication then reject your prescription. I am on a prescription that must be taken daily or I can die from withdrawal. They have rejected it, and the prescription costs $600/month which I do not have. So, in short, I am screwed. If I have a stroke or seizure, I will sue them to the end of the Earth. Change your plan NOW.
NEW MEXICO -- My husband works for BNSF Railways, and for years we have had this insurance. Since ObamaCare has come into play, our insurance costs have gone up dramatically. We have to reach ridiculous premiums for everything. It is out of control. Those of us that have been loyal consumers seem to be getting the raw end of the deal. This is not ok, and hopefully the right people will start reading these posts and so something about this racket!
TEXAS -- My wife has Stage 4 Breast Cancer. At every step of the way, from the doctor's request for scans, treatment, prescriptions, United Health Care (UHC) has initially denied everything. Then there are multiple phone calls back and forth between doctor, labs, pharmacy, UHC, and my wife. After sometimes days, everything is eventually resolved, but at great stress and anxiety for my wife. My wife is battling cancer, she shouldn't have to be battling with United Health Care.
DAVENPORT, IOWA -- This company denies valid claims systematically. I have been trying to get a claim for 6 months about a dental procedure and they keep asking about a full mouth x-ray of the full mouth of before the implant was completed. Dental office sent them the 3-D model, which is newer technology, but they have rejected the claim several times. I understand that they want to avoid paying for cosmetic procedures, but this is clearly not the case.
For as long as both Hubby and I have had full time jobs with benefits, we have almost always elected to use my husband's benefits for medical and dental insurance (mainly because I liked their medical insurance more than mine). We would reevaluate this every November when our respective employers' open enrollment period would begin. It's a system that has worked well for us as the coverage has almost always been comparable between our two workplaces.
Last November, when my job's open enrollment was announced, I asked my husband if he had heard anything from his job about OE. He hadn't so I held off on making any changes until close to the end of my enrollment period when I asked him again about it. He said that they had told him that they wouldn't have any information for a few more weeks but as far as he knew, there hadn't been any talk that year about changing providers (it had been a concern in past years as Blue Cross was trying to jack up the prices as usual).
Assuming that things were going to be status quo, I made no changes to my employee benefits aside from adding ** to my list of dependents for life insurance and vision insurance (I always carried the vision since his job didn't have any at the time). Two weeks after my job's OE period ended, my husband called me at work to tell me that his job was switching both the Medical and Dental benefits to UnitedHealthcare.
Since they had ** footed around and waited until the second week in December to make this announcement, we were SOL. Fortunately all of our physicians were in-network, so that didn't have to change. As far as dental insurance was concerned, I didn't really have any problem with whatever they offered since we had never used the dental benefits no matter who carried them. We just had it as a "just in case."
This spring, we found out that ** has cavities. A lot of them. And they're going to require a lot of work beyond the usual fillings (long story, not going into that). Anyway, we got an estimate from the dentist and I noticed that what was actually listed as the patient's responsibility (about $900 out of the nearly $5K total bill) was much less than what they had told me would be my portion (they told me over the phone that I would be responsible for about $3200 of this bill).
I looked at the benefits sheet for our dental insurance and I saw the line that said "Annual Benefit Maximum" was only $1000. I called UnitedHealthcare (their people are very polite, I'll give them that) and they confirmed that they will only pay about $1000 per year per person. What good is that when you're looking at work like this? It was bad enough that I had to search high and low for a pediatric dentist that was "in network" because the insurance would pay nothing for an out of network dentist, but now the most they'll pay is $1000?
I thought maybe this was par for the course for all dental insurances (they want prevention and early intervention rather than waiting until something like this happens, I'm sure), but then I looked over the benefits that my employer's dental insurance provided (MetLife), their annual max was $3000! There's plenty of blame to go around here. We shouldn't have waited so long to take ** to the dentist. But I blame my husband's job for waiting so long to let their workers know that their benefits would be changing (had we known that they were switching providers, I would have gotten on my insurance even before I knew the specifics).
I blame the HR lady for convincing my husband to take the lower dental insurance that pays nothing for out of network (I wanted the better paying one that would have paid almost same for out of network as in network) even though that wouldn't have helped the benefit max (same for both plans). And I blame UnitedHealthcare for giving us such useless dental insurance for almost the same cost as I would have paid for the better coverage through my employer!
TREASURE COAST, FLORIDA -- As some may or may not be aware United Healthcare terminated 70% of the "Network" providers from their panels. Of course as an insured with UHC notification of this action was not given until after "Open Enrollment" ended thereby locking me in another year with UHC, had this information been available before "Open Enrollment" ended I would not be with UHC anymore however UHC carefully navigated the timing of the terminations of the network physicians so as not to become know till it was too late.
My experience began January 21, 2014 my doctor had ordered "fasting" blood work, I called the lab the day before just to be sure I knew where I was going and confirm the hours, of course there was nothing more than a recording providing the address, directions and hours they are open and informing me there would be no live person to speak to at this location (I should have known right then there was a problem). I arrived at the address provided yet there was no sign, no indication a lab was there upon checking with neighboring properties I was told the lab had closed "months ago".
While standing right there I called UHC and after 25 minutes of checking of course I was told the lab was right there. I mailed them a picture of the empty office and then was provided another location to go to have my fasting blood work done without even an apology, I arrive at the next location provide to me by UHC and again the lab had closed months ago, went through the same scenario with UHC and they sent me to a 3rd location where a lab should have been and yes, believe it or not that location had also closed (Lab Corp was now the ONLY network lab for UHC they did not have to be convenient as we have no other choice.)
The fourth location was the charm. I arrived at the fourth location went to the reception desk to sign in on the sign in sheet for everyone that came in to see I had been there (so much for privacy) and was then told by the receptionist I would need to provide my credit card for them to copy and keep on file for any charges to be put on my credit card if not paid by UHC.
Now understand probably 80% of the time a charge is denied or not paid correctly and they would just put through the charge to my credit card leaving me to fight the battle with UHC and that being the least of the problems leaving your credit card on file for any "authorized" or maybe not even authorized person to use. NOT! I will not leave my credit card with anyone for an in case scenario. It is now 12:30 PM and I am still fasting, the room is spinning and I am feeling very light headed and still no blood work done because without my credit card there will be no blood work done.
I finally left went down the street to our community hospital and had the blood work done and did not provide my credit card to be kept on file and we all know UHC is not going to pay them and I am screwed because UHC only allows Lab Corp as a "network" Lab... what other choice did I have? 3 Locations I was provided to go to by UHC turned out to no longer exist and the fourth wanted to keep a copy of my credit card just in case!
No, the nightmare does not end there! I have been under treatment and had a Mohs surgery (for Basal Cell CA) done April 2013 had a couple of complications so January 2014 I was still under care for skin cancers or lesions that left go can become cancer. In December there was another lesion on my back this time I did not know UHC was terminating 70% of the network providers as of January 1, 2014 and my doctor was one of them. I had an appointment the beginning of January so I mentioned it to the doctor his response was "this doesn't look good" so the biopsy was done immediately, it came back a week later.
Melanoma, and surgery needed to be done. It was schedule to be done Feb but 3 days before the surgery UHC canceled the surgery and called to tell me to find someone in "Network." I am distressed as I already am under treatment for Basal Cell and I must go elsewhere but I moved forward as my doctor said I must get this taken care of. I go to the UHC website, put in my zip code and lo and behold, 51 doctors come up but that was not to be so true.
10 of the doctors are listed as many as 5 times with different addresses, 4 of them are more than an hour each way to get to but none had an available appointment until March 26th and it could not be with a doctor it was with a nurse and she would decide when and if I needed an appointment with the doctor (I am not taking the treatment or non treatment of my Melanoma to a nurse!) No wonder they advertise on TV constantly any quality competent physician does not need to advertise on TV for patients! They want to bill my insurance the same amount for a nurse as a physician they are not on the same level as an MD, sorry!
After much back and forth with UHC they found me an appointment with another doctor, I waited patiently for my appointment day, arrived with all my records in hand anxious to finally be seeing a doctor and moving forward with the treatment for the melanoma... NO that did not happen! Though United Healthcare made the appointment and insist this physician was in "network" his office insisted he did not accept my UHC even after speaking with UHC on the phone at length I was left with no treating physician and a melanoma on my back that can be spreading or even moving to other organs and no "Network" physician to see and treat me!
I spent more than 3 hours on the phone again yesterday with UHC and still do not have an appointment for what can be a deadly form of cancer, I am 58 years old there is no excuse, no justification for this to be happening. United Healthcare decided to terminated 70% of the "Network" providers because the fewer providers, the fewer appointments, the fewer appointments, the fewer procedures or surgeries can be done and guess what that all converts to... United Healthcare pays less money and makes larger profits without regard for the health and welfare of those of us locked into UHC until 2015!! This should be criminal.
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.