If you are considering insurances, DO NOT consider this one, you will pay the price. After visiting the doctor last month, I come to find out after receiving both a doctor bill and medical lab bills that I wasn't insured. I just about panicked, and I called them to have them tell me that even though I had paid my bill, had documents stating I was insured, I somehow happened not to be.
After over 4 hours on the phone, (they don't have a universal computer system) and accepting I will have to pay my bills with no explanation, I received a letter from United Healthcare stating I had been insured that entire month. Now, I called back and they are claiming, oh yes, it was our fault, in fact you are insured. So, after being transferred many more times, I got someone who claims that they will contact all of the labs and Dr. offices and send a check to cover what they should with an explanation.
Now, this isn't the first time I have had a horrible experience. I am honestly expecting them to screw this up to, so I called the billing departments and updated them myself. They seem to mysteriously uninsure people. My sister who had been insured through them gave birth, and found out a month later that they had decided to cancel her insurance claiming her labor and delivery weren't going to be covered by them. In the end- THREE YEARS later she won and was awarded that coverage, although she is still waiting for the $. So, save yourself time, give yourself peace of mind and don't even consider United Healthcare for your insurance, you will be sorry.
I'm not one to air out my life issues. However, a story needs to be told. I was diagnosed with Breast Cancer two and half years ago. Since my chemo, surgery and radiation - I have been in remission. So, call me a survivor if you will. The one thing I haven't managed to survive is the fear of Medical insurance. When I was diagnosed I worked for a Bank and had wonderful insurance. We all know what happened to some of the banks - I lost my job in the middle of treatment. However, my employer and insurance provider stuck by me and I will never have one bad word to say about them.
Shortly, after my battle I was able to find a job and stayed on Cobra until I was able to get onto my new employers policy. The first six months were great, never worried, provided them with my previous insurance information and they paid all of my bills. Then my employer changed carriers four months ago and I just received a notice in the mail yesterday that my insurance had been terminated due to pre-existing condition.
I've never had one day laps of insurance since my diagnosis. I've paid all of my payment and copays etc. I haven't contacted UHC yet, I will do so tomorrow. The thing is I've been going to my yearly followup appointments in the past few weeks and had I known my insurance had been terminated well, I wouldn't have racked up a hefty $5,000 in bills that I now must figure out how to pay. The kicker, I made it a point to call an Attorney before I gave up my Cobra Insurance to go with my current employers. I was advised that they cannot consider my condition pre-existing unless I had a gap of insurance and he told me to never have one day without insurance, and I've done just that.
It's not fair for Insurance Companies to punish people in this situation. I never asked for Cancer - and now that it's out of my body - I feel like I'm dealing with a whole different form of Cancer - It's called BULLCRAP Insurance Companies. If I didn't need you so much - I'd tell you to go ** off.
ATLANTA, GEORGIA -- Since becoming a member of United Healthcare about 31/2 months, I have been denied, or put through the authorization process, about 5 times, medication that my previous Insurer has paid for, without question. They farm out prescription services to Medco. I have followed their procedures, and still they make me change to a cheaper medication, even though my doctor thinks he is prescribing what is best for me. Their job is to "be the judge" of what you get. If your plan does not cover what your doctor thinks is best for you, you and your doctor have to follow an appeal process.
They will spend hours and hours on the phone, and still keep a patient from getting something they don't want to pay for. They will send you an authorization, or an appeal form, but by this time, you have already left your doctor's office, and are waiting. Sometimes you can get your meds, and sometimes you just have to deal with it. If they are so worried about their bottom line, they should be cutting better deals with the pharmaceuticals, but they already do that, don't' they? Or maybe raise their rates. Oh, yes, they have done that too. They even want me use a pill cutter to cut my one med in half, just so they don't have to buy both dosages.
Since most of the competing healthcare insurance companies been gobbled up by Aetna, United and others, their simply is not as much choice for employers to shop around for quality, affordable plans for their employees. Period. If members of the U.S. Congress had to deal with a fraction of this hassle, they would be changing the law in a New York minute! Keeping people out of the hospitals by the use of drugs already is a proven approach for everyone. They do not even have a form, that I can find, that includes a space to enter a date, service, doctor, or billing code, so you can use it to get reimbursement, without having a doctor bill with what they want on it.
This is not practical for the insured, at all. Why keep that service or medication from us, so that we get sicker, and risk an even bigger claim? The answer is that they know we have no one in our corner, as they do in Washington. I urge people with issues of abuse of power, and denial of service to let their thoughts be known, or it will never change. I also urge anyone who is trying to buy health care insurance, to find out all the details you can before you sign up, because after that, it's too late.
I have been getting the runaround from this "company" for OVER 4 months. That has paid out BILLIONS of dollars in lawsuits (last one was $594Million). That if they would use 1/2 of that towards us folk that pay in $$$ for denial of service. Maybe we could GET our preexisting meds!!! Or you can file an appeal (not done by a Doctor), then you can do a 2nd appeal after they shoot you down the first time. And DON"T bother asking for "copies of all documentation that was used to come to our decision".
Cos then you get sent 2 or 3 letters sending you every thing you DIDN"T ask for. (lets waste 4 more months of my time),especially when I sent the last letter with, CC: Tx. Dept of Insurance on the bottom, to file complaint with them Then I got a complaint form from UHC hoping I'd go for a Civil case. I am a recovering alcoholic of 18 months as of yesterday.
Before my boss switched Ins. Co.'s, all was well and covered.After getting out of 6 days inpatient detox and 12 weeks (3hrs a day 4 days a week). My Psychopharmacolagist prescribed me an injection called Vivitrol. It blocks the receptors in my brain, thus elimination the alcoholic cravings and if I were to "back slide" and drink I would feel NO affect from the alcohol. Aetna (old ins. co.) covered on it the 1st prescription my Dr. wrote. Within 3 days the effects shocked me. I DID NOT crave alcohol for the first time in YEARS (I was drinking a fifth a DAY)! Then my boss switched to UHC.
When I went to pick up my monthy Vivitrol to get my injection, I was informed that I need to pay my FULL $1500.00 deductible to receive 1 injection (The drugs cost through Alcomeirs(sp) Co. (that makes the drug ) is $885.00. In my pamphlet from UHC it states "injections need to be administered by a Physician is excluded EXCEPT for DeproProvera, a form of birth control that is placed under the skin and left there. My Vivitrol is a simple injection. THEN in the same paragraph it state "this EXCLUDES pharmaceuticals that can be obtained by Dr.'s prescription and picked up at a pharmacy.
"Well, my Psychopharmacologist Prescribed it 18 months ago,he write my monthly prescriptions and I pick them up at CVS Pharmacy. SO... Contradiction of statements in the same paragraph. Question to all... would you rather ride around with a pregnant person,or someone that's DRUNK?? And if this drug can prevent that, it's got my vote!
If I as a single 53yr. old w/ no children or family, HAD $1500.00 to spare, I WOULD get my medication and deal with the rest later. It's just UHC's runaround tactics are total BS. And hopefully if nothing else (there is a class action suit just for this exact tactic) Texas Department of Insurance will look into this matter. Thanks for listening, sorry I wasn't clearer earlier. Just SO frustrated!! Happy Labor Day all!!
TENNESSEE -- I am a in network provider for United Healthcare, for now. UHC goes out of their way to avoid payment to providers by demanding clinical notes and records with no reason at all but to put up clerical roadblocks. I received denials asking for the patient notes because "information on the claim submitted is either missing, not legible or incorrect". When I called and asked what information is missing or wrong they can not answer. When the reason for requesting the notes for a patient is invalid, why are the notes still required for payment to be made? They also ask for Clinical Submissions to be sent in to ACN Group (owned and operated by United Healthcare) for approval.
Sometimes it is required and sometimes not. However on my last 6 UHC patients who did not require Clinical Submission, all of the claims for these patients were denied because clinical submission was required. When I called to find where the problem is, they apologize and state they made a mistake (actually dozens) and resubmit the claims only for me to receive denials again for the same reason.
Finally I found that Clinical Submission was required for all 6 patients and now are refusing to pay because of their error. I have many UHC patients that will be effected by me getting out of network but I refuse to continue to do business with such an unethical company and am filing a complaint against UHC with the Insurance commission in Tennessee.
I sincerely hope all providers who are in network with UHC does the same if for no other reason but to make them answer for their behavior. PLEASE, if you have an option for which Insurance provider you use, chose ANYONE but United Healthcare. Don't make your Doctor go through what I have. You and your provider deserve better!
MISSOURI -- Good Day. In light of recent coverage in the media regarding healthcare and insurance companies, I thought our situation may be of some interest. Mostly, as a concerned parent, and registered nurse, I think it is important that all consumers be aware that an insurance company does not have to provide standard of care for its subscribers. I considered myself fairly knowledgeable, yet we are still facing a less than expected outcome for our daughter.
Our 9-year old daughter, **, has moderate cerebral palsy. She is lively, fun, and most of the time, does not believe that she is different from anyone else. ** is ambulatory and has been relatively healthy. She enjoys activities that her peers do, including dancing, PE, gymnastics, and swimming. We are so blessed to have her in our lives. Like many children with ambulatory spastic diplegia, **'s tightening of her leg muscles began to affect the growth of her bones. Without proper surgical intervention, ** may very well have lost the ability to walk and run in her future.
After much consideration, we consented to our surgeon's proposed solution: bilateral femoral osteotomy. In English: both of **'s thigh bones would be broken in two, repositioned, plated/screwed back together, and muscles manipulated. The goal of this surgery is to improve positioning of a person's muscles and legs to improve gait and promote healthy bone maturation.
Since this surgery is standard medical care for the external rotation of **'s legs, we did not anticipate any difficulties with our insurance coverage. Our physician office notified United Health Care of the intended surgical plans. I, too, called to verify coverage and notify them of the plans. We received, in writing, that UHC was aware of the surgery and it was a covered benefit for **.
Olivia had surgery March 30, 2007 at St. John's. She did well post-operatively. She left the hospital as planned and went home to recuperate. Physical Therapy Rehabilitation is critical to the success of this procedure. We began as prescribed. ** made wonderful progress... working really hard!
The trouble began when UHC's policy said ** could only have 20 PT visits; she really needed more like 80 visits. Other folks have had similar situations, and with the proper documentation, exceptions have been made. (I personally know a child who had the same surgery, also has UHC with the same contracted 20 PT visits per year, but was given 100 for the first year, and able to increase if needed!)
Olivia should have been going to PT 3 times per week, intensively, and been finished with rehab in 6 months. She did her home program faithfully and we thought all was going to turn out well. But United Health Care denied our request for review-- FOUR TIMES. Sending the same form letter repeatedly. **'s physician and his staff attempted to call, asking for "peer review" of the case, as we were advised to do by an UHC employee. They were put on hold for hours at a time, as was I. No answer other than the form letter was ever provided. Our physician was not allowed to speak with another physician regarding the standard of care for this procedure.
Healthcare really does need reform. Admittedly, so many folks have abused the system, especially concerning out-patient therapies. As a nurse, I have witnessed this first hand. Often, **'s diagnosis of cerebral palsy sets off alarm bells. We were not expecting her to receive care that was above and beyond what was needed to make her as strong as she was before surgery. But since we had to private pay for physical therapy, even with financial assistance from St. John's, she did not receive what she needed. She is still in rehab, we are still private paying for her care the best that we can, and she is not back to her pre-surgical abilities.
As I face the prospect of her potential future, I am afraid. She will need surgery in the near future to remove the hardware placed during her March surgery. Will she ever regain her strength? We cannot afford (financially and otherwise) to let ** down. She is a remarkable girl, full of spirit and ambition. She dreams of being a pediatrician that helps other children with cerebral palsy. To be frank: ** was treated unfairly, perhaps even discriminated against because of her medical condition. Parents, and consumers need to be aware that insurance companies are not required to provide the standard of care. **
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.
MARYLAND -- To start off, I've had terrible experiences with United Healthcare since I started their coverage a few years ago. It's come to a head recently after a coordination of benefits issue meant that they paid a hospital bill for my husband and then retracted the payment from the hospital. TWICE. Now the hospital, of course, is coming after us for the 6,000+ bill.
I have called and emailed countless times over the past 2 months. I've sent emails. I managed to get direct lines to 2 different people and have been leaving voicemail after voicemail, which has been ignored. I've sent the paperwork and letter from the other insurance company verifying the coverage dates and confirming that United is responsible for the bill. Nothing. And the hospital is threatening to sue us now b/c it has gone on for so long.
Finally, today, I left a nasty review on their FB page. I didn't really have much hope for this other than maybe warning others to try to find different health insurance. Not 10 minutes after I left the review, a member of their social media team contacted me. He got all of the information on the problem and filed an escalated ticket to get it handled quickly. AND he called the hospital and they've placed a 30-day hold on the account, with no collection activities, to give United time to deal with the coordination issue. So, what can I say? Um, the rest of United is TERRIBLE but their social media department is great, so far anyway.
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!
PENNSYLVANIA -- I have already written to the CEO of UnitedHealthcare so I will be brief. This company has been stupendously inept. Here is a summary of their excuses for not paying...
Each correction to their process takes an entire billing cycle - hence 10 months have elapsed with still no resolution. The hospital has lost patience and started debt collection proceedings against me. UHC assured me they would expedite a "Cease to Bill" letter - I have had to ask twice and still no letter after more than 2 weeks. I have noted everything so next I will be taking my evidence to the Ombudsman.