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Terrible Prescription Coverage
Posted by Pfsr on 12/16/2009
United Healthcare has again reduced coverage for my prescriptions during the plan period. As it has happened many times before, my first knowledge of this "change" happened when I drove to the pharmacy to pick up my medicine and was told they would not cover it. Such changes during the plan period negate any statements regarding copayments or maximum out of pocket expenses. These statements are therefore worthless.

I have made many unnecessary trips to the drug store and have spent numerous hours on the phone with United Healthcare and they refuse to honor their written commitments. The amount I have to pay exceeds the copayment listed in their plan and their website. Millions of other consumers are having to do the same.


     
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Posted by goduke on 2009-12-17:
What change did they make? It could be that a new generic is on the market for the brand drug you take, so that the brand is no longer available to you without a prior authorization.
Posted by pfsr on 2009-12-18:
For one of my medications, that treats a side effect of my cancer, they quit covering it completely. For Lipitor, which I have to take every day, they will only cover 90 every 65 days. So, if I get a refill of thirty every 30 days, I now have do do without for 5 days before I can get the third refill or pay full price for 5. Of course, this means another round trip to the pharmacy in addition to the one I already made. Today, I am gong to have to drive in this blizzard to get the refill they would not cover on Monday.
Posted by Alain on 2009-12-18:
Any possibility your doctor could help you find something they would cover?
Posted by goduke on 2009-12-18:
You might want to get your Lipitor from the mail order side. It works very well for maintenance medications, and they'll be able to give you the full 90 pills, which should last 90 days.

You might also want to take the latest formulary to your MD, to see if there's another class of drug or another drug in the same class which is covered which might work. You might also ask them if it can be covered if the doctor will submit an authorization for it.
Posted by pfsr on 2009-12-18:
It would be much simpler and more ethical if United Healthcare simply did what they promised in writing. The latest - When I called UHC on Monday, they said I could pick up my prescription today. Of course they changed their mind. After 45 minutes on the phone, I was told They would not cover anything until January 8! I asked to speak to a manager. It took her 15 minutes to tell me I could pick it up tomorrow. I explained that we are forecast to have 18" of snow by morning and that I would not be able to get to the pharmacy and asked her if there was any way I could get it approved today. The answer was no. Since I am snowed in for the next few days (without medication), I am writing each of my congressmen, filing a formal appeal with United Healthcare, and filing complaints with my employer, the Better Business Bureau, Consumer Affairs, the state Insurance Commissioner and the state Attorney General. There will be more as soon as I can think of them. I encourage any others that have had such shoddy treatment to do the same.
Posted by LenaSunShine on 2010-08-04:
pfsr is right. This is bad medicine. Patients are not supposed to keep switching formulas because they do not contain the exact same ingredients, and also people who take multiple pills a day become confused when the look of their meds keep changing. Further, a patient should never discover they can't afford the new price of their needed medication the day they actually need it because if they don't have the money, then they go without their medications and that can do serious harm. Bad medicine period!

If a doctor and patient choose a specific formulation, whether it is the name brand or a generic, the pharmacy should fill it no questions asked. It is the business of only the patient and his or her physician why they've requested that brand and that drug. Having to justify it to countless, faceless, nameless employees of the system is an invasion of medical privacy. The pharmacy receiving it and filling it without question unless they note something dangerous about it and call to talk to the doctor and patient about it first (which they don't do anymore because they don't want to pay employees for that anymore) is good medicine.

These practices pfar is addressing are all merely penny pinching for greater profits at the expense of the health of their customers. It shouldn't even be legal because it is physically, mentally, and economically hurting our citizens!
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World's Worst Health Coverage
Posted by Candy296 on 10/13/2012
TRUMBULL, CONNECTICUT -- One star is way more than they deserve. I pay a fortune for the worst health insurance I've ever had. In order to avoid a $1,000 deductible, I have to get my x-rays and lab work done at facilities other than a hospital. I called United Healthcare to find out where I could get blood work and an x-ray done without incurring the deductible. Turns out there ARE no places where I can get both done, which is an outrage in itself. So, I went to 2 different places, 20 minutes apart. A couple of weeks later I got a bill for the X-ray! They told me where to go, then they charged me for it. It was in-network, on their list of approved facilities, and they sent me there, but I still had to pay for it. Great work, United Healthcare!! You're really on the ball there.
     
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Posted by Susan on 2012-10-14:
What does your policy specifically state regarding whether or not your deductible excludes the cost of x-rays whether or not they are performed at an in-network facility?
Posted by clutzycook on 2012-10-14:
So did you call them and see why you got a bill?
Posted by Starlord on 2012-10-14:
It is not United's fault that labs don't do the complete job at one site. As far as not incurring the deductible, dream on. My Medicare Complete policy is insured through UHC, and I am very happy. You just have unrealistic expectations.
Posted by Anonymous on 2012-10-14:
Going to an in network facility doesn't mean you are covered 100%. You will still have a deductible to meet. And labs don't perform X-Rays. So you will have to go to an imaging facility for the X-Ray. Imaging facilities don't perform labs. Not United's fault.
Posted by wjk898 on 2012-10-14:
What kind of policy is it? My UH deductible means anything and everything applies to the deductible after which they cover eveything. At humongous cost of course!

Not that it makes it any cheaper, by the way. Health insurance has become money extortion in this country and nobody is saying or doing anything about it. Do you know where that money for your health insurance policy goes? Do you know anything about the financial activities of your health insurance company? Of course you don't. Nobody questions why health insurance is more than double what it was 10 years ago...with NO and I mean NO NO NO big difference in costs paid to physicians, nurses, and all the other people who actually do the work! Biggest fleecing I've seen in all my 60 years. And nobody is asking questions. Obamacare is NOT the entire story - and in fact, mostly touted as an excuse! This business of escalating premiums - through the roof! predated Obamacare and nobody is calling out these crooks. $13,000 a year for an individual policy? Are you people nuts?
Posted by Discerning Consumer on 2012-12-02:
Beware of the UHC beast. I have witnessed first hand of their tactics. I had a favorable opinion became an employee . I became an employee and saw their deliberate miscommunication with enrollees and upper management condones it.I quit after nine months because I have a conscience!!!I tell all seniors I know to beware of the Beast-UHC.
Posted by Terry Smith on 2013-07-30:
Thank you for being truthful!
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Terrible Insurance - Beware Everyone
Posted by ArkansasMoon5 on 04/30/2009
MASSACHUSETTS -- I am so glad to see I'm not the only one that is terribly unhappy with United Health Care! This is the absolute WORST INSURANCE I have ever had in all the years that I have worked. I knew when my late husband's company switched to United Health from First Health (a great company!) that I was in big trouble, everyone I have ever talked to told me that United Health was the worst in the nation, all they ever do in deny, deny, deny!!! I had gallbladder surgery recently, the total bill was 4500. Medicare paid 3100, United Health paid only $3.00. This is absolutely horrible!!! They did me the same way last year when I had my knee replaced, refused to pay anything at all...I had to scrimp and dig up 2,000 dollars. I will be so glad when the end of the year is here and I can get off of this terrible insurance.

Please don't get this insurance, you will regret ever having it for they pay almost nothing. I heard once that a United Health worker had made the remark to someone, that every claim denied, which in my case is all of them, is PURE PROFIT for the company. That is their attitude. God help us all if we deal with companies like that.

Thank you for letting me VENT!!!

Suzanne Fisher
     
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Has to be the most deceptive company ever!!!
Posted by Timmy51 on 05/12/2011
Only way to describe the service of this company is, they SUCK!! Take your money and pay nothing. If it were not my only option from my company it surely would not be happening. They are totally deceitful and one person to the next that you talk to answer your question differently all the time.

Something definitely wrong when you call and ask if a colonospcopy is a cover procedure and the representative says yes it shows it is a routine preventative procedure and is covered %100 per your coverage. So you have it done and the find a few polyps and remove them. Couple weeks later here is a bill for $4700!!!!!!!!!! NOW the insurance company says, well, being as you had polyps that changes the procedure to a "medical" diagnosis and you pay the whole wad yourself.. KISS MY %$$!!!!

They do not want to prevent cancer??? That would cost them a BUNDLE if that came to the forefront??? They are TOTALLY out of control and need to be investigated for deception and fraud!!!!

STAY AWAY from this company at ALL costs if at all possible!!!!
     
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Posted by Anonymous on 2011-05-12:
This is a complaint I hear everyday at my job. A routine colonoscopy is 100% covered. If they find something, like a polyp, then it's no longer routine. I don't get why people have a hard time understanding that.
Posted by trmn8r on 2011-05-12:
IMO, the routine exam should be covered.

However, if they find something, and additional tests and procedures are required, those are billed separately and covered as dictated by the plan.
Posted by LauraW on 2011-05-12:
So UHC is, in reality, discouraging people from getting colonoscopies, since there is no way of predicting whether one has polyps. If one doesn't have several thousand to pay for polyp removal, that would deter them from getting a colonoscopy.
Posted by trmn8r on 2011-05-12:
LauraW - Perhaps. I think the assumption is that if there is a problem, all patients would want to resolve it. Would a person want to walk around knowing that they have polyps?

I think my brother told me he found out routine colonoscopies aren't effective. He mentioned that one test is. I wrote this stuff down and misplaced it!!!
Posted by yoke on 2011-05-12:
So in other words the colonoscopy is covered but the removal of the polyps are not. That would be like saying a blood test to find out if you are pregnant is covered, but the delivery is not since you were pregnant when you came into the office.
Posted by Anonymous on 2011-05-12:
Depending on what their insurance coverage is, the removal of polyps should be covered under surgery benefits
Posted by Anonymous on 2011-05-12:
I have recently read that most of the insurance companies do this when it comes to colonoscopies. As shorty said, it should be covered by another portion of your insurance coverage and I would definitely apeal their denial. I know that in my coverage it clearly states that the colonscopy will not be paid in full if other medical issues present themselves. Makes no sense whatsoever.

The article I read said that it's a "glitch" in the insurance companies systems. Uh huh. They went on to say that if you appeal the decision, they will look into it and pay whatever your coverage is for surgery--80%, 90%, 100%. I hope you get this resolved to your satisfaction. The insurance companies are resorting to some slippery slopes of coverage and you have to practically question every single claim.
Posted by Anonymous on 2011-05-12:
I would suggest the OP call their insurance and see if the claim can be sent back for review. If they STILL deny it, then file an appeal. An appeal will take longer than a review. United porobaly still won't cover it at 100%, but they should cover a certain percentage
Posted by yoke on 2011-05-12:
Sometimes insurance companies are crazy. When I had my daughter we had Tricare. Had the blood test done at NAVCARE and then went to doctors office with the referal I got from them. They got the authoirzation (or they thought). About a month later I got a bill from the hospital for my daughter. Called them and asked why she was not part of the OB authorization the doctor and hospital got from Tricare. I was told that since it was preexisting I needed to get another authorization to deliver her. My doctors office laughed when I told them, they took care of it. Would the insurance company in the OP's case rather the OP go back for another procedure to have the polyps removed at a greater expense to them. Common sense insurance companies, common sense.
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Deceitful Practices
Posted by Cmyers900 on 03/23/2011
SALT LAKE CITY, UTAH -- My doctor office called to see if a procedure was covered by United Healthcare. United Healthcare stated I only need to pay my $20 copay which was great as I am in financial hardship along with the rest of the world. I even asked the doctors office again when I went for my appt. if I only owed the $20 and said yes per United Healthcare. I would NEVER of had the procedure done if I needed to pay more. I don't put myself into matters I can't pay for. I have my pride.

I get the procedure done and then get a bill for my deductible. I just about die when I opened the bill. How can this be I was reassured I only need to pay the $20 copay. Do you see something the matter with this situation? Then they try to tell me it was surgery. Surgery, a shot in the arm, implant placed by needle in arm, surgery are they on drugs? 15 minutes in the doctors office and they say I had surgery.

I can't believe that they can get away with being deceitful and rape people of their money. Doctors called, I double and triple checked that I only needed to pay the $20 and again told yes. I am so sick over this as I have to pick paying mortgage, gas to get to work and food. When the heck is something going to be done about dishonest practices such as this? I will never recommend United Healthcare to anyone.
     
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Posted by dan gordon on 2011-03-23:
I don't think you can blame United. The way the dr turned in the bill and the coding they used makes all the difference. If I had a cold and wanted a checkup if they billed insurance as an office call I'd have to pay, but if it was billed as preventative then it would be covered. Blame the whole screwed up medical billing profession but I think the insurance is the least of the issue.
Posted by tnchuck100 on 2011-03-23:
dan is right. I have had the same thing happen to me. The only way to resolve it is to keep telling the doctor that insurance WILL pay it if it is coded properly. Remain polite, but firm in the fact you will not pay your portion until the insurance has paid their part. In my case it took six months of hassles and finger pointing between the doctor and UHC. When the doctor (really the billing department) finally came to the realization that I would NOT pay until they got their act together and the insurance paid their part. THEN I paid my part.

Sometimes it takes plain doggedness to make the system work.
Posted by clutzycook on 2011-03-23:
I'm with dan and chuck. It sounds like a coding issue. You can request an itemized and coded copy of your bill so you can scrutinize it and see if there's something there that might not be. Question everything and get everything in writing is what I always say.
Posted by BEJ on 2011-03-23:
Call both United and your Doctor's office. More than likely it is a coding issue and the doctor needs to resubmit with the corrected code. At the outset, the doctor's office should have gotten an approval code for the requested procedure.
Posted by Anonymous on 2011-03-23:
Any procedure done at the Dr's office will be listed as surgery, no matter what it is. Doesn't mean you had surgery, that's just the category used. Check your benfits brochure to see if the deductible applies to injections done in the dr's office.
Posted by saj80 on 2011-03-23:
When I go to the doctor for a procedure, I pay my copay at time of the visit, and it is not uncommon for the remaining cost to be applied to my annual deductible. While this may be a coding issue, it could also be miscommunication between United Health, your doctor, and you. You may have been told that you needed to only pay the $20 charge, but that may have only been to get in for the procedure. Your doctor was probably told the procedure was covered, and his only obligation at that time was to collect the copay, assuming you knew that any additional charges would be subject to your coverage and deductible.
Posted by momsey on 2011-03-23:
I agree with the others who say that it's a coding issue and before you start complaining about United, you should speak to your doctor's billing office. They are the ones who verified your benefits and presumably they gave the correct information at the time they were verifying benefits. The onus should be on them to figure out why what they told you turned out to be untrue.
Posted by Anonymous on 2011-03-23:
I recently appealed my insurance company's denial. My benefits state that my doctor visit is a $25 copay. When the insurance company processed the claim, they said they applied it to my deductible. They were wrong and reimbursed the doctor's office for the balance THEY were supposed to pay.

I also used to check patient benefits for the neurology clinic I worked for. I could call 3 different times, ask the same questions and get 3 different answers. I always encouraged the patient's to call and also check their benefits too. I knew exactly what to ask the insurance company's though, and oftentimes the patient didn't. The insurance company's are tricky in that way. My guess is that the doctor's visit was a co-pay, but the procedure was part of the deductible which hadn't yet been satisfied.

My suggestion to you is to appeal the insurance company's decision. It is definitely not the fault of the doctor's office. They check your benefits as a courtesy to you. Every single insurance company I dealt with occasionally gave incorrect information or forgot to tell you how much of a deductible the patient had to satisfy. Sometimes I would be told there was no deductible, when in fact there was.
Posted by Anonymous on 2011-03-23:
It's not a coding error. The OP is just not aware of their benefits. Any procedures done during an office visit will most likely go to the patient's deductible.
Posted by trmn8r on 2011-03-23:
I don't believe "deceit" or "dishonesty" is at the root of this problem. I think it is a miscommunication. It sounds to me like you would have only been responsible for the copay if your deductible was already met.
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UnitedHealthCare worst health insurance in the United States
Posted by LKT on 08/11/2009
My elderly mother has United Healthcare as her retiree coverage. I (her daughter) have spent literally hundreds of hours dealing with UHC customer service and "rapid repsonse unit" (ha ha -- I wish!). They process virtually every claim incorrectly. They refuse to acknowledge errors, and cite to other ratonales for a denial that are equally incorrect. As an 83 year old, my mother is completely at the mercy of unscruptulous insurers like this. You literally have to have a lawyer or be a lawyer (I am) to deal with them, because you have to know when you are RIGHT and not let them bamboozle you. I'm so frustrated that I'm writing this complaint in an effort to warn people: if you have any choice at all, stay away from these people.
     
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Posted by Anonymous on 2009-08-11:
Totally unacceptable treatment from United. If you have already gone through the "chain of command" at United your next best bet would be to contact your states department of insurance. If your mother is on a Medicare plan, contact CMS. Follow this link and it will take you to the contact page. I'm sorry your having such trouble. Good luck to you! http://www.cms.hhs.gov/ContactCMS/
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Don't Use This Medical Insurance
Posted by Buteyn2 on 01/15/2013
MARQUETTE, MICHIGAN -- I retired in December 2011. After retiring, I had to pick up my own insurance for my wife, son, and myself. Our premium was $560 per month with a high deductible of $2500. This insurance did not cover anything.

I had hand surgery. The doc schedules me for trigger finger surgery. Two weeks later, I have surgery. I then need therapy on the hand. The therapy was $3000. 3 months after hand surgery, I get a bill from the hospital saying United not covering surgery. I get a $2000 bill. A simple hand surgery cost me $5000 out of pocket plus my premium. I blame the hospital also for getting authorization for surgery, but not checking to see how much the insurance was covering. Only $500 was covered.

My son had a shoulder injury. United covered the MRI, but I got stuck with another $3000 in therapy for my son.

My wife had a bunch of women's testing. We get a bill showing United is covering $9.00, yep, $9.00 out of a $150 charge for a test.

I figured I spent about $6000 in premiums, and about another $10,000 in out of pocket money for things not covered. From what I guess, only about 5% of everything was covered.

I am getting a new insurance plan. This plan really sucks. You could do better putting your premiums in the bank and paying cash for medical cost.

Thank God nothing serious happened to any body in my family while we had this insurance. Golden Rule should be called Golden Shower.

I plan on researching to the penny what I paid and what United Health Care did not pay. It is amazing. Do not use United Health Care Golden Rule.

Steve,
Marquette Michigan
     
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Posted by Alain on 2013-01-15:
Contact the Michigan Office of Financial & Insurance Regulation consumer hotline at 877-999-6442 and see if they can't give you some assistance in dealing with United Health Care. You may be able to contest their denial of payment.
Posted by Vinnie11 on 2013-01-15:
I also have United Healthcare @ $490/mo with a $3500 deductible. I feel your pain. My daughter was in ICU in August and somehow that $3500 deductible resulted in my spending $10k out of pocket. Then I became ill and had surgery and found out the deductible is $3500 INDIVIDUALLY so I had to shake the money tree and come up with some more. Their trick to delay payment is to say that the medical institution sent the claim to the wrong address or whatever and to resubmit dragging the process out for months and toying with my credit. What I REALLY want to know is what the heck is ObamaCare and how does it fix this? If you are not VERY poor, you're just screwed.
Posted by Obsfucation on 2013-01-15:
"Golden Rule should be called Golden Shower"

That alone made the review worth reading!

It might be worth pushing back a little and questioning their decisions, and document the reasons they denied payment. Sometimes you get surprised.
Posted by Susan on 2013-01-15:
Ultimately it is your responsibility to read and interpret your policy and verify what is covered and at what percent prior to utilization. I'm not saying your insurance isn't expensive and/or doesn't seem to cover much but unfortunately it is paying what you agreed to when you signed up for the policy.
Posted by Vinnie11 on 2013-01-16:
It's not that simple, Susan. There are all kinds of nooks and crannies not covered in the plan docs. For example, my mother and I had the EXACT same surgery with the EXACT same doctor. But after mine, they sent to the doc for my records and deemed mine "cosmetic" and not medically necessary and didn't cover it. I had to appeal. I ended up paying for it anyway but as a result of the appeal, it met my deductible for that year. Then you are punished with a rate increase. Individuals aren't protected under the umbrella of guaranteed group rates. They raise our rates and they raise them frequently. If they find out you have a "problem" they don't cancel you, they raise your rate until you can no longer afford it and cancel them. The industry needs regulation and they need it fast.
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Health Care Partners Violated Company Policy Re Second Opinions
Posted by Milbear12 on 05/12/2012
CALIFORNIA -- It was the worst experience imaginable. Although Secure Horizons/United Healthcare policy allows a second opinion, my authorizations for a second opinion with an in-network provider were repeatedly denied by Health Care Partners, who were apparently connected with them. I had a cancer diagnosis & wanted to see another in-network doctor for another opinion. It was only when the case was scheduled to go before an Administrative Law Judge that they relented. They did everything they could to make it difficult for the second doctor, such as refusing to turn over results from previous tests. After a great deal of difficulty (& after almost two months,)I was allowed to be operated on by the second doctor. As soon as the new enrollment period came up I enrolled with another company.
     
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Posted by Alain on 2012-05-14:
It looks like Secure Horizons/United Healthcare/Healthcare Partners did everything they could not to honor your policy. I'm glad to see you took the time to fight them and win. Hopefully, your new company will serve you properly. Thank you for letting other consumers know that this company may be untrustworthy. Best wishes for your recovery!
Posted by Ginny Thomas on 2013-10-12:
They have been bought out by another company but will probably continue the same policies. They generally go with the doctor that will cost them less money. For instance, if one doctor's policy is not to give radiation after cancer surgery unless cancer is found in the lymph nodes, and another doctor gives both radiation and chemo whether or not cancer has spread to the nodes - Guess what, they will go with the first doctor. It's cheaper. They are more concerned with making a profit than what is best for the patient.
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Mammogram runaround
Posted by Seeking a mammogram on 07/02/2010
Recently I found what might have been a lump in my breast I went to my doctor, she ordered a mammogram to see what going on. I called united health care to find out my benefits I was told that a mammogram was a covered benefit and would be be paid and not go toward my deductible. I went to a participating facility had the mammogram, guess what it was not paid for. The explanation was that it was billed as diagnostic not routine. I asked what mammogram is not diagnostic they could not explain that to me. I was told by a supervisor that because I had a breast lump the mammogram was not preventative and would have to go toward my deductible. I fought this through an advocate and subsequently through the state attorney general to no avail. I have documentation form United Health care stating that even if it was preventative it would have to go toward my deductible with an attached benefits summary stating that preventative mammograms are covered at a participating facility at 100% and does not apply to the deductible. This is an unfair practice, I paid the hospital (they did nothing wrong and deserve to be paid for service) they agree that the practice is ridiculous. I wonder how any woman can know if they have a breast lump prior to having a mammogram. If I had any other option for insurance I would take it. I have had to fight United Health Care each time we use the insurance we pay for. If you have any other option for insurance please take it. United Health Care does not care about anything but the premiums. A Nurse in New York
     
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Posted by leet60 on 2010-07-02:
Your post is very revealing in regard to the status of the health insurance industry in this country. With this insurer, I can definitely relate to your situation.

I had a long, drawn out battle with this insurer after an Emergency room visit, which required a CAT Scan, MRI, and diagnostic lab tests. UH decided the entire visit should only be paid at a rate of $350.00 to the hospital. My copayment and annual deductible were already met, the hospital bill totalled over $6000 and UHC decided it was only worth the measly amount. The hospital told me it was constantly in a battle with this insurer to pay the amounts they had contracted to pay.

Remember insurance claims adjusters are not paid to service you the insured, they are paid to find reasons to deny your claim at any cost.
Posted by LenaSunShine on 2010-08-04:
This year for the first time, UMR, a subsidiary of UHC, refused to pay for my covered papsmear and mammogram. I had them at the same time of year I normally due to ensure there is a full year between them, and I'd met my $2500 deductible several months before. Yet, they refused and claimed a new rule to our coverage that I am covered 100% for a pap, mammogram, and well adult exam and labs, but the well-adult is covered only up to $500 and I'd already used it for the year. For the first time they stuck the pap and mammogram into the well-adult exam category and said I had to pay because I'd used my $500 allotment for the year. One exam with accompanying lab work, a pap, and a mammogram cannot even begin to be covered by only $500. What a scam! In addition, everything I had done that week, not even related to the pap and exam, they refused to cover for the same reason, but my coverage contract states that I have 100% coverage for everything after I meet my $2500 deductible. They ended up costing us an extra $3000 out of pocket a the end of the year and didn't even bother to respond to my appeals!
Posted by tnchuck100 on 2010-08-04:
The entire health care industry (procedure billing and insurance) is a scam. Providers charges are excessive and insurance companies can deny payment without penalty. We will always lose. You pay the premiums. You pay the deductibles. You pay the denied claims. You pay so the doctors, labs, hospital administrators and insurance directors can enjoy their country clubs and yachts! Keep paying. These people must not be deprived of the finer things.

And to add to the problem many people take the attitude "when it comes to my health it doesn't matter what it costs". The medical industry sure capitalizes on this!
Posted by Frustrated Member on 2013-05-01:
I had my first colonoscopy at age 51. United did not pay it as preventative, and I had to foot the entire bill. I had not prior medical history or problems. I tried to fight it but forget it. Now, I am trying to find out who they contract with for a mammogram. It's like it's a deep dark secret so you end up going to someone who is Not contracted then you get to pay for it.
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Don't Use United Healthcare if you don't have to
Posted by Misha2 on 02/19/2010
I have had UHC as my healthcare provider for six years. To get many of my claims paid, I have had to spend enormous amounts of time creating folders and charts that show when claims were submitted and what UHC's response was. I have also had to spend a lot of time on the phone with their customer service center reps. For example, today, a representative named KinDell told me that she would not discuss why claims for my husband were not being paid without authorization from my husband. I am the policy holder and she said it didn't make any difference. When I asked to speak with her supervisor, she put me on hold. After 30 minutes, I called again through the 800 number of my card, only to be told that that number was no longer correct. I finally reached another rep, who told me policy holders could speak for the beneficiaries. If you have a sore throat or ear ache, then UHC is okay. If you have anything more serious, be prepared for problems. My employer has moved us to a new insurance company. Hopefully they will be more responsive then UHC. If I were ever asked to testify to what appears to be a systemic practice of denying and delaying claims, I have the records to back it up. So, if you can choose another insurance company, I would recommend it.
     
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Posted by Anonymous on 2010-02-19:
Unfortunately, most of us who are working cannot choose the health insurance carrier, as our employer does that for us.

I have Cigna and have the same exact issues as you do. It seems we really do need an overhaul of these companies. Unfortunately, the customer service and the ways they get out of paying claims are pathetic, at best. I previously had UHC and also had problems getting claims paid. I think they hope most people will just give up pursuing payment. I'll bet many do.
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