Health Net of California
reviews and complaints

Coordination of Benefits problem I enrolled my spouse, *** on my *** is also enrolled in University of *** school Health insurance plan under ***. Her student insurance plan is a GROUP insurance plan which is a discounted health insurance plan. As per law, group insurance is always SECONDARY and well document in *** also contacted *** and confirmed that *** is primary insurance. I contacted *** of *** But after waiting for months Health is providing wrong information and stating that *** plan is primary. I made more than 20 calls but they keep forwarding me from one person to other person. Health is going back and forth.

thursday, january 14th dear ***, You need to take my PHONE number (XXX) XXX-XXXX of off your harassment, telemarketing, calling list. thursday, january 14th dear ***, You need to take my PHONE number (XXX) XXX-XXXX of off your harassment, telemarketing, calling and robocall List and STOP CALLING MY NUMBER ANY REPEATED NUMBER OF TIMES on TOP OF IT with Your Nonsense and ***! in FACT: i do NOT wish to be called at all! this is NOW considered *** and there are laws in place for it! if YOU need to contact ME then it will ONLY be done by EMAIL FOR NOW ON at: ***. do NOT make ME ask YOU this Very Special Request for a 2nd Time! Take The *** Number Of: (XXX) XXX-XXXX Off Of Your Calling List NOW! sincerely yours, *** Py and upset healthnet.com customer /hps

They still have not paid for a doctor visit of mine (in network) from march . I am facing collections..Every call, they say they'll send check. I visited an in network doctor in march . I was billed *** Health net said they would cover but had old address of doctor on file . They had to cancel check, I facilitated new address by requesting doctor billing address to fill out new paperwork. Health net received new address and said they would send another check. The doctor still sends me bills. I call every month and someone from health net says they will send check and it should be resolved soon. It's been 15 months and I have to call with every billing statement to make sure I dont get sent to collections. I dont understand who at healthnet is lagging to send payments. I no longer have healthnet and I do not see that doctor anymore. It is very stressful to still be calling and not even be a member.

I have *** and had been having a *** My doctor put me on high dose *** and *** He aimed to put me on *** (the only *** drug for *** ASAP and take me off the other *** In the last two months, I called the insurance, the medical group, and the specialty pharmacies countless times. The pharmacies wouldn't dispense the drug because they need prior authorization (PA) from the insurance, but the insurance said the pharmacies only need PA from the medical group, not the insurance, since the medical group is paying for the specialty *** The insurance couldn't get this resolved with the pharmacies, so it tried to expedite a formal grievance for me, but later I got a letter denying expediting this case. This is causing me a lot of stress and worsening my *** The delay of my treatment is causing me a lot of hair loss and bald spots, bone loss, muscle loss, joint damage, etc. I feel very hopeless and frustrated, my insurance is not helping.

For approximately the last 2-3 years, I have used Health Net of California for my medical insurance provided under Covered California. In anticipation of turning 65 on 01-14-2022 and starting Medicare, I contacted Health Net & Covered California to cancel my coverage. My first attempt was somewhere last October. I requested to have my coverage end on 10/31. When the billing continued, I called again in January to inform Health Net that I had previously requested my coverage to be terminated. To this date, I am still receiving monthly billing from Health Net The uploaded invoice, dated 2/10/2022, has now grown to $***. The monthly premium is $896.16. During my actual coverage, my monthly premiums fluctuated between $50 and $250. I have no idea why the premium increased so drastically after I cancelled. When I first attempted to cancel last October, I was on auto-pay so my balance was $0. When I received my first bill after I cancelled, I went into my HN account and discontinued my auto-pay. My desired resolution is to hear from Health Net that they have stopped my coverage without a balance due. Thanks.

My daughter is unable to see a doctor after having a seizure because of needing to change her PCP. My *** year old daughter had a seizure and was taken to the ER by ambulance. When i called the PCP Health Net assigned to her I was told that they are not accepting new patients. I then found a PCP that was in network and called Health Net to have then change her PCP to the one I found. I explained the situation and urgency of her needing to see a doctor. I was told that the change would take effect immediately and to go a head a schedule her appointment for the next day. The day of her appointment i received a call informing me that the change of pcp was not going to go into effect until November 1st (This is the first week of October) because my daughter had gon the the ER in October and ,as they put it, "received services" they were unable to change her PCP that month and she had to wait till November to see her new doctor! I again informed the Health Net worker i was speaking with of the situation (My *** had a seizure and needed to see a pediatrician immediately) and i was told there was nothing they could do and that I was just going to have to wait till November!

HealthNet Claims taking more than half a year to process My mother is a HealthNet Member ***. I am her authorized representative. She had a heart attack in the Philippines and was hospitalized in November 16 - December 17. She is currently stuck in the Philippines due to the COVID19 travel restrictions. We filed a claim with HealthNet and received a Claim #*** back in January. I have called multiple times to get a status on her claim. First they confirmed they did not receiv the claim, so I resubmitted. They they said they received our claim but are still processing. Then on my last call they say that they can not find the details of the claim although something appears in their records. Each time I call them there is a different story. I requested some kind of messaging or notice if there's any update on the claim. They say that they only do that when it's denied or when they need more information. They do not even send a notice when they are processing it. They expect the patient to wait indefinitely and keep guessing. My mother is stuck in the Philippines to the COVID19 restrictions and she was just re-admitted to the hospital. I can't tell if HealthNet is just so disorganized that they can not process this claim or if they are purposely avoiding processing it. Either way it is such a horrible way to treat their customer.

Unable to get the desired breast pump though insurance Extremely frustrating dealing with this insurance company and *** physician network medical group trying to get a desired breast pump. I am a nurse practitioner with an extremely busy job and need a wearable/ portable breast pump I can use hands-free at work e.g. *** or ***. I have called both insurance and medical group numerous times about this and always get a different answer. Insurance says medical group pays for it, medical group says insurance pays for it. The insurance gave me 2 options for vendors (pumping essentials and hygenia health). Neither one of them carries the pump. Even with prior authorization from the medical group/ my OB and me willing to pay out of pocket for it, the insurance has failed to reassure me that I will be reimbursed for the out of pocket cost of an expensive pump. They give me the run around with no clear answer and tell me the pump "may" or "may not" be covered until I submit claim and after I've already dropped over $500 on it. What's the point of pre-authorization and approval by medical group if the insurance can't tell me it's going to be covered. It's illegal to deny a pregnant woman a breast pump and forcing me to get a pump I cannot use at work is unfair and not helpful. It will most likely end up in my child needing formula and me not breastfeeding. I am beyond frustrated and stressed with this entire experience while being pregnant and trying to get a pump I need.

The charge for service at California rehab Sports Therapy are processed incorrectly. My responsibility for each occupation therapy should be $15. I have contacted Health Net Billing department(where the claim are processed by Adoc Medical Group)since April regarding the claims for service at California Rehab Sports Therapy. The service dates are 1/28, 2/3, 2/10, 2/17, and 2/24. With my Platinum 90 CommunityCare HMO membership, my responsibility for each occupation therapy should be $15 per service. The claim were processed and ask me to pay $30 for each service which is why I am getting bills from California Rehab Sports Therapy after I made $15 copay for each service. Here is history with billing department: 4/27: Spoke w/ *** 1. Confirmed the copay should be $15 for therapies, will reprocess the claim. 2. Will take about 30-40 Business Days. 5/20: Spoke w/ *** 1. Re-send clarification for $15/copay will take 24-72hrs to reprocess. 2. For service 1/28, 2/3, 2/10, 2/17, 2/24 5/22: Spoke w/ *** 1. Confirmed the clarification of $15/copay. -done 2. *** emailed management to look into the issue yesterday 5/21 why the claim department said it is process correctly. 6/02: Spoke w/ *** 1. Management has not receive response back. 2. Will send another request and call 9030 when result comes back. 6/09 No one anwsers, cannot leave voice message. 6/16 Spoke w/ *** Follow up EOB Status. Pending for call back(no return call as promised)

Health Net Healthy Rewards Program offered Gift Cards to *** for completing certain Medical Visits during 2021. They sent me *** Gift Cards for 2 Visits: Annual Checkup and Osteoporosis Management. On December 31, I got my Flu Shot at ***. I put in what was Required: the Date I had it and I chose the *** Gift Card for $25.00. My Mammogram was done on JULY 21; I don't remember the Reward amount. There were one or 2 more Dr visits I completed, but I don't remember what they are. I didn't write them down because they were all listed on their Web Page as Active and their Web Page was Pinned in my Browser so I kept making sure they all said Active; and, therefore I was expecting the Cards. When the 2 *** Cards came but not the others I called them. They refused to Honor their Reward Program by sending me the Cards. Their only excuse was the Rewards Program ended Dec 31, 2021, it didn't matter that I put in the Dates Completed and chose The *** Card for the Reward and that they were completed by Dec 31, 2021. When I went to their Web Page they Removed all the Active Requirements I fulled, except the 2 mentioned above. I am disabled at home and *** delivers everything to me so I chose the *** Gift Cards. I completed all Medical Visits required except the Osteoporsos Test because my Dr said I didn't need it. I would like the other *** Gift Cards for everything else I completed and entered the Dates for that I did complete. Everything that was required to get the Cards by the end date of December 31, I did, except the Osteoporosis exam.

Healthnet made an error in coverage enrollment that I am now being responsible for. Healthnet is the contractor for Tricare-West and I wish the DoD didn't subcontract things like this out. Healthnet (along with Humana) constantly makes mistakes and never own up to them. The customer service is terrible. Nothing is ever document properly and you have to continually reiterate your issue to whoever answers the phone. They will always blame the error on someone else and say there is nothing they can do. My current issue with them is that my daughter was moved from the east to west, however was never put on a plan (Prime, Select,etc). I was unaware of this until I took her to the ER ad was later notified I had no coverage. I asked them why she did not have a plan when it was a simple PCS move. They stated it was common for eligible people to not use TRICARE. HOWEVER, I'm an active duty single parent, therefore this is the only medical coverage she has. In addition, its 100% covered by the military. My daughter has been on Tricare since she was born 3 years ago. Due to deployments and PCSs in the last 2 years, she has moved from TRICARE East to west, back to East, and now back to West, with occasional slight issues. But never an error this bad. I am now left with a ER bill but to their error. I submitted an exception waiver, explaining everything and it was denied. Seriously?!?! I don't feel like they read or care what you write on the forms or don't' fully understand the dynamics of military, PCSing, switching medical coverage. One of the reps told me they have some criteria where they automatically deny if you meet one of those, regardless of your justification. I've been advised by my PCM and advocate to contact Defense Health Agency and legal if need be. No one should have to fight this hard for coverage they've earned or fix Healthnet's mistake.

HealthNetMediCal has me as $0 HealthNetMediCal as of January 1, 2022. HealthNetCoveredCalifornia has me owing monthly payments as of January 1, 2022. DPSS/MediCal has me as "full MediCal" "$0" "Free" "MediCal. Regal Medical Group has me as HealthNetCoveredCalifornia and won't payout to a Specialist that I saw on 2/2/22, because HealthNetCoveredCalifornia has not been payed for all months owed. 1. HealthNetMediCal refuses to contact HealthNetCoveredCalifornia. and HealthNetCoveredCalifornia refuses to contact HealthNetMediCal. 2. Regal Medical Group only contacted HealthNetCoveredCalifornia and refuses to contact HealthNetCoveredCalifornia. After many hours of abuse from calling each call-center; the result is cruel apathy, and sending me to contact someone else in endless circles. Many requests for supervisors & managers to callback; resulted in increased apathy and a lack of concern. It is obvious to me that HealthNetCoveredCalifornia doesn't want to lose money, although it is my right to be represented truthfully, by HealthNet of California. This website of Complaintsboard.com says do not include account numbers or member numbers. I would like to give it to Complaintsboard.com or any appropriate help to this. I AM SEEKING THE RESULT OF: HealthNetCoveredCalifornia removing all owed from January 1 2022 as of them acknowledging that I have HealthNetMediCal which is free for me as of January 1 2022 to current, and for HealthNetMediCal to change me back to Regal Medical Group that I had before the mistake, and for Regal Medical Group to acknowledge that I have HealthNetMediCal, and for Regal Medical Group to payout to the services given to me on 2/2/22 by *** in Los Angeles that Regal Medical Group sees in their computer. MediCal ID#*** for DPSS/MediCal & HealthNetMediCal *** for HealthNetCalifornia and I give permission for Complaintsboard.com and affiliates to help in thses matters aand to use the numbers.

I purchased covid19 self-test kits, they are covered for reimbursement by Federal Law. I called Health Net to know the procedure to have the covid19 test kits reimbursed, the customer service representative on the line made me wait for over 2hs on the line to tell me the correct form, he wasn't educated on the issue. I filled out the form and put the receipts, and mailed them out to the address on the form. The form was received within 2 days. I called Health Net to have a payment date, since it has been over 15 days that they received my claim form and I've been in the line with Supervisor ***. for over 2hs, they are saying that they didn't receive the claim form. In 2hs that I have been on the phone, the supervisor above is going in circle and is making me wait for over 30 minutes at a time for me to give up and hang up the phone. Very frustrating and stressful situation without a resolution. On 02/18/2022 I received an email from: *** ERU/ Escalations Response Unit Appeals and Grievance Coordinator II, asking for my information to make the payment. The information was promptly forwarded. On Mar 1, 2022, at 2:36 PM, EXEC_ESC wrote: Hello . ***, The claim has processed. You will be receiving a check for $57.98. Please allow 7-14 business days to receive your check. Thank you, *** ERU/ Escalations Response Unit Appeals and Grievance Coordinator II On 03/17/2022 I sent the email below to ***: Hi I didn't receive my check yet. It has been over 14 business days. What day am I going to receive it? I received the answer below on 03/21/2022: Good Morning . ***, I had a check tracer done on your check and it shows that it is with USPS in Santa Clarita, CA as of yesterday 3/20/22. So hopefully you will get it very soon. I do apologies for the delay. Thank you, *** I contacted . *** a few times after this last email and she never answered me back.

Cancellation of policy a month prior with slightly less of a months dues paid and refunded. Im not sure of the actual dates. But all I know is that when I initially got coverage. I asked all kinds of questions regarding late payments, and how its dealt with and so forth. I asked a question about what happens if i fall behind? I was told that with this plan if you fall behind you are given 90 days to catch up. I asked How are partial payments handled, and do they buy me time, meaning like If i pay *** or so towards the plan do I get more time, like does it buy me a few days to a week? I was told yes as long as you are paying something it does buy you time. And I used an example and I elaborated on the example because I know I have been known to fall behind and I did say that to them. And was told that it doesn buy you days. So I was paying some on time and some behind the time, a couple times came close to being 90 days but got caught up or bought me some time. and then this last time I got very close. My monthly premium was about *** and change. i had paid up to *** one month leaving about *** or so unpaid for that month. and if you do some math it was about a day or two that wasnt paid for for the month. And at the time I would have been a little over 60 days past due, not 90 days past. And I was having a hard time because of this Corona Virus ***, (thank you *** My hours got reduced but cost of living remained the same. That drop in the bucket of a stimulus didnt go very far. And I was still behind in rent. Anyway back to the complaint. I was about 2 months behind and was going into the 3rd month when all a sudden I get a refund of close to a months premium. I called in immediately to see what was happening, and thats when I was told that I was 90 days or more past due. I said how can this be especially when I was "buying time." plus it being a day or two without full payment for the month. I should have been added to the next bill which I know it was. And how come in the middle or start of this pandemic would an insurance company cancel a policy that is vital to the persons well being and health. Especially when I was making an effort to pay. And I know that there are some that are not making an effort to pay. Bottom line, Why was almost a full months premium refunded to me? Possibly so they can make the point that I was 90 days past due and cancel me. also I pointed out to them that they tried to say I was more than 90 days past due. And I said not with the last bill I received I wasn't but companies will say they mailed it out and the envelope is still in their hand. But also why during a pandemic they decide to cancel someone who is making an effort to pay? Possibly cause they don't want more people to insure so its less that they have to pay out.

Our credit card was automatically debited *** without authorization. HealthNet has not provided explanation. On May-15 I receive e-mail notice that our credit card had been billed *** by Heath Net. Normally this this is a $652 charge, representing a *** unauthorized withdraw. Prior to e-mail notification, I attempted to purchase medicine. CVS wanted $500's for something that normally cost $15, so I declined it. I did not think it was an insurance issue because we pay the premium in advance each month. I checked online after receiving the notice and found out my account status was suspended. On May-15 I contacted Health Net customer service and was told that the charge came from Covered CA. We had Covered CA in 2019, then transferred to cash individual policy for 2020. My wife was also on the account in 2019, then transferred to Medicare when she turned 65 in August. The rep could not see what the charge was for. I was transferred to an inoperable Covered CA line where I was not able to speak to anyone. I notified the insurance agent asking for inquiry, Health Net informs her that they need 2-3 business days to investigate the issue. On May-17 I receive a paper invoice showing the June/2020 "Adjustment" was for "Invoice Correction". On May 21 I followed up with the insurance agent. She is on phone with Health Net at the time. They have not been able to resolve billing issue with Covered CA. She tells me at least they have placed the police in active status... My wife calls Covered CA and after speaking with two different reps finds out the charge is for her cost after she transferred to Medicare and that it is not their issue, but she could file a grievance. I called Heath Net and spoke to a representative that put me on hold for an excessively long time as she attempted to find information about the charge. It must have been 30 minutes before she got on the phone and read me the information that was on the back of the billing invoice. That "Adjustment" was for "Invoice Correction". I immediately ask to speck to a supervisor. It took a while to get transferred, the rep kept checking in to see is I was still online, telling me her supervisor was on another long call. I spoke to the supervisor that was no more helpful than the reps and even less able to put me in touch with an inaccessible "Billing Team". I was furious at this point. I had to pass the phone to my wife who is transferred to the "Resolution Team" member. My wife calmly spoke with the resolution person who had to reply the account info and reason why we had called and then insisted that I verbally authorize her to let my wife speak on my behalf. By this time, I am about to lose control. We had been on the phone for hours and now this! Is this the policy of Heath Net executives? My wife could not get an answer about the charge and was given two options for resolution. The first recommendation was to remove the automatic deposit and then "what most people do" reverse the charges and wait for Heath Net to send a revised bill. The rep stated they would not cancel the policy for 90 days, but it would be up to us if we wanted to do that. The other option was to request a review from the "Billing Team". This would take 10 days to complete. They would then have to issue a refund if the charge was made in error. We chose the latter option. This call lasted 1-hour and 44-minutes, ending with no explanation for the unauthorized charge. I am contacting Complaintsboard.com because I have little faith in Health Net's ability to resolve their billing issues. There has been no attempt by anyone from Health Net's billing department to acknowledge receipt of the request made on the 5-15 and 5-21.