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Humana Complaints & Reviews - Stay away from Humana!

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Humana

Posted:    Diane Garton

Stay away from Humana!

Complaint Rating:  87 % with 38 votes
I had humana insurance and had to have a c-section to deliver my baby. Humana said in their contract they will pay if it was life threating. All of the paperwork had been submitted and the claims had still been denied. Their excuse was were do not have the right documentation to process this claim. I went to the doctors office and hospital made copies of the file and over nighted them to their office. Still nothing has come from it. I have filed a complaint with the insurance commission and have also spoken to an attorney. Stay away from humana. They look for every reason not to pay.
Comments United States Health & Life Insurance
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 29th of Oct, 2007 by   Keith in Chicago 0 Votes
I agree with you that Humana will look for every reason not to pay. I have a group plan with a high deductible ($2,500.00). I met my deductible for the year (2007), and now Humana is denying most of my claims. They are refusing to cover a $6,207.00 surgery that I had done in September. I have contacted a legal council and the Illinois department of insurance.

Hood luck to you.

To anyone reading this: stay away from Humana if you possibly can!
 10th of Jan, 2008 by   Patrick Palmer 0 Votes
Humana is terrible. I had prescription coverage for a year and a half. When I finally got a prescription they cancelled my coverage saying I had moved. Have been in the same house for 3 years. What a a lie and lame excuse to avoid a $100 payment.

My sister use to work in BP Human Resources and said they had all sorts of problems with Humana. She said they were absolutely the worst. Too bad I didn't know that before I signed up.

My advice: STAY AWAY FROM HUMANA !!
 24th of Apr, 2008 by   Stephanie 0 Votes
Humana IS horrible. I work for a provider, and let me tell you, I have dealt with one issue for over a year. The same issue. Most of their phone reps. are rude and each one tells you something different. It's an absolute nightmare. I have NEVER in my life seen such an awful insurance company.
 23rd of May, 2008 by   John M Evans 0 Votes
I subscribed to Humana Part D Medicare Prescription Drug Coverage on 01/01/08. On my application I disclosed all the medication s which I take. Two of them are generics and are very cheap, one is a formulary treatment for type 2 diabetes which, according to their web-site and Medicare, Humana is supposed to cover.


After I refilled the prescription for the first time, I received a letter stating that coverage was being denied and that they would no longer pay for this medication. Their reasoning ws that they did not have a record of a doctor's authorization for this med. My doctor promptly faxed them their form, showing that he had indeed prescribed this treatment. Another denial letter followed with the same reasoning, stating that I was taking more than the prescrbed dosage. Their little phone person said that their records indicated that I was taking 2.4 prescriptions per month, while the prescribed dosage was one per month. They didn't even know that 2.4 is the monthly dosage in Milliliters and when administered in 10 microgram doses, the 2.4 ml lasts 30 days. The last straw was when I appealed to Medicare and they said that Humana should be covering this drug and forthwith filed a complaint on my behalf. Humana responded that their pharmacy review committee had decided that I should not be taking this medication and thus they were again denying my claim. Thank God I can afford this medicine on my own, since they have moved from insurance to primary care provider and their pharmacists can override my personal physician's prescriptions. Anyone who wants good health insurance better stay away form Humana as they are running one monumental rip-off.
 24th of May, 2008 by   Davney 0 Votes
I too think that Humana is a horrible insurance company. The kids on the phone don't have a inch of training or education in the medical field and act like doctors. I agree that one says one thing and another will tell you something completely opposite. They try to wiggle out of paying claims and in the past Humana paid their workers bonuses to deny claims. I am having problems now that my doctor has lied and told me they carry Humana and Humana has told me they are out of network. But the doctor took my $25.00 co-pay. Some one is lying. I am finding doctors lying more and more to patients because of problems with insurance. How do you fight injustice. Doctors are problems too - they have to keep up that rich lifestyle - the Mercedes, McMansion, etc. So it's the insurance and the greedy docs.
 31st of Aug, 2008 by   Filip 0 Votes
i totally agree with you guys. i currently working with humana. though i handle elegibility and benefits inquiry. sometimes claims call are rerouted to us. 4 monthe working with this company and I clearly see some lapses and loopholes in the system. I can't blame you to hit on us CSR's of humana. But this people or let me say Humana outsourced their Call Center and telling you that they are from Kentucky. They have to say that, though it is obvious from the accent. Furthermore, there are lot of claims that was denied even for small reason. Imagine just a simple office visit was denied and when we pull up the reason code in our system it is just blank. I asked my self if this is intentional or Claims Specialist forgot to pay add the reason code. But how many of those simple claims that are not paid? A lot. Delaying claims is one thing that humana do best. It is not true that the company care for your health. Just one thing keep in you mind that Healthcare is business. If you can roll money and sacrifice members claims payment, Mccallister will become god of this industry. Evenshare of the profit to us CSR? We wish but for me...I hope this profits should be returned to the members. Or better yet, enhance our system to services out providers better. But I guess it is a remote possibility. I'm sorry if I give negative feedback. I am currently doing some research if only Humana recieves this kind of complaints. Looking for any lapses from Aetna and bluecross. Goodluck and Goodhealth from the Philippines, Humana CSR.
 19th of Jan, 2009 by   Pebbles1 0 Votes
Ok I not only agree with you on Humana being a bad Insurance Company but its also a very bad place to work. I also saw a complaint/advise blog on Adecco Employment Agency...I wish I knew what I was getting into before I agreed to give the temporary job a shot at Humana in West Chester, Ohio brand spankin new building and distrbution center nice inside and out but the employees carry ice picks in their back pockets. Its all true and I know from personal experience. This facility needs alot of help. From the management in every department to the people their bringing in there... all the company who is assisting with the hiring wants to do is put a warm body in a cubical. Adecco is working with other agencies to recruite people to fill Humana's needs, but the problem is they are firing Temps as fast as they are hiring them if they don't work fast enough this is a production company everyone it is about money also. You have to learn a computer system and how to run it in 2 wks, and be up to par in 3wks to 4wks if not your history ...OH did I mention most of us could'nt log into our computers for 2 to 3 weeks because our logins did'nt work. When my group of Temps started we did'nt even know what department we were going to be in they did'nt figure it out for us until 3 wks into this job. 1st it was Item Entry then it was Dr. Call oh it might be Order Entry or Patient Services we got taught a little of all of it because they could'nt make up their minds, and the worst part is the people training us did'nt even know some of the things that we were being trained on. One trainer spent so much time on her cell phone texting and on her computer using her Lotus Notes IM it was insane. Call it the blind leading the blind...wounderful...great for business... so I can understand all those fustrated people out there..! After I ended up in my department it was horriable ...Payton Place, and being referred to as Temp Island by regular Humana Employees was really bad and degrading, we were included in things but there was an attitude or a presence like a code between everyone we are Temps and thats it. Certain things were not taught to us as they were with regular employees that were brought into Humana with us, but they expected us to perform the same duties and functions as a quote ...Temp. I have in the last few weeks watched the management terminate several individuals from my group I came in with I have recently spoken with several of them and funny thing is...they wer'nt happy either. I have watched before I left several FLL's and SME's working with the Temporary employees, and they already have their favorites. I personally called my agency and asked to be removed from the job I did not like the attitudes of Supervisors or FLL's and in some departments they have SME's that help coworkers and they chose who to help and who not to help. I have never been into clicks much and in a work place its worse and since MEDCO has been closing across the street from Humana in West Chester alot of the peole who worked there went to Humana and guess who they are Management, FLL's and the SME's and a few newly promoted SME's um very interesting uh. They have been saying there is career advancement in this company um well I think it will run out soon because it was filling up fast with all the new promotions I heard and saw people getting in various departments oh and most of the people won't be going anywhere anytime soon they are in their 2o's and 30's and most have'nt been there 3 months. For the company and everyone I spoke with like the training people and some FLL's and they all sware Humana gets it...Funny you would'nt know it from my fellow Temps end or mine. I think its sad for a company just getting started in a brand spankin new building and distrbution center to have such a bunch of crap going on if they can't get it together inside ...no wonder the customers on the outside won't be happy...!. ITS NOT ROCKET SCIENCE HUMANA! So the best advise I can give from personal experience is STAY AWAY FROM HUMANA INSURANCE ... STAY AWAY FROM HUMANA EMPLOYMENT...! DEFINANTLY STAY AWAY FROM ADECCO EMPLOYMENT AGENCY THEY DON'T GIVE A CAP ABOUT YOU AND NEITHER DOES HUMANA.
 6th of May, 2009 by   charity 0 Votes
i work for humana for over 9 months already. I handle eligibility, benefits and commercial claims. well, it is true that they are denying the claim WITHOUT a reason at all. This is business. And our Claims Processor have a quota to deny a claim for a day like about 100. So that they will call every now and then, the customer service will assist them. And A business wherein they profit that whenever providers don't call us back for the status of their claims, the money will go to them directly. Contrary from this Some of the Claims Rework Unit especially from Cubao don't have a KNOWLEDGE. they just check but don't READ nor UNDERSTAND.
-may2009 charity
 28th of May, 2009 by   *Live* 0 Votes
It is very sad to even read these comments because to think when people pay so much money a month they would be able to get some maybe even a little comfort in knowing that they are covered - but they are NOT. I was working PT and enlisted with Humana just so I could have basic coverage for check up, yearly whatevers, and so on. Little did I know that 4 months later I had a ruptured cysts on my ovary and had to have emergency surgery. With all the emotional stress from surgery I wouldve never thought that my insurance would ruin everything on top of that. First off, they refused my ultrasound on my ovaries stating that is wasn't a medical emergency - even thought he doctor stated to them on the phone, that it was imperative to have. Nope - DENIED. So after I do my part and pay my god-awful $2500.00 deposit ( not inlcluding the 120.00/month) when the surgery was over, all the bills started rolling in - and guess who wasn't covering them, our good ole friends Humana. After I called they said my account was under review and they were waiting on medical records - PEOPLE my surgery was in November 2008 - I am still under review after the fact that I had to call the doctors office myself and give them humanas contact number to fax the medical records - then when all those were sent in - they asked for more medical records...Just got off the phone with them now - same ole crap, they are awful - u are better off not having insurance and just filing bankruptcy if something happens...bc they could care less...You have to do the job yourself otherwise they will forget who you are right when you hang up the phone - be assertive and demand and keep up with whats going on cause they will tell u anything just to get u off the phone...I am sorry for all those out there suffering under them - I am in the same boat...Good Luck to you all...
 6th of Sep, 2009 by   HelplessinFlorda 0 Votes
I have HUMANA ONE & I'm thinking of cancelling it and going back to being uninsured.
I don't like that they debit my checking account monthly & refuse to send a bill...and for my birthday ...HAPPY BIRTHDAY! Your premium just went up 30%...

I do NOT have any peace of mind having HUMANA ONE & I do not feel like I'm insured.
I pray to GOD I don't get sick & have to use this insurance.

The $240/month & $5200 deductable is unaffordable... plus... they put a permanent exclusion rider on my insurance plan ...because 7 years ago I had a preventive proceedure that is highly recommended for everyone after age 50.

I tried to appeal the permanent exclusion rider...and spent hours getting medical records & articles off the web to prove why procedure can prevents cancer 99% of the time...Appeal DENIED!

I shopped around a lot & did lots of research...and for a HSA, HUMANA Is the most affordable compared to other companies out there. I'm afraid if I cancel, aa a new insurance policy with another inssurance company...or HUMANA mayl have a $10, 000 deuctable with a 20% copay up to $15, 000...for the same premium...What do you do?

The problem with all these insurance companies...GREED!
Providers are GREEDY & Pharmacuitcal companies are GREEDY Too!

PLEASE President Obama PLEASE make s Healthcare NON-PROFIT...so that Americans can get reasonably priced healthcare without using these GREEDY insurance companies!

We need an consumer agency to monitor & AUDIT all health insurance companies & claims...All fees for provider services should be transparent...not some secret surprise whn you get the bill!
We need an Government agency to STOP insurance companies from RIPPING PEOPLE OFF!

Will they let you die if you don''t have millions of $$$$+ for medical care & Insurance?Probably!

So many people are homeless because of health related problems that lead to foreclosures & bancruptucy! Millions of other are UNINSURED becuase ipremiums are unaffordbale and coverage is questionable...

Humana & all other insurance companies spend millions of $$$ on TV advertising & marketing to attract more policy holders... and they compensate the CEO's of these companies EXCESSIVELY with million dollar compensation plans! American's are picking up the tab!

OBAMA PLEASE stop these companies from ripping people off !
PLEASE& fix this broken Healthcare system so we can have some peace of mind!
Every US Taxpayer should have the right to affordable medical care. Illegal aliens...please get care your healthcare from your country of birth...Sorry we cannot pick up your tab on this one..

The Baby Boomers, are at high risk. They pay high premiums & have high deductables...They are not old enough for Medicare...and not young enough to compete for those $7.35 hour jobs with no health benefits!

If anyone knows a solution...please let me know ASAP...
GOD BLESS...Hope we all stay healthy until there is some healthcare reform
 28th of Dec, 2009 by   i give a damn 0 Votes
the problem is simply greed. the insurance, drug and doctors lobby's spend millions to line the pockets of the law makers in washington. the same group spend millions advertising against reform and advertising to sell new products. all the while the ceo's and law makers make hugh salaries and have excellent health care but deny even adequate affordable care to us common folk. the current health care reform movement is a joke. why cant these assholes fix medicare and va care first and do it right. we dont need another bloated mismanaged care group. ALL THEY WOULD HAVE TO DO IS TAKE THE SWISS HEALTH CARE SYSTEM AND COPY IT. THAT WOULD BE BETTER THAN WHAT EXIST NOW AND WHAT THEY WILL CREATE FOR THE FUTURE. also i would recommend that we vote out, impeach, tar and feather, sue and arrest all the current law makers, drug/insurance lobbyist, ceo's and any one else who has contributed to this current debacle. a friend just committed suicide because at the age of 52 he needed either a liver graft or transplant. he was on disability and medicare. poor and trapped. medicare over the last several years has repeatedly refused to pay for this operation all the while my friends health declined. he fought them but got no where. finally he just gave up and christmas week he took his life. my only complaint is he didnt do it on the steps of his local governors mansion or the steps of the medicare building. and call the news groups just before his last breath.
 1st of Mar, 2010 by   twister777 0 Votes
I was switched to Humana by Medicare this year against my will. I called them back and told them I was happy with the company I had and did not want to change. They informed me that I could pay and extra $1.88 per month and taty with the company I had, and I said "Ok". About a month later I got a letter from CMS that said my "request to change companies had been denied because the enrollment period was over)-- to my OLD company - could not be granted because they were no longer certified by Medicare. I looked it up, and they are still listed for my area.
Anyway, they went ahead and changed me to Humana. I was surprised becaue Pres. Obama had gotten into a tiff with them last summer.
First thing out of the box: no refills on label medications (I take several for which there are NO generics). No recommendations on what they WOULD pay for, just a "friendly heads-up to see my doctor and get something else."
Next, they are beginning to deny even some generic medications as "over-cost". They suggest foreign-made generics, mostly (according to my pharmacist) made in Mexico or China, one in Africa, for God's sake!
I smell a rat! First Obama was mad at them, then there are press reports of "backroom deals" with insurance companies, then everyone is getting "nudged" over into the very company he had a fight with?
And then they begin to deny coverage? (well, according to you guys, THAT isn't anything new) Lots of folks here in Oklahoma are having this done to us, and the doctors are fed up with Humana as well. But it's not just Humana with them. My doctor's office manager says she doesn't know what happened, but everything seemed to changed about January 3, 2010.
 30th of Mar, 2010 by   E.Fletcher 0 Votes
I agree humana is full of it. i am a 70 yr old female with limit income that suffer with high blood presser. My blood presser was 210 my daughter rush me to the nearest unguent care clinic. they refuse to pay, because it wasn't a hospital emergency room and i was out of my coverage area and didn't have a referred.
 12th of Apr, 2010 by   Catherine Ratliff 0 Votes
I agree that Humana is horrible. They made a lot of money last year profits way up. How do the do this? By handling cases like they are now handling my Humana Medcare Advantage case. I am scheduled for back surgery tomorrow, and Humana called my surgeon to say it can't be tomorrow, they have to have their nurse look at my case and decide if I need the surgery. Meanwhile, I have no ankle pushoff, I have a spreading area of numbness, dead spots on the plantar surface of my foot. Pain, weakness, cold areas, spasm. All the people lined up to drive me, stay overnight, have to be told that surgery is delayed; they changed their schedules for me, I got deadline extensions on briefing schedules. I am so angry that Humana is interfering with my need for treatment, disagreeing with the professional opinion of my neurosurgeon.
 24th of Feb, 2011 by   PISSEDOFFMANAGER 0 Votes
I AGREE AS WELL. FOR THE PAST FEW YEARS I HAVE BEEN TRYING TO GET PAID ON CLAIMS THAT THEY DECIDED TO "AUDIT" WHICH IS NO PROBLEM. WE HAVE ALL THE DOCUMENTATION TO PROVE THAT ALL SERVICES WERE INDEED RENDERED. HOWEVER THEY ALWAYS SAY THEY DONT RECIEVE OUR CLAIM INFO WHEN I HAVE FAXED & MAILED ALL DOCUMENTS MORE THAN ONCE. SOME CAME BACK PARTIALLY PAID, BUT WE RECIEVED NO PAYMENTS FOR THE OFFICE VISIT. HOW CAN THEY PAY ON SURGERY AND NOT THE OFFICE VISIT????? THE PATIENT HAD TO OF COME IN FOR THE SURGERY RIGHT??? DUHHHHHHH!!! THIS IS TYPICAL INSURANCE B.S. THEY FLIP FLOP ON THEIR DECISIONS DAILY EVEN THOUGH ALL CLAIMS GET SENT OUT THE SAME WAY ON A REGULAR BASIS. W.T.F. IT IS A CONSTANT STRUGGLE TO GET MONEY THAT IS WELL DESERVED... ON TOP OF THAT, ITS A BATTLE TO JUST GET PATIENTS TO PAY DEDUCTIBLE AMOUNTS, EVEN A LITTLE COPAY. I GUESS WE SHOULD WORK FOR FREE. NOTTTTT!!!
 3rd of Mar, 2011 by   TLH - Anonymous 0 Votes
I worked at Humana in Louisville Ky, the downtown office that has all of the CSR's (the Americans anyway) and houses most of the "big-wigs". There is such an elitest attitude there among the management! They work their poor employees to death, it's no wonder your CSR has no idea what's going on, because Humana doesn't train anyone just throws them on a phone and tells them NEVER to route anyone to a Supervisor, if that CSR can't get you off the phone that CSR gets in trouble and wrote up/fired! That's why you get dropped calls and put on hold forever, they WANT you to hang up because when the Supervisor has to talk to, you'll definitely know that he/she has no idea what your problem is about and doesn't want to deal with it. And if you get to talk to a "Supervisor" I bet it's just that CSR's friend across the aisle they handed the phone to, trust me. *****I joined in 2005 when the Part D plan rolled out and no one had any clue on how to interpret the CMS guidelines, it was a mess. If you want to disenroll from your plan, it has to be during a certain "Window" that CMS has allowed you to get off your Medicare Advantage plan - that window is from 11/15/11 - 12/31/11 (or whatever year it is) and if you call on 12/01/11 to disenroll, your request is routed to CUBA! Yes, Cuba! It was called the "Retention" department, they were to call you back and ask why you wanted to disenroll and talk you into NOT getting off the plan. Well the CSR's in Cuba were so overloaded with disenrollment requests (imagine that?) that they were not getting to requests for weeks or months...so if you called to disenroll on 12/01/11 and Cuba didn't get to you until 01/05/12 then you couldn't disenroll that year!!! They did it on purpose! And then people started catching on - Humana was served with papers from the government BANNING them from selling ANY Medicare Advantage plans for all of 2007 (maybe 2008?). Profits plummeted...they lost the Part D contract in California (HUGE money loss)...more plummeting...employees were given no raises for 2 years. I was even called by a lawyer asking for my input on how Humana was able to screw so many people! That was after I left though, so I told him all kinds of good stuff, what a joke Humana is. There are good people there too, like any shady company, but they're often abused and taken for granted and made a scape goat, just like anywhere else. If you have no choice but to deal with Humana, please try and get yourself a case worker through them. The case management people are often very helpful, kind of like a social worker, and try to get you the best resolution but even they are stymied by the big money machine that gobbles up your monthly premiums. If you can't get through to anyone to help you, google Humana offices and just start calling random numbers, if you annoy enough people your issue will be dealt with.
 24th of May, 2011 by   amdphoto1 0 Votes
My mother-in-law was admitted to Christus Spohn Hospital in Corpus Christi, Texas on January 18, 2011 for kidney failure. I was referred by a case worker at Christus Spohn Hospital in Corpus Christi, Texas to a Humana representative on January 24, 2011. I asked the representative how Humana works and what our options were for caring for my mother-in-law on her health care plan. I explained that one option we were considering was moving her to St. Louis because she had no family in Corpus Christi, Texas and she needed to start dialysis as soon as possible. She indicated that she would need to get permission from the medical director, because of the urgent nature of her illness, to cover my mother-in-law if we moved her to St. Louis, Missouri because the coverage she had was for Texas. After receiving approval and telling me that we were good to go, she explained that I would have 90 days to select another program with Humana once we moved her to St. Louis. She facilitated getting a hospital bed, bedside toilet and wheel chair in St. Louis for my mother-in-law as well as told me the number to call to set up an appointment to select a different Humana plan in Missouri.
I contacted Humana at 866-205-0000 and spoke with a representative on February 11 and made an appointment with Humana Sales Representative on February 15, 2011 at my office. During my meeting, I asked the sales rep to explain my options under Humana. I also told the sales rep the entire story of my mother-in-law experiencing end-stage renal disease in Corpus Christi, and that we chose to bring her to Missouri after talking with the initial Humana representative in Texas so that she could receive care in St. Louis where her children reside. I told him that I was told by the initial Humana representative that I would be able to pick another plan in Missouri with Humana. He told me that switching policies was no problem and that since she was a Humana customer with end-stage renal disease she can switch to another plan. I proceeded to select a new plan and fill out of the enrollment form with Steve.
I learned on April 12, 2011 that my mother-in-law was cancelled from Humana. I later found out from Elizabeth V. on May 2, 2011 that there is an exception 2-20.2.2 #5 to the exception that if you are already in an advantage plan, you can stay in that plan or join another plan offered by the same company. She informed me that we could not move my mother-in-law to another state.
As you can imagine, I was completely outraged because your company representative told me that this was an option that was approved by Humana’s medical director when we were trying to determine the best possible care for my mother-in-law. No one, in their right mind, would move their loved one to a different state knowing that they would not have continued coverage. Humana has made an error. Their representatives did not give me the necessary or correct information in order for me to make an informed decision about the care for my mother-in-law. If your own representatives do not know the guidelines your company operates under, how are your customers supposed to be cared for? I did everything I was instructed to do from every Humana representative I spoke to. My mother-in-law’s coverage needs to be reinstated as of March 1, 2011 based on this misrepresentation. This is negligence on the Humana’s part and Elizabeth V. simply calling me and telling me sorry is not acceptable. I doubt this falls in line with your corporate social responsibility. This decision is devastating to my mother-in-law’s care.
 24th of Aug, 2011 by   ronald white 0 Votes
i had humana in ky. have been on home dialysis for four months, also am a diabetic with heart problems. moved to ga. to stay with relatives and was told i had to cancel ky. plan and would begin a new plan in ga. they mailed my books, my new card. i thought all was ok. when going to first drs. visit was told my new policy went into effect on 8-1-11 and was canceled on 8-1-11. now i cannot get dialysis medicine or anything else, don't know how long you can live with esrd without meds. humana keeps giving me the run around am afraid the stress will cause another heart attack!! can anyone help with my problem? i don't have much time.
 30th of Jan, 2012 by   Bright Newhouse 0 Votes
HUMANA is such a poorly run company I can not begin to explain. If this helps one person stay away from Humana than this is worth writing. We have recently retired and purchased health insurance through Humana. We have an HSA account which means we have a very high deductible. We set up a draft through our bank account. The first month no problem ... The second month however was another story as they drafted our bank account three times the amount of our first premium. They called us with an automated system telling us of the over drafted amount and would credit us back the amount. Well, a month later they still haven't taken out the premium so we called to straighten things out to find out find out our policy is almost lapsed and now owe 10 TIMES the amount due. We were put on hold for an hour to get things straightened out . Still no human to talk to ... We are canceling as they are quick to take our money but SLOW on customer service.
BKN -- I should have read the complaint below first before I bought!

March 3, 2011
I worked at Humana in Louisville Ky, the downtown office that has all of the CSR's (the Americans anyway) and houses most of the "big-wigs". There is such an elitest attitude there among the management! They work their poor employees to death, it's no wonder your CSR has no idea what's going on, because Humana doesn't train anyone just throws them on a phone and tells them NEVER to route anyone to a Supervisor, if that CSR can't get you off the phone that CSR gets in trouble and wrote up/fired! That's why you get dropped calls and put on hold forever, they WANT you to hang up because when the Supervisor has to talk to, you'll definitely know that he/she has no idea what your problem is about and doesn't want to deal with it. And if you get to talk to a "Supervisor" I bet it's just that CSR's friend across the aisle they handed the phone to, trust me. *****I joined in 2005 when the Part D plan rolled out and no one had any clue on how to interpret the CMS guidelines, it was a mess. If you want to disenroll from your plan, it has to be during a certain "Window" that CMS has allowed you to get off your Medicare Advantage plan - that window is from 11/15/11 - 12/31/11 (or whatever year it is) and if you call on 12/01/11 to disenroll, your request is routed to CUBA! Yes, Cuba! It was called the "Retention" department, they were to call you back and ask why you wanted to disenroll and talk you into NOT getting off the plan. Well the CSR's in Cuba were so overloaded with disenrollment requests (imagine that?) that they were not getting to requests for weeks or months...so if you called to disenroll on 12/01/11 and Cuba didn't get to you until 01/05/12 then you couldn't disenroll that year!!! They did it on purpose! And then people started catching on - Humana was served with papers from the government BANNING them from selling ANY Medicare Advantage plans for all of 2007 (maybe 2008?). Profits plummeted...they lost the Part D contract in California (HUGE money loss)...more plummeting...employees were given no raises for 2 years. I was even called by a lawyer asking for my input on how Humana was able to screw so many people! That was after I left though, so I told him all kinds of good stuff, what a joke Humana is. There are good people there too, like any shady company, but they're often abused and taken for granted and made a scape goat, just like anywhere else. If you have no choice but to deal with Humana, please try and get yourself a case worker through them. The case management people are often very helpful, kind of like a social worker, and try to get you the best resolution but even they are stymied by the big money machine that gobbles up your monthly premiums. If you can't get through to anyone to help you, google Humana offices and just start calling random numbers, if you annoy enough people your issue will be dealt with.
 1st of Aug, 2014 by   Trish55410 0 Votes
I work in the billing office of a medical provider. Humana has outsourced their call center to the Philipines. The representatives barely speak English, and have not the slightest inkling of the workings of the nightmare known as the American medical system. They have no ability to help you if a claim denied, nor can they transfer you to an on-shore representative. In other words, if your claim denied in error, you're screwed. No one at Humana will take responsibiliy for anything.

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