SALT LAKE CITY, NEVADA -- I was hospitalized in May of 2015. I first went to urgent care and was transported from that facility, by ambulance, to the emergency room. I was diagnosed with pneumonia, sepsis and was in renal and respiratory failure when I arrived. I was intubated and put on a ventilator and spent 8 days in ICU. The policy I had, had a $5000 deductible and a $6250 out of pocket maximum. I have satisfied the out of pocket max but I am still having problems getting UHC to pay the physician claims.
On my first appeal, they responded that they had not received the H&P and other medical records to support the claim. I responded with another letter and included all the clinical notes from each day in ICU. I then received a response with another denial saying that they could not find a claim for this appeal. The provider listed on the second denial was my new insurance carrier which was not effective until 11/1/15 and was never mentioned in any of my letters. The letter also stated that I had exhausted my limited appeals.
I responded with a third letter, highlighting all the information and I insisted that a supervisor look through all the documents and respond back to me by phone. I am giving them one week to respond and then I will go the state regulators. I have all the documentation and I am sure in the end they will have to pay the claim. I have never experienced such incompetency and poor customer service in my entire life.
MILWAUKEE, WISCONSIN -- When I contacted UHC on October 2nd to get a letter saying that my daughter would no longer be covered as a dependent on my account, I was told she would not be covered after October 31st and a letter would be sent stating this. When the letter did not arrive after a week, I called back at 8 am on October 9th and was told that there was a note in the file that they would not send the letter until after October 31st. My daughter needed the letter in order to enroll in the insurance plan at her new employer. The last day to enroll in her new insurance plan is October 31st. I asked repeatedly to speak with a supervisor and each time the cs representative argued with me.
I was eventually put on hold and then told there was no one available. I asked to have a supervisor call me and was told they had 24 to 48 business hours to call back and someone would call by October 14th. I asked if that meant by 8 am on the 14th and was told that would be the earliest anyone would call. I pointed out that that was not within the 24 to 48 hours mentioned. I went to the website in the hope of finding a different way to contact anyone at the company. There is no email or other phone number for customer service.
I called back and spoke to one more unhelpful person and asked to take the survey at the end. I left a message at the end of the survey. I do not expect to be called back. There is no way to resolve an issue with this company. They have a one-star rating - much too high!
KATY, TEXAS -- I have had insurance through most major carriers in my 40 years of working and some were good and some left a little to be desired, but United Health Care is undoubtedly the worst insurance company on the market. As with other stories here, they lie, they misrepresent and they deny coverage for coverage they say they in fact do allow for.
I am changing after the first of the year and will never use or recommend this insurance to anybody. My wife is going blind and she needs a medication for her eye (which Aetna when we had them had no problem approving) that UHC will not cover after lying to us and her doctor and saying, "Sure we cover that." It is $200 a week and a medicine she will have to use for a couple of years before she can get a cornea transplant something else they don't cover. All I can say is buyer beware when dealing with these crooks.
MINNESOTA -- In May of this year my husband received a notification from United Healthcare that he owed doctors and hospitals over $20,000 for the period between 08/14 and 04/15. On close inspection it turned out that they first paid the claims, and then TOOK THE MONEY BACK from the providers. Several phone calls to the (rather ironically called) "Customer Care" representatives resulted in empty promises of return phone calls and no resolution. The employees were clueless. My husband sent a letter to the CEO, no response. Then it transpired that allegedly the bills were not paid because my husband allegedly has Medicare part B (which he does not).
Further, this is not a supplemental insurance: he pays FULL PREMIUMS for his insurance, so what does it have to do with Medicare? Anyway, after a letter to United Healthcare documenting lack of Medicare part B and another to their appeal department, no responses and no resolution, and the bills keep on coming... This is a totally evil company, they cheat everyone: their shareholders (by backdating stock options), their employees (by refusing to pay overtime), the providers (their new tactic is to take back payments for service as alleged "overpayments") and policy holders, by refusing to pay the claims. And why do they get away with it?
If you look at their political contributions, they contributed to the campaigns of every house and senate member, and their lobbying expenses are over $1 billion. And they have AARP endorsement, so if you are a member, please lobby AARP (as I will) to drop their endorsement of this company. The only way to deal with them is to change to another insurance company. All of them are bad, but this one is particularly nasty.
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.
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!