CHARLOTTE, NORTH CAROLINA -- First, let me start with the fact that the customer service group was always very friendly and understanding. This was not the problem. The problem is that I had shoulder surgery in June 2018. It is currently March of 2019 and I am still fighting with them to pay bills from June/July of last year. As a matter of fact, the anesthesiologist was just paid last week!! I have these bills hitting my credit report now. I get a different explanation from each person I speak with, as to why the bills haven't been paid yet. They always blame the provider. They also refuse to let me speak with their management.
The doctor was very clear with them before the surgery that more PT would be required than what my plan covers. They agreed. In the end, my approved PT visits ran out. We knew this would happen and the provider had to send in for prior authorization. I received an approval letter for 12 extra visits. I went to three of the visits. My provider then tells me the claims are being denied. I called UHC immediately. They said, "Oh we approved for you to go to more visits, but we never did not say that we would pay for them". I lost it.
I explained that I didn't need their approval to go anywhere! I only need their approval to pay the claim. It has been nonsense from day one. I am also a Type 1 diabetic. It is a constant fight to get the supplies that are required for me to live. I ended up having to pay for these visits out of pocket. I just feel that it is criminal! There are many people who have no idea how to fight these things and they just pay bills as they come in. If I had paid for what they said I should have, it would have been close to $10,000 after I had already met my out of pocket maximum of $4,000. How many people are paying for medical expenses that they shouldn't??? And why on earth should they be able to tell my doctor what he is allowed to prescribe???
I have been handling my own medical issues and insurance for more than 20 years. I am a T1D as I stated before. My son sees a couple of specialist as well. I have had several different group insurance plans with BCBS, UHC, Aetna, and Cigna. I have NEVER experienced such a complete mess in my life, as I have with UHC. According to my Orthopedist, they even cringe when they see that a patient has UHC coverage, if they need anything out of the scope of a standard visit. It is such a sad thing. Thank you for allowing me to vent.
PHOENIX, ARIZONA -- Worst health insurance company ever. They force me to live a horrible life of pain and agony simply because they won't approve the artificial disc replacement surgery my team of specialists say I need. I live a life of narcotic pain killers, nerve ablations, lots of painful and damaging epidurals and they continually deny me. They should not have a choice or say in what quality of life I am forced to live. My family suffers from my situation. They have denied the surgery I need to restore my life, for 2 years now. I guess I need to sue them in federal court. Shame on you UHC.
MINNEAPOLIS, MINNESOTA -- To start this, I have an HMO plan. So I expect to jump through a few hoops to get coverage on what I need. This being said, this has been the most backwards healthcare I've experienced. Expect to call their customer service department every other day to make sure your procedure approval isn't dropped or on hold. I was told they have received my lab results and the approval process is pending and it will take 10 days to process only to call back the next week and learn that those lab results are not in their system and that they have not received them at all.
The nurses from my healthcare provider have said they've never had any other issues with this procedure from any other insurance provider. This is the third terrible experience I've had with them in a few short months. I cannot put any more emphasis on how mismanaged and unorganized United Healthcare is. I will be moving to my wife's insurance no matter how expensive it is.
SUNNYVALE, CALIFORNIA -- It is simply outrageous that regulators have done nothing to reprimand this firm. They deliberately have their customer service representative make you circle around yourself for years until you give up. They put you on hold for an hour at a time, hang up, and when they finally admit they have no in network providers because half of the list is bad phone #'s and the other half are full or have a specialization that doesn't apply to your condition, they bluntly deny the service. When you insist on gap exception, years have passed and 99% of population gives up and pays out of pocket.
This is a strategy that I have seen repeatedly. Reporting them will likely yield you nothing because regulators have befriended this big powerful company. They look the other way and pretend they don't see any of this. The delaying and denying while they pocket billions. Where is justice? Cathy **, sr manager hung up on me. Jolene ** used me to get promoted. Gave me a bone and then said "sorry for your circumstances. Pam ** is the most evil, ill willed person I have ever known. She is another senior manager who discriminated, harassed me and went as far as accusing me of fraudulently producing bills.
My daughter has seizures, and the original medicine she was prescribed (which UHC covered) caused bad side effects. She would turn into a different person for the first couple hours after taking her medicine. She was almost manic! As the medicine wore off each day she became depressed and mopey. Her school work was also suffering, and the teachers were asking us if there was a problem. She had previously been a good student and all the teachers loved having her in the class. This was at a low dose of the medicine, as the doctors were ramping her up to the normal dose for a child her size.
After discussing with the neurologist, he then prescribed a new medicine. The new medicine was the same as the old, except it was time release. With the new medicine she has gone back to her old self, and doesn't experience wild mood swings. Unfortunately, UHC will not cover the time release medicine. Because the time release medicine contains the same ingredients as the cheaper first medicine, they will only cover that medicine. We have appealed, with doctors and teachers writing letters to describe the side effects of the first medicine. None of this matters to UHC.
We will continue to pay the $650/month for the time release version. We are lucky enough to be able to afford this. However, I feel for those in the same situation who are being denied and can't afford it. We probably would take her off the medicine completely and risk further seizures if it meant going back to the first medicine. Prior to this happening, UHC denied my cholesterol medication. This medication had previously been allowed by Humana before my company switched providers. My specialist told me I was better taking an over the counter version instead of the medication UHC would cover.
However, he recommended I continue to take the non allowed medication. I did continue to take this medication until we had the issue with my daughter not being covered. At that point paying the monthly amounts for both was not an option, so I have discontinued the cholesterol medication. UHC has a well-earned reputation for not covering medical necessities. They offer lower premiums to companies, and then make up the profits by not covering items the doctors feel are important.
ARIZONA -- Prior to retirement I was bombarded weekly by printed material by AARP advertising United Health Care. Since I knew I was moving from TX to AZ at the end of 2015 I signed up with UHC in October so I could start getting coverage from Jan 2016 when I started living in AZ. I contacted UHC and they gave me the name of a GP physician I could see. I saw that person for a diabetic checkup Jan 18, 2016 and was told they did not accept UHC insurance after UHC indicated he did. I incurred a bill of $247.
Month after month I contacted UHC trying to get them to pay the bill only to learn I had NO coverage since Jan 1 due to a mistake the person at UHC made when they completed my enrollment. It was after April before they recognized their error and made my coverage retroactive. In the meantime I settled with Honor Health Scottsdale for $197 and paid it myself given verbal assurances from UHC they would pay.
It is now July 10, 2017 and still no payment! In Nov 2017 my coverage was made retroactive to Jan 1, 2017 and I go back and forth with customer service. First I had to fill out a written claim and send it to one P.O. Box in Utah. I did that--no response. Then someone else at UHC said I had to sent it to a P.O. Box in CA. I did that too--no response and also no way to contact anyone by phone at their claims office. Then I was told I had to contact LifePrint since they paid out claims. I did that and they said, no, they don't do that and I had to contact UHC again. I did that and got a new case ID.
Then they said it was sent to the wrong group. I called again and they said it went to the correct medical group. Now I hear that they need more information. This is totally insane. The company is so big and nobody has the power to resolve claims quickly. After 18 months this has become almost laughable if it was not sad. AARP should drop UHC completely. I am 70 years old and do not know if I will outlive this claim at the rate things are going!
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 firstname.lastname@example.org) 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.
MINNETONKA, MINNESOTA -- I just read an article that says, “Hospital executives rank United Healthcare as the worst insurance company in the United States.” (It is available here: www.allbusiness.com/health-care/health-care-facilities). This will come as no surprise to many members and providers alike. Like many others, I want to share my recent experience with United Health Care so that people can decide for themselves whether or not this is the kind of health insurance they feel they want to purchase for their families.
I am a neuropsychologist and was asked to see a UHC member for neuropsychological testing. I filled out all of the appropriate forms required by United Healthcare and received a telephone call authorizing me to test their member. They gave me a cap on the hours (13 hours total) and an authorization number. I provided the services as promised and then sent the appropriate claim to the United Healthcare offices.
When they sent me the check, there was a note on the Explanation of Benefits saying I had agreed to a discounted fee (an approximately 50% discount, mind you) through an organization called MultiPlan (If you haven't heard of them, you're in for a treat. They contract with insurance companies to try to persuade clinicians to agree to a reduced fee and they get paid a percentage of what they "save" the insurance company.) Needless to say, I do not and never will have an agreement with this company, as I do not support business practices such as this.
When I contacted United Healthcare to straighten this out, they told me I had to deal with MultiPlan. Multiplan never answers their phone (I wonder why) so I got nowhere until I filed a complaint with the Better Business Bureau. This got the attention of **, a Consumer Affairs Advocate for UHC (1-800-842-2656). She researched this issue and came up with a fabulous solution!
She decided that United Healthcare had authorized this treatment in error and paid me in error AFTER I HAD RENDERED THE AUTHORIZED TREATMENT to their member. They then "recalculated" the claim form and decided that I actually owe THEM money! They have asked for the entire amount back ($966.68). They have a very fancy way of explaining their "logic" and have added that the original error was with their processor and they have arranged for her "to receive additional training or other intervention as appropriate."
With a second patient, they attempted to get me to accept a reduced fee through MultiPlan for another member and I declined. After that, they refused to pay me AT ALL for the services I provided to the other member while he was in the hospital. United Healthcare also authorized these services and the correct authorization number was submitted with the claims.
In both cases the services were requested by a physician and approved by United Healthcare. The services were rendered as authorized and the appropriate claims were filed. Unfortunately – and this really is the sad part – both of these claims will have to be paid in full by the members. These claims total thousands of dollars.
As I'm sure many of you know, United Healthcare is the focus of a Class Action Lawsuit in New York because of their questionable business practices. When I Googled “United Health Care reviews,” I was SHOCKED at the number of complaints against this company. How is it that they are getting away with this kind of behavior?
SALT LAKE CITY, UTAH -- If you can find anyone else to get your insurance through, do it! I have them through my workplace and they are TERRIBLE! I have never had an insurance company make you jump through so many hoops to maintain coverage. Every time I turn around I have to verify that I don't have any other insurance coverage. Now I have to send in a marriage certificate, copies of tax forms, "proof of ownership", and birth certificates just to prove to them that I have dependents. What the ** do they think I am paying them for? If I didn't have dependents, I wouldn't be paying their inflated rates!
If you have a claim, then it gets worse. They deny everything and then make you do all the work to try to get them to approve it afterwards. They will never contact you first regarding any information. No wonder they had to refund money because they made too much profit. They make their profit by failing to pay out for coverage you pay them for.