fraud and cheating
About six months ago, my husband's company switched from United Healthcare to Humana health insurance. The first thing I did was go to Humana's website to make sure our family's doctors - my son's pediatrician, my OB/GYN, and our family dentist - were in Humana's network. I really liked all of our doctors, I'd done a lot of research to choose the best ones, and I did NOT want to change.
My son's pediatrician was the only one that didn't show up on the network list. I called their business office to see why they didn't take Humana. They said they used to take it, but had a very hard time collecting from them. They said Humana had a habit of automatically paying the doctor less than the agreed-upon amount for a service, and then making the doctor's office jump through hoops to get the rest of their money. They said when they did pay out, it took forever to get a check, and often required multiple claim submissions. And they said Humana refused to pay for what the doctor considered to be routine care for a child, including some vaccines and screenings, and that they nit-picked every chart in an effort to get out of paying for care. They said their relationship with Humana got to the point that it wasn't worth it anymore, so they dropped them. And as disappointed as I was, I can't say I blame them.
So I went to Humana's website and found a pediatric clinic that is in their network. I went there and I hated it. It was clearly an inferior facility and inferior quality of care compared to my previous doctor. And I was even more frustrated when, a month or so later, I got a bill in the mail for $104 from the doctor's office. Apparently Humana had paid only $34 of my son's 15-month well-child check-up. I called Humana to tell them there must have been some mistake. They said they only paid a small percentage of the claim because I went to an out-of-network doctor. I said, 'No, actually, the only reason I even know that doctor exists is because I found them on YOUR website.'
After putting me on hold for more than 10 minutes, they came back on and told me the clinic I had gone to was in-network, but the particular doctor I saw was not. I asked them how in the world I, as a consumer, am supposed to know that just because a clinic is in-network doesn't mean the individual doctors are. After much, much, much back and forth, they agreed to resubmit the claim and pay it. They acted like they were doing me the biggest favor in the universe, and kept stressing that this is a one-time ONLY exception they were making for me. Gee, thanks jerks.
Not long after that, my husband went to see our family's dentist, which was in-network. Humana paid for his entire check-up, no problem. He didn't even have to pay a co-pay. Two weeks - yes, exactly fourteen days - later, I went to the same doctor and got the same check-up and x-rays. When I finished the appointment and went to check out, the office manager informed me that I owed them $280. I informed HER that I had dental insurance - here's my card, which I've already shown you when I came in.
She said, 'Oh, I guess they didn't tell you we don't take Humana anymore.' I said, 'What are you talking about? My husband was just here two weeks ago and you took our insurance THEN.' She was very nice, but she told me they had been in contract negotiations with Humana for months and couldn't reach an agreement. The dentist had requested a small and routine increase in fees, and Humana had bluntly refused. She said the amount they were willing to pay would not even, in some instances, cover the dentist's costs. I told her I refused to pay, since they should have told me when I walked in and showed them my card that they no longer accept Humana.
I called Humana to protest and got nowhere. They said it was my responsibility to know whether the dentist was in-network. Apparently I should have checked to make sure the dentist was still in-network just before I walked out the door to go to the appointment. Checking before I MADE the appointment wasn't good enough. So now the $280 is in limbo, with me, the dentist, and Humana refusing to budge.
After the dentist incident, I thought it might be wise to go back to Humana's website and make sure every doctor in the state hadn't dropped them. I was especially worried about losing my OB/GYN. I had established a great relationship with them during my first pregnancy, and I felt comfortable with the thought of future pregnancies knowing I would be in their good hands. So when I pulled up a list of in-network OB/GYNs in my county, my stomach dropped.
Not only was my doctor not on the list anymore, but there are only three doctors in my entire county that take Humana. And I don't live out in the boondocks, I live in Raleigh! For comparison's sake, I went back to United Healthcare's website to pull up a list of their in-network OB/GYNs in my county, and got a message that I would need to narrow my search criteria because my search had returned more than 300 doctors. THREE HUNDRED. Humana offers three doctors, none of which is less than 40 minutes from my house, and only one of which delivers babies at the hospital closest to me. I called my OB/GYN's office to find out more information about why they dropped Humana and... well, by now you can guess what they said.
Last week, I woke up in the middle of the night with horrible lower abdominal cramps. I started to get worried that it was something serious, since I very rarely have any abdominal or gynecological issues. Then I thought, 'It'll be okay, because if this still hurts in the morning, I'll just call my gynecologist.' And then I remembered that, thanks to Humana, for all intents and purposes I don't have a gynecologist. Or a dentist. Or a pediatrician. Or any good alternate choices available that DO accept my insurance. It was a terrifying feeling. I guess this is what it's like to not have any health insurance at all.
So we're shopping around for a health insurance plan that we'll have to purchase out of pocket. It will cost a lot more than we pay for Humana through my husband's company, but we're willing to pay for peace of mind.
The complaint has been investigated and resolved to the customer’s satisfaction.
price/prescription approval, etc
My husband and I have worked for the state of Ky. for 13 years (for me) and 14 for him. He was also a member of the Army Reserves for this entire time. He recently retired instead of rejoining for 4 more year until he is 60. When I was working we cross referenced and our payments were maybe the most expensive was 40.oo a month for both of us and our daughter and son. I never had a complaint, NEVER until just the last couple of months. We had Tri care and of course I was not out anything for surgeries, medications that were prescribed we 3.oo and no more than 22 if they werent formulary. I want to get in touch with the head executive of the comany and find out what I need to do in order to make this affordable. 400+ dollars for my husband and myself is totally unrealistic.
I went to get my effexor refilled. I have been taking this medication for 6 years. I have never had to pay anymore than 29.00 for this medication, My husband went to have his Cozaar refilled, same story, the insurance company has to decide if this is the right thing medication for the doctor to prescribe for us, so it needed to be preapproved before we could get it. Okay it was approved and it was something like 165.00 WITH the insurance. Now let's add a minute. I am paying 400+ a month. I am now paying premiums at the doctors office anywhere from 10-20 for that. I have no other insurance such a dental or optical with it, just strictly medical. My husband's blood pressure was in the stroke range, and the drug store could and would not give him enough meds to get him by to see his doc to have them changed. So I have wound up in the emergency room, I have had to see a gastronologist and he would not even treat me for the other things that need to be treated because without the Effexor, my abdominal problems would not respond well to the medication. so I have been down in the dumps. I have isolated myself from all my family and friends, they get on my nerves, and I can't stand myself so I just dont want to bring them down with me. I want the CEO headquaters comepany, I also want to bring this to thier attention. I will be mailing out several letters to senators, and other folks who think they are much more important because they do not have to worry about insurance when they are older. Just to let you in o n what has been going on since we had no medication while waiting on Humana to say it is okay to have them or not, My husband has had a blood pressure of 157/116, I cried, been to the emergency room because my stomach was cramping, so, i still thought what a waste of time I am spending in an emergency room taking up space that others with life threatning injuries may need, simply because it is easier than waiting on my physician to get into his office, so he can order me something that my 450.00 a month premium insurance is not going to pay for supporting people in Ky who have no health insurance, but I think it is unfair when we pay that kind of money, and the welfare system gets better care than we do. Prison life is good for insurance.I worked there for 13 years, I KNOW beyond a doubt if something is NON FORMULARY for the inmates, a stroke of a pen when it is presented to our Dept of Corrections Medical Director of the state who by the way is a Mental Health Doctor a bona fide Psychriaist who used to work at the Ky State Reformatory as an on staff Psych MD. I will be submitting letters to everyone that I can get through to, this is highway robbery, this is why people cannot afford insurance and go on welfare so their kids can be covered, but what happens when that parent becomes so sick he can no longer take care of his/her children, because he cannot afford the insurance for himself, or the medication for himself. I would appreciate if you could send me other addresses, so I may get this out there. I f not that is fine I will find them on my own. I know this is going to be a long drawn out process, but I can be a patient person when I beleive in something.
scam
My son was enrolled in Medicare part A, B & D during his transplant in 2004. We received a letter at the beginning of June 2007 stating that coverage for Medicare would end the last day of June 2007. However since Humana was the Medicare Insurance for part D, they should have removed him from the part D coverage. The part D coverage is for prescriptions. Since this was all new to me when they started billing me a premium I just assumed that my son had to have Humana so that he could still get his prescriptions so I paid the monthly premium.
At the beginning of January 2009 we called in to have his scripts refilled and Medicaid would not cover the cost because they stated that he had another insurance which is Humana Medicare Part D. Medicaid told the pharmacy that they needed to run them through Humana Medicare part D and whatever costs were left the Medicaid would cover that cost. So at the last minute we had to have Medicaid to an emergency Humana Medicare override so that we could get the scripts, and keep in mind that my sons anti-rejection medications are $3500 to $5000.00 monthly. At this time my sons transplant coordinator and myself started working with Humana to have him disenrolled. I started calling Humana on January 20, 2009 as of today March 26, 2009 I think I finally got this resolved but with NO HELP from Humana. I called Humana 9 times and got 9 reference numbers and got told the same thing, 'I will send this report to the disenrollment department and they will contact you within 24-72 hours. At one point they said that I needed to write a letter that was signed and fax it to the disenrollment department so I did. I still did not hear back from anyone. I had to ask Medicaid to do 2 Medicare overrides by this time. One in February and one in March so that we could get the prescriptions paid for.
I think that Humana has got to be the worst Insurance company out there. They will continue to take your money and contact you as soon as you are late on a paying the premium, but all be damn if anyone over there will help you if you want to disenroll. How in the United States of America can we let a company do this. My husband and I are both working citizens that each of us work 40 hours a week all I have ever asked from the government is to help my son during and after his kidney transplant to cover those costs.
Over the last few months I have spents HOURS on the phone to Humana, during my work hours. We have another child that we pay for his insurance and this is how this insurance company treats us. While there is allot of people that take advantage of the system I am NOT one of them, yet they have taken advantage of us. This is a very serious matter that has happened to several citizens and it needs to be taken care of.
The complaint has been investigated and resolved to the customer’s satisfaction.
numerous problems with all aspects of contact
Do not choose humana perscription drug insurance — unfortunately I did. My premiums and copays went up by 50% just three months into my plan. (Bait and switch?) their customer service people are poorly trained at best and rude at worst. They sent me a letter denying coverage for a drug I had never heard of nor was ever perscribed for me! Tried to say I hadn't paid premiums even after they had a copy of the cancelled checks from my bank showing they had cashed them well in advance of the due date. My pharmacist just cringes when the name humana is mentioned. They are a problem all the way around.
The complaint has been investigated and resolved to the customer’s satisfaction.
After huge increases in fees I phoned Humana last year during the annual election period and said I was canceling my policy. They suggested that I also inform Social Security, which I did by phone. When they kept billing me I phoned them again and they said they needed it in writing, which they had not told me before. I sent in the form in writing with a letter saying I had previously cancelled by phone. They they cancelled the policy but said I owed them for the first quarter of the next year. I mailed them a protest letter and they advised me my protest was overruled as they had no record of my call, and I still owed them the money. I got a letter from a collection agency. I would never do business with them again!
claims and reimburssment
Health insurance is on the front burner of most political conversations. I offer a honest and complete story regarding Humana's health insurance polocies. In short, I have seventeen pages docuementing phone calls, written letters, and actual bills to support my previous statements. In the worse case scenario, you lose an hour by reading about Humana's detailed fraud. At best, you are the first to break a story involving health care that will "blow everyone out of their seats." While I am 98 percent sure you will write me off as a crazy person looking for revenge, I hold onto the other two percent. I'm offering a story that is important to all persons. Please give me the option to send you my previous docuementations. (I can't spell!). thankyou, jenny schmitz
The complaint has been investigated and resolved to the customer’s satisfaction.
I know this complaint is true. It is similar to my experience. Humana is the provider for my employer. They are absolutely terrible. They freeze coverage without warning. You can send them a claim via their message system and they will deny receipt of it. They will claim not to be able to read faxes that they request. They assert their 60 day review period in an attempt to delay payment as long as possible. They ran out the clock on my HSA claim effectively stealing almost $400 from me. It was clear to me that what they were doing was intentional. .
My direct experience with Humana Health has been anything but pleasant. Unfortunately for me, Humana is an employer insurance plan. My unpleasant and direct experiences with Humana stem from 2004 and 2010 experiences. In 2004, I had a routine procedure and Humana twice told me over the phone of a lower co-pay than what I was actually charged. Humana then communicated they no record of the calls, and when I communicated my record of the second call, the representative denied she communicated to me the lower co-pay. After a number of exchanges, I finally told Humana the representative and I would have to undergo a polygraph test to get to the bottom of the discrepancy. I then never heard back from Humana. In 2010, I paid out-of-pocket for a claim Humana told me I could get partially reimbursed for. Humana advised where I should file the claim, which department denied my claim because it wasn’t filed with the right department. As again advised by Humana, I re-filed with a second department with a claim form and my receipt. Humana then paid the supplier, whom I had already paid, which was an overpayment. Humana went on to advise I should “contact the provider
for any eligible reimbursement.” Hence, Humana’s advertised guidance in my case has been lies and deception when you need it least.
scam and cheating
I needed a series of three hepatitis B vaccines for nursing school. I called my prescription drug insurance to see if it is covered. They told me since it is a vaccine and not a prescription, it would have to be covered by my medical insurance. I called Humana and asked if this is covered. They told me yes it is covered. I had to pay upfront and then send...
Read full complaint and 5 commentsdecreased services
Every time I turn around Humana decreases what they will pay for. The most frightening thing is the pain and sleep medication I have been taking all my life. They just stop covering medication that is addictive! I hope every one of those executives and the "fake helpful" service reps come down with MS, Cancer, Diabetes, and every other incurable condition and they can't find any insurance to cover thier basic needs. Let them see what it is like to be told "In 30 days you can no longer have your medication". Drop Dead Humana! Burn in Hell!
The complaint has been investigated and resolved to the customer’s satisfaction.
Conspiracy theorist.
I like that you wish horrible things on representatives who have about as much to do with your insurance benefits as a monkey does. Wishing people death and burning in hell is not a great way to make a change.
God knows I aggree with you. They have stopped paying for the small portion of my medications they used to cover. However, I think the only way we can attack Humana is through getting many persons to "chime in" with us. Right now, I feel like the best thing I can do with my life is devote it to a positive health care system. In order ot do this, we need to find as many persons as we can to take on Humana. I'm trying to start a movement that could eventually be huge. Please help me achieve this goal. Jenny
deceptive practice
Humana is the most difficult company I have ever dealt with.
What can be said about a company that has class action suites against them by Doctors, class action suites against them by Investors, and law suites against them by the people who make them monthly payments. Not to forget about a variety of complaints on various web sites.
I find the things they tell me to be deceptive, misleading and inventive to their advantage. Their Customer Services reps sometimes make no attempt to be helpful. It is just get off the phone as soon as they can. Ask those reps for details and don't accept what they say as all that could be said. If you don't like an answer call back again. NEVER wait on them to call you as the delay may eat up your appeal time. TAKE NOTES on everything they say. Write everything down.
If you feel you are getting nowhere with them with your claims here are a few places you can contact for help.
1. Contact the state Insurance Commissioner, every state has one. File a complaint with that agency. Be detailed and include paperwork.
2. If Medicare or Medicaid is involved contact Medicare and ask about your problem. Again file a complaint including paperwork and any documents sent to you.
3. Contact your US Senators and file a complaint with him. Most have a Representative dedicated to problems that come up with questionable conduct of Health Insurance companies. Demand better legislation and for the rights of the consumer to be protected. Call it a health care consumer bill of rights.
4. Do the same with your Congressman. Hope that he has not taken campaign funds.
5. Some states have a contracting agency to guarantee the quality of Health Care in that state. Ask the state Insurance Commissioners office for that agencies number.
6. Your state may have an organization called SHINE to assist senior citizens. Ask their assistance with your problems.
7. Scan the Internet for any class action legal action. There are search engines to assist you.
We need to call attention the those questionable statements and practices of this and other companies that cost us money and a complaint is the only way we can get that short of retaining an Attorney.
With Regard to Deceptive Practices:
A few years back I called Humana on an information search to try and find health insurance w/Rx coverage for my 25 year old daughter who was going off of her Dad's policy. I wanted to get info sent to me and get an idea over the phone of their rates range.
They wanted me and her to give application information so we'd already be that much further ahead if she did decide to apply. We did (I gave info first and then they questioned her after me) She had pre-existing conditions and we knew these could cause her some acceptance problems. (She has Asthma and G.E.R.D and a number of allergies and ADD) Before they hung up they told me that she would be denied and they said they'd be sending her out a letter of denial. I said "but she was not applying, yet and they said that she did when she answered the questions for the application. (The one they said they would not process, but just have ready if she decided to go with Humana after my research!) So she's been denied for coverage...single and at the age of 25, w/o intending to apply with them at that time! This means ALL insurance companies know she's been denied and is now as "marked" applicant. Fortunately, she has insurance benefits now thru her employer. I'll NEVER consider going with Humana when I apply for Medicare this year because of their deceptive practice during that information gathering session on the phone. NEVER!
This sounds like more of a rant than a complaint, but in any event, what insurance company doesn't have class action lawsuits pending against them? Frivolous claims are everywhere.
was sent a brochure recently from Humana to let me know they would be in my area and needed to apply between Nov and Dec to change from Medicare to their Plan. Wanted to do this because according to them they offered all my needs which Medicare does not. Well went through the speil of giving them all the information they needed, then they would ask me on a Scale of 1-5 how would i rate them, one was average the other 4 i gave a 5 as they were very knowledgeable, wrong thing to do because they did not follow up like they said they would, they did not call me back so yesterday on 11/13/08 spoke with a Supervisor who had to again do the spiel of needs, she said they would have someone call be back right away, it is now Thurs 11/14/08 and still nothing, well I called their Corp Office listed on the net and could not get passed the operator, she wanted to send me back to the call center Supervisor, i stated no that I want to talk to Corporate she stated I could not, so I said will file a complaint on the net, and that is what this is all about, oh the Supervisor told me to call her back today Thurs and let me know if anyone called me instead of her calling me the Customer back, The first Sales man was to come to my office on Mon of this week, he called on Sun about 6:30 p.m. to let me know he would not be here and would call and interview me on Mon that did not happen.
Read today that they have been double dipping Medicare for millions of dollars and other dipping of recipients.
In short: Customer Service is horrible they do not care about us the Customer, they just want you to give them a good rating so it looks good in the Call Center for them, do not give them a rating, do not expect them to follow up because 5 of them did not do that nor the Supervisor. I would not do business with a Company with a sloppy Customer Service that does not care about the Consumer who pays their salary nor a company that has such negative blogs on the internet which is ripping people off.
BEWARE OF HUMANA HEALTH INSURANCE, ESPECIALLY FOR THOSE ON MEDICARE, IF YOU RECEIVE A BROCHURE OR CARD FROM THEM BE VERY CAREFUL.
Humana will suck the life out of you. They are impossible to work with and will fight you for every dime in your claim.
They are Health Scam experts and have company meetings to see how they can make money off of you.
failure to process claims, slow, unwilling to pay, lack of doctore
We have had several claims from doctors on the plan denied, with promises from Humana to reprocess. Five months later nothing has happened. I noticed their profits are up a lot over the last quarter of '07.
What a joke. If I had a choice between national health care and Humana, I'd take National Health Care, and I'm a conservative.
Just got off the phone with a Humana representative after being transferred 4 times, it is impossible for them to process claims correctly. I'm told processed according to repricing, however when I contact the repricing company, they have confirmed that the correct repricing according to contract, Humana receives it and then from there on it's a hell of a mess...takes them at least 4 months or more to reprocess and mind you does no good to contact appeals or grievances department, they just give you the run around, so next step is reporting them to the department of insurance. Geting to a point where we shouldn't even contract with them but due to the fact we have patient's covered by them, hate to turn them away. Then again, the insured patient's go thru hell with them as well...
Physician Finder Plus - MyHumana
Other Providers:
Physician Details
Perry County Family Practice Inc
Network: HumanaChoicePPO (Medicare PPO)
1625 Airport Rd
New Lexington, OH 43764
County: Perry
Phone: [protected]
Fax: [protected]
This is my Dr's office but Humana says it is out of network?
It seems you have a taste of Humana. It's a bitter taste that lingers forever. Humana has made it darn near impossible to send in claims and get reimburssed. For instance, I fought like hell to get Humana to reimburse me for one appointment. I filed the claim on 2/2/06. I recieved my small check from Humana on 8/27/07. Math is not my strong point, but I believe that is around 18 months and twenty or so days. Every company is allowed to make a mistake. I filed another claim on 3/14/06 in which I was reimbursed on 11/8/07. Again, math is not my strength, but I believe that equals around 19 months that it took Humana to send me a check.
Humana's delinquency turned out to be the least of my problems. Humana finally sent me a check for 339.68. (the check has faded, but I believe that is the correct amount.) Briefly after recieving the check in the mail, I deposited it via the atm machine at my bank. To my complete surprise, Wachovia called me to notify me that the check from Humana that I deposited was invalid. It quickly became the talk of my small town, including my bank, that Humana actually issued an invalid check to me. Although my story must soudn absurd, I'm telling the truth. I should add that I have had to call Humana over 70 times due to problems. I'm begging for other persons who have had problems with Humana to speak out. Humana will continue to run "business as usual" until enough persons speak out about the company. If you don't want to email me I understand. But, if you know of anyone else who is willing to come forward about Humana, please give them my address. jtbirdiusrex@yahoo.com Thanks, jenny schmtiz
I have a few claims still not resolved from June. I had my Doctors office call to see why Humana wouldn't cover my visit. Humana told me it was filed as a sick visit. The Doctors office told me it was filed as a physical.
After the the Doctors office contacted Humana, Humana agreed that they were supose to cover 4 visits 100%. This one would have been viit #2. So back for evaluating it goes.
worst insurance coverage on the planet
Humana is the worst insurance company without question. After paying high premiums ($556.00 per month) for my son and myself, humana has refused to pay for any of my doctor visits so far. Out of a $300-$400 bill for a pap test (Routine cervical cancer test), humana payed a whopping $16 for the lab fee, and I had to pay the rest. For visits to have a wart removed, once again, I paid about $250 for 2 doctor visits while humana paid about $30. I just got a bill from my allergy doctor saying I owed $463 for a $500 bill for allergy tests and treatment. So humana coughed up a whopping $37 for that. I have called the company numerous times, filed a complaint, etc., but they weasel out of it every time. Run from this company. They love to dissect each and every doctor claim and refuse to pay based on unclear wording in your policy. I would love to see a class action lawsuit against this company for their refusal to pay claims based on unclear/misleading wording in policies.
sick of them never ever in all my years have i ever had an insurance company that calls all the time..i pay my premium monthly and do not need them calling all the time for this and that. I even have gone so far to block calls then they always call from another number anyone else have this problem? There is absolutely no reason an insurance co should be calling all the time. Had blue cross blue shield for 40 years and never a call.. Planning to go with someone else.
Every doctor I select off their website is not covered (in-network doctor and out-of-network-facility) even the PCP Humana helped me select is not covered. There are thousands (perhaps tens of thousands) of doctors listed on their website that they refuse to cover. Even the doctors listed are horrified at this scam after talking with Humana Colorado HMOX. I have two implants that are wired to me. I am a federal employee I am trapped until next open season. I may die without medical care before the next open season in a year. I don't know how the Humana employees sleep knowing their members are dying for want of basic healthcare.
I chose the plan that best fits my needs and am completely happy with Humana Gold Plus. If there comes a time I'm unhappy with the plan I will change it back to Gold Choice.
It is all about your plan, but then some people will never be happy.
Humana sent me a check for monies owed me because they over charged me. When I went to cash it they had cancelled the check and my account was charged $20. Humana refused to give me back the $20 saying that I should have known better than to cash that check.
I have Humana since February I have a Silver Plan HMO and no doctor will take the plan. I was told by a receptionist corporate says to stall with appointment cancellation and rescheduling hoping they will go somewhere else. She did say they would take Humana Gold. So for 4 months now I have no primary care and doesn't look I will find one off there list. There is list is worthless... But they keep taking my money every month
I think the only positive comments are coming from Humana employees. I was blatantly lied to. I specifically went with Humana because I was told repeatedly my very expensive medication would be covered. A med I have taken for over 20 years, it was not, even after several Drs. Said I should take it. Shame on you Humana. I was also told, both my husband and myself, and again this should be in Humana's recoding phone calls to us, that we would have a $4200.00 reimburment after the gap! So my 1st prescription this month was $345.00 the 2nd prescription was 145.00 and now I'm in the gap for $4700.00 and no reimbursement of $4200. Yes I was told of the gap but, I also was told I would get $4200.00 reimbursed. Now they are saying there is no reimbursement!
They are designed to frustrate, confuse and prey upon the elderly!
This is the truth. There is no accountability. Customer service is no more than a game of password. Nobody has the same information. Nobody is taking care of your account. You can't speak with anybody on a higher level than the inbound operators. They have breached their contract with me as far as I'm concerned! Over the course of a year and perhaps a dozen calls not once have I received the same information. There is no continuity. One rep said the hospital and clinic need to appeal, the next rep said my doctor needs to resend in a referral, the next rep said the dates are wrong, the next rep said my doctor called in but they didn't know what she was talking about, the next rep said the hospital dropped the ball by not responding, the next rep said it's too late to appeal. When the hospital called Humana, that rep said the member has to file a grievance. Follow up with her. Impossible! Today's rep said she didn't leave any notes nor did she leave her name. Today's rep also said I'm in a never-ending loop and agrees my next step should be outside the company. They are raising my blood pressure. I need to find a different company.
HUMANA screwed up on my drug plan application and as a result, I am without any coverage.
I signed on as a first time medicare member when eligible in October and subsequently received welcoming emails, notice that my card was in the mail, and then in a couple weeks afterward, the payment book showing first payment due Jan 1 of 2012. (I should have taken this a warning sign then!) Then to my surprise my prescription I went to fill on November 23 was denied and I realized I had not subimtted my "new" card to my pharmacy yet. Then I realized I had not received any new card yet and when I contacted HUMANA the rep informed me I was not covered yet and my coverage was not effective until Jan 1, 2012 as the coupon book indicated. SO, I have NO prescription coverage yet! Just glad I am not in dire need of any meds currently. I now plan is to find another drug plan provider, maybe one that has all coverage in one package but definitely NOT HUMANA! If they cannot even get my plan date correct, how can I be sure they can get anything else right?!
I have been in the insurance business for over 42 years and have never dealt with a company so incompetent as Humana. Every call to this company is transferred and then you end back up in the same place. It is just like the TV commercial I am Peggy which is a man. You never get to have your problem fixed. Also their RightSourceRx lies all the time and does not ship through the postal service as they claim. They use a trucking service then into the postal service so when the prescriptions finally arrive you are past out on the floor if you are lucky. Their prices for mail order many times are higher than the price to buy at a local pharmacy. If I have to pay more the transfer to another company, I will, but the Medicare makes you suffer until renewal date which can be up to a year of pain.
never had a worse experience
worthless!
Stay away from humana, your health does not matter profits do. They transferred me from an acute care facility to a cheap care facility. Maybe there stock price went up, maybe the ceo bonus went up. Stay the hell away from humana!
I underwent Surgery on 09/24/2017 and was literally thrown out of the Trauma Unit and sent home on 09/27/2017, because HUMANA refused to pay for my care and Physical Therapy! I am a 77 year old woman, now lying at home and cannot move because of this. My family at home all have severe Back Problems and cannot even lift me onto the toilet. So, I have to suffer for the rest of my life because someone at HUMANA made the decision to stop paying. Hopefully, my Hip will heal on it's own, even if it does not heal properly. MY WARNING TO YOU IS TO STAY AWAY FROM HUMANA! They are the WORST EVER.
I used to work for this dismal place in Phoenix. I was fired for using doctor and HR approved FMLA. They fired me shortly after I starting using this allotted time and gave me some ### excuse. Mind you I was always on time, my phone metrics were top notch, and I was on no verbal or written warnings whatsoever ever. They told us not to accept Rx returns even if a customer service rep misquoted a Rx copy. Disgusting company to work for an do business with. Phones rang off the hook due to endless complains and Rx misfills. The day I left was the best day if my life. I now work for an amazing fortune 500 company and they value their employees. Take a page from another company's book HUMANA. IF YOUR EMOUREA ARE HAPPY PROFITS AND BUSINESS WILL PROFIT. All of the customer service reps are ghetto and there is no reprocussions for their crap attitude and work ethics. This company will eventually will crumble. Just look at all the complaints! It doesn't seem like the fat ### CEO wants to take a break from his champagne and plate o'ribs and fix the company. Humana is only making its money because the healthcare industry is a monopoly. Get out people while u still can u will get ripped either way.
HUMANA AND ADECCO AND OTHER AGENCIES! 01/11/09
I can say all of this and I know its true I lived it ! Our family has recently decided to go with another company and has decided to drop Humana Insurance. when the time comes So not only is Humana loosing customers but they are ticking more and more of them off everyday, but they are loosing customers that use to be employees buy screwing them over..! KEEP DIGGING HUMANA ...YOUR TIME WILL SOMEDAY BE UP IN CINCINNATI AND WEST CHESTER AND YOU JUST GOT STARTED.
I can help explain why Right Source Humana Pharmacy is so messed up. I was hired through a Temp agency and I am not the only one. Adecco is going through other agencies in the Cincinnati and West Chester Ohio area looking for Pharmacy Techmicians...SO BEWARE ! And they are taking anything they can find..! Alot of these individuals have little or no experience and some have plenty, but the problem is they have opened up a new facility, and distrubution center using some individuals who have only been with the company for a short time to train the incomming new perm employees and Temps. I personally can't believe they let these individuals train new hires and they don't even know the computer modules themselves. Many of the individuals doing the training have'nt been with the company that long and to get answers they didn't know were Instant Messing Pheniox Az. where the main distrubution center is to get answers. In my training class a Temp who had worked for a small family based pharmacy found a prescription that had been filled wrong 4 times, and no one caught it not even the Pharmacists that work at Humana ... she did..! And guess what she is no longer working there they fired her shortly after that! The blind leading the blind. They should embrace people like that instead they sweep good talent under the carpet to keep from looking bad. She would have been an asset..! Also this new facility in West Chester is having many...and I mean many computer problems, and when you combine poorly trained people and slow bad computers your not getting much accomplished. When I worked there in the morning the computer modules were empty we sat around alot, and it was'nt by choice ! The computer modules were empty and sometime untill 3:00 pm and we got in at 8:00 am. Having to wait on Pheniox is a nightmare in every sense of the word..!
Now moving on ..! Most of the individuals working at this new center have come from various other places. I noticed alot of upper management and supervisors, leads, SME's have come from the same company. I noticed that there were many clicks ...ALREADY and if you were new or a Temp they wer'nt to friendly. Many of my fellow Temp co-workers told me in private that there were several supervisors in Order Entry, Dr Call, Patient Services that were mean to the Temps. Item Entry didn't even have a Leader they took orders from the Supervisor of Order Entry who had no experience with the area...and thats scary when it comes to entering individuals prescriptions..! ...but who cares how you treat people when your getting a good paycheck right! I also found it degrading to be refered to by regular Humana employees as a Temp on Temp Island. The way that Human employees in this new facility put it to us the first week when they did'nt know what department they were going to put us in. Temp Island is, and area infront of the door where all the Temps sit over there away from everyone. Thanks to all the computer issues most of the other Temps I worked with also told me their logins did'nt work form anywhere from 2 to 10 wks. So when asking questions to get help in your module be careful, and don't ask to many questions they don't like it, and to give the Temps any kind of perminent info. What I mean by perm info is when we arrived to start our first day we all met in the lobby. After everyone was present and role call of names was taken this is how it was put to us. A represenitive from Adecco met us in the lobby, and told us point blank. This is a Temp job this is not a Permanent job. If your agency told you that I want to know now ...and usually your agency told you it was Temp to Perm to get you onboard. We were then told it would be 3 to 6 months, and when our time was up we could then if we wanted to apply with Humana ourselves we could...but what they did'nt tell us was while we were being hired, and half @zz trained they were hiring permanent people, and fully training them. I found this out about a week into this what seemed to be never ending job of BS and deceptions. I would have thought Humana the company who suposly got it from what I was told from Supervisors, SME's, and Higher ups... would give everyone the same training to get the job done right. I feel sorry for some of the Temps who are still working there because they are under the wrong impression they are keeping them so they can hire permanent individuals, and your agency told you one thing to get you there, and Humana and Adecco will show you another! SO FOR HUMANA AND ADECCO I HAVE YOUR NUMBER AND I WON'T BE CALLING YOU... AND YOU CAN BET...IF THEY CAN'T GET IT RIGHT ON THE INSIDE THEY WILL NEVER GET IT RIGHT ON THE OUTSIDE WITH THE CUSTOMERS. I had myself removed from this job because I know they don't treat there customers right I spoke with several people who were in my group who went to Patient Services and they told me they wer'nt happy most of them left before or right after me. They had gotten tired of getting yelled at everyday by angry customers. Some not by choice...!
I also wanted to say they only trained most for a week ...and funny go figure then pulled alot of people except for the perms they hired back into the training room again for to many mistakes... and other problems. So I can honestly say GO FILL YOUR PRESCRIPTIONS SOMEWHERE ELSE DON'T WAIT 14 DAYS OR SO, AND DON'T FIGHT WITH HUMANA GUIDELINES... GO GET YOUR STUFF NOW AND BE HEALTHY, HAPPY AND HARASSMENT FREE...! I AM
I agree stay as far away from Humana as possible. They are putting my husband and I through the wringer. They will not pay legitamate claims and they answer to no one.
stay away from humana!
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...
Read full complaint and 43 commentsAbout Humana
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Humana has deleted my ID number and I have been a member for 2 years. There is no one in Humana who is willing to correct this error and I am unable to continue to receive medical care. The customer service reps. are supposed to fix these problems butthey act as if they cannot fix the problem. How does this happen in the United States?
"Well" is unfortunately a 4 letter word at Humana. It appears to be a problem within, which of course, affects their services. In their training, they teach "perfect service" - however, the caliber of nurses and staff is "terrorist-like", and if an employee shows signs of applying "perfect service", the employee experiences horror stories, and may be threatened with sharp cutting objects. It is common for a Humana employee to appear to brag that they may be the next "terrorist".
I was not able to use Humana's insurance. Although I paid for it to start at the beginning of the month, it was not ready, so I could not receive the medical services that I required. Many Humana members are in the same boat. The insurance applications are not processed on a timely basis, so even though you have paid for the insurance, you cannot use it. If Humana took the time to steer their employees away from terrorism, then they would have more time to process the applications promptly. The health care industry is in the hands of nurses and other staff who behave like terrorists - Humana is probably the worse example of such decay.
White humana employees be like...
In Dec 2010, my daughter needed her wisdom teeth extracted. Our family dentist referred us to a Dr. Fish, a specialist in Chandler, AZ. Upon entering the office, the receptionist asked for my insurance card. I handed it to her, and asked that their office pre-determine my out of pocket costs for the services. She said I could talk to the person that handles their insurance claims. After the Dr. finished the initial examination, I also mentioned to him that I would like to know what my out of pocket responsibility would be. He said that would be available from the insurance person. Finally, I was sitting at the desk of the insurance/financial person, and again requested to have a predertermination of my out of pocket costs. She said they don't offer that service, but they would invoice my insurance company and everything would be all right. Two months later, I started to receive billings for the total amount of the work. I called the office and was told that they were "out of network", and that I was now responsible for all charges. I told them that I had asked 3 times during the initial visit to predetermine my costs, and was refused. About one week later, I called the office and without telling them who I was, asked if they accepted SecureCare Dental insurance. The receptionist immediately responded "NO". I am convinced that the insurance person knew all along that we would not be covered, but didn't want to turn away our business! I told them that I would be willing to pay exactly what I would have been responsible for had they been in-network, but they refused to budge. I would expect to experience unethical treatment from a used car lot, but not from a dentists office!
Physician Finder Plus - MyHumana
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Physician Details
Perry County Family Practice Inc
Network: HumanaChoicePPO (Medicare PPO)
1625 Airport Rd
New Lexington, OH 43764
County: Perry
Phone: [protected]
Fax: [protected]
This is my Drs office...how can they say it's out of network?
I am having the same OUT OF NETWORK problem with Humanna. Have only had their PPO since 03/10. I verified that our Doctor and his office are in network. Now, even though most of the customer service people that I talk to assure me that my Doctors office is indeed in network and say they will resubmit the claim and get it paid...nothing happens. Some of them are down right rude and tell me that my Drs office is billing wrong or that it is up to me to file a dispute. If the customer service people can't figure out whether or not some one is in network...how the heck do they expect me to know? I'm stuck with them until Nov. then I'm switching to another company. People warned me and I should have listened but they were so nice when they wanted my business.
Your account is riddled with half-truths and no-truths.
You, as a member, are always responsible for verifying a provider's network status regardless of what is was 2 weeks ago or an hour ago... plan changes happen all the time. The here-say you heard from a doctor's office about their dealings with Humana are just that - here-say. And no, dentists are the real greedy ones here.. they make more than enough to cover their costs and they don't ask for small increases.. they ask for outlandish ones.. so Humana was probably wise to not renew their contract with your dishonest dentist.
Wow something similar to your dentist visit happened to me with my eye doctors. I have this brain condition which also involves my eyes. I have been going to the same eye doctors down the street since I was a little kid. THEY are the ones that discovered my brain condition and they have all the tests, medical equipment, and prescription writing abilities to take care of it, but Humana says I can only go to them for glasses and check ups but anything involving the condition I have to go all the way into the city to the main campus for a guy to do all the same tests my local eye place did. Which never works out because I always end up late even when I leave hours (HOURS) earlier than necessary because I'm not familiar with the area and they always give my slot away and refuse to see me for another three to six months. No kidding. If this appointment is so unimportant that it can be put off for so long then why have it at all? Well anyways, it's been over a year since I had my last eye exam and I really need new glasses. So I made an appointment with the people down the street but after I gave them my credit card and the new temp gave me the receipt I realize she charge me more than they normally did. We came to the conclusion that she accidentally charged me for a special eye test that I do need, but could no longer get there because it is connected with my brain condition. She seemed to be having trouble getting the extra amount off my bill, so a full time worker came to help and as soon as she came over and saw my Humana card she said they no longer took Humana. It sparked a big debate with all the workers there weather they did or not. (It was so funny, them not knowing if they still took my insurance) Finally someone got on the phone with Humana and they figured out that if you go to any out side place of Humana (which my eye place was now considered as), the card would still work and act like it accepted Humana. However, you have to pay up to 3, 000 dollars each year first, then after you have paid that full amount Humana would pitch in a fraction of any costs after that. So the lady that called Humana explained to me that the bill I initially got would have just gone toward the 3, 000 dollars and I would have gotten a bill for the rest later. I almost let the bill go at first thinking that it had been a long time since I had that special test done and should really get it, luckily I anticipated that that might cause me problems through Humana and decided against it. I had no idea what problems I would really be stopping! And its good to know that thing about places accepting the card even if they don't actually accept Humana. Now I'm paranoid every where I go though. Also, after I had finished catching up with all the lady's that work at my eye place, and turned to go, I nearly wanted to cry. I had been going there since I was a little kid...now I had no reason to go back...
I did find out that because of a recent change in the insurance I wont be eligible for it in a year, but in the mean time I have a question for you Lloyd, or anyone that reads this. Where is the list of places that do take Humana because I've looked and looked but I can't find it!? Any help would be much appreciated!
I'm responding to the woman that lost denist, ex. Humana is famous for choosing not to act in accordance with their actual documentation they said a client in the mail. As far as I have been able to tell, the company makes money upon the premiss (I can't spell) that persons will not notice the actual cost of their appointments. I hate to say it, but the bulk of persons on medicare are not familiar with computers. They expect to recieve the benifits they pay for. I am a mere thirty-one years old, but due to disability, I am on medicare. I currently have seventeen pages docuemented regarding Humana and the number of times I have called and submitted claims. Spending much of my life in situations where I felt helpless, I am determined to expose Humana's reckless actions resulting in a higher profit for Humana. Please let me know if you have a way to educate persons about this company. For once, I am not fueled by anger, but am determined to help persons make the correct choices about health care. Please call or write me, jenny schmtiz, jtbirdiusrex@Yahoo.com, [protected].