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Complaints & Reviews

misrepresentation of 0 pay plan

I subscribed to Humana's 0 pay plan: H45184153 with Marciel Lee (a knowledgeable licensed insurance producer). I was told that 0 pay is 0 pay and I agree with him. I recently got a report from Humana stating that I had a $7 co-pay? No one told me there was any co-pay on the 0 pay plan and the accupuncture center assurred me that there was NO copay and that Humana never told them there was...they were paid the accupuncture bill submitted. I called Humana who told me that the 0 pay plan included a co-pay but this makes No sense? 0 pay is 0 pay! Even Marciel told me 0pay is 0 pay. Why is Humana doing this leaving me confused and misinformed? Next year I will leave Humana and enroll in a plan that has 0pay and no copay.

Dental

Humana is the worst! We've been paying two years for dental services we cannot use. Last May I found a dentist on their website and went there for a cleaning. Humana denied the claim saying they were out of network so we ended up having to pay out of pocket. I'm still fighting with Humana to get reimbursed. In September 2019, my husband went to a different dentist, referred to us by a Humana representative, that claim was too denied for the same reason! This is ridiculous. I cannot cancel or change providers until open enrollment. I'm so outdone.

denied pre cert for mom's rehab-state of ohio

My mom (#H64695236) had a severe stroke on Dec. 14, 2019, she was released to a rehab facility on Dec. 23, 2019.
I chose Humana as her primary Medicare advantage plan (offered as a Hoover company retiree) which would've taken effect on Jan. 1, 2020.

The rehab facility called Humana for a pre-cert for her continued rehab.
She was denied twice stating that she hadn't made any progress!! everyone at the rehab facility was aghast at the fact that she was denied. The phrase used was "Humana is being DIRTY". Christ she graduated from being fed with a spoon to being able to use a straw, to me that is progress.

The poor woman had a softball size bleed on her brain, paralyzed on her left side and hadn't had any significant sleep for 10 days while in the hospital. Morphine didn't even help!

Humana must expect people to be doing cartwheels so soon after a stroke!

I am waiting on her medical records to file my first appeal, if that doesn't go our way, the next step will be filing a complaint with the Ohio Department of Insurance, and I have a message out to an insurance attorney.

Boy do I regret signing her up during open enrollment. I should have just left well enough alone and kept her strictly on Medicare A & B.

Game on Humana!!

Lynn

humana medicare advantage gold

I had Humana Medicare Advantage Gold Plus for many years and in all instances, I never was able to use the Dental side of the plan. The Dental has a list of providers, but when you call them none of them accepts the plan. Even the Customer Service Rep. called many Dentists and was unable to locate one. She promised to find out more and called me back. That was two years ago, and she never called.
I decided to change companies, but reviewing the benefits all of these companies offer, I noticed that Humana offers a reimbursement through the medical side up to $1, 000 per year in dental procedure, and all you have to do is send the bills and they "would" reimburse the amount. I decided to take advantage of this complimentary benefit of Humana and submitted my claim to Medical. They in turned sent all the documents to Dental. Dental needed more information and finally they declined the claim, indicating the Dentist is not in their network. I already knew that there are no dentists on the Network, as I had tried to use it before without any success, as explained above. So, I called the medical and explained the situation to one person and after putting on hold for 20 minutes, another rep. appeared on my line asking me what she could help me with. Are you kidding me???? I explained all of this, three times. I was put on hold and now you showed up on this line asking me why am I calling???
She knew I was frustrated, so she transferred me to a lady who at least had the courtesy of taking her time finding out more and offered to transfer me to the correct department that will be able to take care of this claim. Here comes a man with an Indian accent who did not allow me to explain any further and hang up on me. I called back to complain and asked her to tell me who I had been talking before and what was the name of the department that she had transferred me and I was treated such a lack of respect. She did not know.

This is Humana, they lie about dental, they lie about extra benefits like Dental Reimbursement.
Humana is a corrupted company, who does not assume responsibility.

insurance

your company lied to me to get me to pay for coverage. Now that my coverage is over in January you are refusing to cancel. I have wrote to the BBB and i will continue to post...

prescription drug program

On 11/05/2019 I enrolled my wife and myself to Humana Walmart Value RX.
I did this online at their website and received a confirmation that both applications were received. Received ID card for my wife but never received one for myself. They can't find me in the system and now they say it is too late to enroll. Have written proof of my received application.

Hal Bleich - [protected] [protected]@outlook.com

  • He
    heliosue Jan 01, 2020

    Maybe you are better off without them. As of 01-01-2020, my Part D Plan with Humana was converted from a $29 per month plan to a $64 per month plan.I was unable to access my email for several months prior to this change and therefore, unable to receive email notifications. No other contact was attempted by Humana to get my agreement to this change. At the same time Humana made this change, they created another plan (much less costly), that is similar to my previous plan, but instead chose place me in their new Premier RX plan that is more than twice the cost of my previous plan. I regularly use three Tier 1 medications and my annual cost went from around $300 plus to $900 plus with the new plan.

    0 Votes

Humana Pharmacycancellation of prescription and to find out why

Plan: Medicare employer PPO ID H31871801 Plan #(80840)[protected] Diocese of Savannah My Name:
Clarence Mansell Card Issued 9/7/19

Problem: Script submitted by doctor and cancelled by Humana
Answer from 5 different reps of Human: In your computer it is noted that the script should be referred to my primary insurer which is medicare (you are secondary : Humana
Medicare PPO so..why has this script been refused when
others submitted (for other meds) has been accepted?
The med is a nasal spray and its name is also in you computer. Should I ask doctor to resubmit, prescribe a different med or what? Is this going to continue happening? Why can this not be resolved? Your reps have been very kind and tried to be helpful so this is not an
employee problem. Help!

customer serv.

After a long wait a young man answered that had no ideal what he was doing after a considerate amount of time. He tried to transfer my call and hung up on me. waited for call back...

unethical behaviour

I called on 10.23.2019, and was assured that my order for Metformin 1000mg, placed on 10.21.2019 was being shipped out on 10.23.2019.
When I called today a representative, a supervisor, and a manager attempted duplicitous excuses and was unable to give me an assurance that the medication would be shipped out today.
Is Humana Pharmacy so inefficient that they are unable to process an order where there is a prescription on file, and a valid Credit Card on record, without having to make spurious excuses for delays?

medication

I moved to Delray Beach, Florida 5 years ago, since my time here I had 8 back surgeries and 2 total knee replacements, I have been on medication since then. On March 5th 2019, my younger brother died, I went back to Pennsylvania to take care of the funeral and his estate. Came back 2 weeks later. In June I get a call my parents (both in their 80's) needed some help. My father had fallen and my mother tried to catch him, he fell on her and broke her hip. Now I have to go back to Pennsylvania to help them for 3 weeks. So I call humana and they give me something called a prescription override, so I can have enough medication until I get back, great. Fast forward to October, I decided to move back to Pennsylvania to look after my parents. Bought a house, have closing on Oct 15th. I get a rental truck for Thursday Oct. 10th, leaving early Saturday morning for the long drive back. Problem, my medication will run out and humana will not give me a vacation override, they say they will not do it more than once in a 12 month period, which was never explained to me before. I will be here on Oct. 11th, I cannot refill my prescription until the 14th, 3 FREAKIN DAYS! I was on the phone (over 4 ½ hours) and went to the local humana office to straighten this out. Their solution as told to me twice. On Oct 15th, after closing on my house in Pennsylvania, I should fly back to Florida just to refill a prescription. Are these people crazy? All I wanted was to have my prescription filled 3 DAYS early so I can move, they denied it. I even went as far as to call ahead in Pennsylvania to a pain center, but could not get an appt. until Oct 30th. So from the 15th to the 30th, I will have no pain medication. Pleaded with humana a for the 3 day override, they will not budge. I do not know what to do, I cannot have a script written in Florida filled in Pennsylvania. I will be without meds for 15 days and humana does not care! This is why people turn to getting other forms of help, weather it be legally or illegally. Humana is a heartless company and this is just a warning to whomever uses them, be careful, they do not care if you live or die.

repeated requests for eob — humana is ignoring me.

I am steve hagerman member h59711166-00 humana insurance company
Group x2550001.
I have made repeated requests by phone for my february 3, 2016 — eob (explanation of benefits). I first asked on july 3 — then august 14, then september 4 and 9. each time they tell me they will mail it in 2 weeks. the last time I got a reference # for our conversation which is: [protected].
I need humana to provide this record for me.
The va hospital has requested this information from me. it is unavailable on their web site and I need it. can you help me obtain this? I tried to attach the transcripts of my chats but the form will not allow. pdfs

humana medicare advantage gold hmo

We are having issues with claims denying stating no referral is on file. However, dr. Janis fowler-gulde is showing listed as the patient pcp, but claims deny stating service...

Human Advantage PPOdental

Before I booked an appointment for dental services, 11/13/2018. I called Humana for provider directory and verified benefits for the routine cleaning and filling that I would be receiving. Then almost a year later I get a bill from the dentist stating that Humana had denied the claim saying the dentist was not on the list. Of course, he was...I have the list they emailed me and he is on it. I spoke with Humana and they had the nerve to ask me to file an appeal, which I refused to do given that the dentist was on the list. Sent them the list they sent me just to prove it and did not hear back. Second visit to the same dentist a year later, and another bill. The dentist assured me before the work they were on the list as they had been before. Now I am billed $500. The short story is that now I filed a complaint with Medicare, Humana does everything possible to dissuade you from getting a claim paid. I don't get mad anymore...I file complaints, write scathing reviews and finally get resolve. Enough of this crap,

Provider service representatives

Date of Incident: 08/20/19 I am a Healthcare provider and calls Humana Monday - Friday for updates on claims or to find out why a claim denied. The representatives are so rude...

refusing emergency care

Long story short, my father was taken by ambulance to the ER on august 9th with Acute respiratory failure.after arriving it was found his co2 level was 90%, he was in kidney...

Humana Pharmacy — www.humanapharmacy.com/my pharmacy/my account/communication preferences

Most recent occurrence: 8/16/2019 9:24am Phone call from number: [protected] I logon to ‘www.humanapharmacy.com/myaccount' and go to ‘Communication Preferences', then...

humana dental

A couple of warnings. There dental coverage is average with other at best. Getting reimburse takes an act of god. But on the other hand there are people in the business world who do not believe in ethics or morals of any type. One such company is Aspen Dental. Long story short. Went to Aspen Dental for a routine check up and cleaning. Asked if they took my PPO and of course they said "yes". Took my card, copied it, did the work and found additional dental issues that needed to be addressed. The bill over $2K when they were done. Second opinion found these supposedly service were not warranted or even possible. Aspen Dental never submitted my claim for services that they did render. Humana has special prices for In Network providers. The dentist was in fact in there list, but Aspen Dental was not. The address was the same as the listed dentist. Only a little deception at this point. After service provided, Aspen finances the full amount of services to be rendered. Services that could not be rendered according to the second opinion. The bill was from an outside finance agency with extremely high interest. Not one bill went to Humana which they claimed they took right up front. Still to date, 6 months later, Humana has not reimbursed me for the services that were covered at 100% per my insurance as stated. Aspen Dental is still in business as of this date. Deceptives business practices, no insurance investigation and no check from Humana. Thankfully this case has been handed over the states attorney general's office with all the documentation stating the facts. Keep all your records, including chats, bills and any communication. Deceptions lurks in the wings of those who will pry on you.

  • Jo
    Jocelyn S. Sep 06, 2019

    I had a terrible experience at Aspen Dental yesterday, in Orange City, Florida and then I see that others have had quite the same. Stay away from this Provider. They are scam artists and, I'm sure, are able to convince people, especially older patients, that they have "terrible bone loss"; advanced "periodontal disease"; "infected gums", etc. even when the patient has never been told, by any other dentist they have seen, that this is the case. This is all in an effort to maneuver the patient to speak to one of their "closers", to sign up for one of their plans or programs and the costs of same. The cleaning that I was supposed to receive was not done and I was told that "no new patient ever has a cleaning on their first appointment". Really, how about on their last appointment? I walked out the door.

    0 Votes

Humana Dr. Trudell Doctor — did not provide needed xray and did not respond to calls (this is 5 days later)

On wednesday july 31, I called trudell's office (I refuse to call her "doctor" after this experience) to make an appointment regarding an injury my wife had sustained after a bad...

medical & pharmacy

Very Bad Service. I will be leaving this rotten service as soon as I can which will be leaving Jan 1, 2020 Can, t get medical service scheduling is often months out. My 1st Dr appointments took 5 months, referrals is a miss, take 2 additional months or more, physicians do not know very much. As to the Pharmacy what a wait of time. they tell you something and then say something else. To get a new prescription, takes the pharmacy 3 to 5 days to process the new medication then 3-5 days to sent it to Post Office then up to 10 days to get it delivered.

health insurance

I went to see my PCP Tuesday for an emergent visit for abdominal pain. Upon receipt I was asked for a $85 down payment. I told the front desk my copay was only $30. They checked...

Humana Federal Advantage Dentalbilling

Since the incident on 04/25/19 that occurred during my dental visit, Humana Federal Advantage Dental told me that they accepted my insurance plan and that Marbella Dental would also accept it. After my visit I paid $50 and now I received a bill from Marbella stating that I owed $83. After my visit I called my insurance company, to where they stated that I should not have paid $50 since my visit on the 25th of April was an emergency. After becoming aware of that information I then called Marbella to let them know what the insurance company had told me, however they said that they would not return the $50 to me until my insurance company paid the $83 to them. So, since April I have been calling Humana Federal Advantage to see whether they were going to pay Marbella for my procedure and or return my money. My experience with Humana Federal Advantage has been terrible, due to dental being taken away from Military Insurance, I had believed that Humana would be a good option for me since it is intended for Federal employees, however the service and treatment to their clients is very poor.

dr. todd walter

Dr. Walter terminated me without letting me know . H also told the other physicians in his office not to take me as a patient. I am now without a physician and I need medical care.

He also invaded my privacy by letting all the staff in his office know. On my records it specifically states that no one is to be given my information except when they need to know for medical reasons. His entire staff has been given access to my information.

I found this out because another staff member told my husband who is a patient at the same medical facility.

HELP!!! I need a doctor ASAP as I'm without some of my mediation!!!

humana pharmacy

These people are making sure that you are out of medications. They are causing inconvenience, hard ship, and problems. I am about to soon switch back to the pharmacy I was with before. Back in the day before I switched for Humana Pharmacy I always was able to pick up my medications, and they were always available when I needed them after I get refills from the doctor. Because of this poor company, I am down to 10 pills left over, and they are still messing around, pushing paper work around. They do nothing but give excuses that they cannot fill out my prescriptions with a sent letter for denial. If I don't get my medications that I need before my doctor appointment, I am going to be switching back to my old pharmacy that cares about me.

Humana Insuranceunethical behaviour

DO I MUST DIE???
The Humana Pharmacy require that I contact them every 3 months to approve the shipment of medication, even when they have a script from the doctor. I am 77 years old and I forget and in 2018 I did miss 3 months of medication. This year, 2019, first they refused to send me one medication, I did complain and the medication was approved until 2021. We are as today June 21-2019 and I did not received this medication. They have a Network that includes Doctors Groups. One Group called Uro Partners, the only one that Humana has with my insurance, refuse to let me see an Urologist. I do not see an Urologist with Humana Insurance since January 2018 until today June 21-2019. Whit no other Group close to me I do not see an Urologist. I did call Humana Insurance and they send me an EMAIL with Doctors for 4 County but my County, Lake, Illinois, has only Uro Partners Group which refuse to let me see an Urologist. My body do not produce TESTOSTERONE and Humana insurance is not providing me to see an Urologist and Humana Pharmacy do not send me to right medication putting me in a greater danger of dying. My primary care Physician is not responsible for this problem, He Send the Script to the Humana Pharmacy and the request for an Urology Doctors.
[protected] I did speak with Debbie at Uro Partners Group Headquarters and I was told that DEBBIE is calling MICHELLE, DIRECTOR of the Group. So far I do not have received any response making my health in more danger. Uro Partners Group is refusing me to see an Urologist because 4 years ago I saw an Urologist belonging to Uro Partner group which is asking me to pay first $50 and now $74 for bills when I saw him. This bills are with a credit collector. The problem is very simple: Humana has no doctors with any other Groups and Uro Partners is not willing to let me see any Urologist of their Group. MONOPOLY???
Ettore

Humana Insurancenetwork

DO I MUST DIE???
The Humana Pharmacy require that I contact them every 3 months to approve the shipment of medication, even when they have a script from the doctor. I am 77 years old and I forget and in 2018 I did miss 3 months of medication. This year, 2019, first they refused to send me one medication, I did complain and the medication was approved until 2021. We are as today June 21-2019 and I did not received this medication. They have a Network that includes Doctors Groups. One Group called Uro Partners, the only one that Humana has with my insurance, refuse to let me see an Urologist. I do not see an Urologist with Humana Insurance since January 2018 until today June 21-2019. Whit no other Group close to me I do not see an Urologist. I did call Humana Insurance and they send me an EMAIL with Doctors for 4 County but my County, Lake, Illinois, has only Uro Partners Group which refuse to let me see an Urologist . My body do not produce TESTOSTERONE and Humana insurance is not providing me to see an Urologist and Humana Pharmacy do not send me to right medication putting me in a greater danger of dying. My primary care Physician is not responsible for this problem, He Send The Script To The Humana Pharmacy and the request for an Urology Doctors.
[protected] I did speak with Debbie at Uro Partners Group Headquarters and I was told that DEBBIE is calling MICHELLE, DIRECTOR of the Group. So far I do not have received any response making my health in more danger. Uro Partners Group is refusing me to see an Urologist because 4 years ago I saw an Urologist belonging to Uro Partner group which is asking me to pay first $50 and now $74 for bills when I saw him. This bills are with a credit collector. The problem is very simple: Humana has no doctors with any other Groups and Uro Partners is not willing to let me see any Urologist of their Group. MONOPOLY ???
Ettore

dental coverage with aspen dental

Was informed that Aspen Dental accepted Humana Gold. the location in Galesburg IL needs to be audited. I was told deep cleaning would be $1000 but since I had insurance, $500. I was not told Humana
Dental did not cover these services. I was seen 4/8/19 for Gingival irrigation, topical fluoride varnish and numerous x-rays.( A young student repeatedly touched my mouth to align the bite tabs and touched walls, etc. with the same hand, never changing the glove, didn't know how to run the machine, spend 30 minutes with her until a staff person came to assist her) Again 5/1/19 for Perio charting, perio maintenance. To date $670 paid. Minimal cleaning. Now received another bill for $109.50 for who knows what for.
My local dentist charges $200 a year for x-rays and biannual cleaning and checkups. I will be going back to him in November. Aspen Dental is over priced and scary.
Please consider a $200 allowance for a reputable dentist and don't offer this poor substitution for dental care. Health Alliance offers the $200 annual credit with a qualified dentist which is a much better option than the over priced fees charged at Aspen Dental.
May consider opting out of Humana if this was the only option. No medical savings here. I was never told Humana didn't cover these services. Would to have these fees dropped.
Please feel free to contact me if you have additional questions. I would appreciate a response.
Betty Nelson [protected]
Member ID H72343509

humana hmo mcare - auth request

I called on 06/17/19 to start an OON Gap Exception (pt was a prior ortho surgical patient who showed up at follow up apt with new Humana insurance.) I got transferred at least once and spoke to a rep to start this auth. She put me on hold at one point and the call was dropped (this was around the 30 min mark). I called right back and had to be transferred a few times and did eventually get someone on the phone who apparently could not hear me and hung up on me (this was after 36 min on hold/transferred, etc). Because this was near the end of our work day, I decided I would call again in the morning when hopefully the wait times were lower. I called back today (06/18) to make sure the auth had been started correctly and that all the info needed was there. I did have the automated system tell me that my auth was pending from yesterday but I wanted to speak with someone to make sure there was no info missing - I wanted to give it the best shot to be approved. I, of course, got the benefit rep (why do I always get the benefit rep when I choose the option for auths????) who had to transfer me. I got Yen Yen or Yen Yan, who after hearing me explain that I needed to confirm the auth I started yesterday, simply started a new auth. I didn't realize for several minutes because she didn't tell me this was what she was doing. When I asked her if that was what she was doing, she said it was because she couldn't find the other auth (which must be somewhere because the auto system had it) and because I didn't have a reference number (because the call got dropped prior to this info being given to me). I at that point asked to speak with a manager or a supervisor because she was obviously not understanding what I was needing, despite her and I discussing this for quite some time (total call was over 1 hour long). She put me on hold for a time and came back and just continued to finish up the auth and give me a pending ref# ([protected]). I asked again to speak with a manager and was now told they were in an emergency meeting. I asked her to find a manager/supervisor that I could speak with. She put me on a long hold again and told me that she just s/w a supervisor and he said that I should call back later. I can almost guarantee that this young lady NEVER inquired about getting a manager on the line. I asked her if I could even speak with one of the nurses - that was also a NO. I am absolutely appalled at the customer service that was given. What will probably happen is that your nurses will deny this request because it will look like I am starting this after the date of service. I explained this to the rep and she could only parrot the only info she has to give - fax in notes and they will call you if they need anything. To have a problem so small like this that could not get resolved in several hours over 2 days is APPALLING. The fact that she WOULD NOT transfer me to anyone over her head is very concerning. Please know that that I will make sure that I never use your product for myself or ANYONE in my family. I will tell everyone that I know to RUN from your products. If you can't get a small issue like this sorted out, then I feel for your patient's who are trusting you with their lives.

clinical staff assistance

Upon calling humana I was first meant with a very long hold time with a recording the entire duration constantly repeating that I can go online for assistance. Once I finally made it to a live person after 25 minutes the person got all the information and then stated that I had the wrong department and that I would need to be transferred elsewhere. She transferred me, upon another 10 minute wait time with the repetitive hold recording telling me to go online to only have the live person ask me ALL the same information to only tell me, yet again, I had the wrong department and she would transfer me. I was finally transferred and upon another 10 minute wait time I received a live person who AGAIN needed all the same information. When I was finally almost about to give her the fax number so our office could actually receive the denial letter that was never sent to us, for the previous person I spoke to somehow cut in and stated that she had a live representative. This was very frustrating and I told her I was already talking to someone and almost had things figured out. The two woman than conversed and the previous one finally got off the phone. I was able to relay the fax number. I waited to do the survey, as it stated when I first got on the phone that if you want to wait after the call you can do a survey. I waited for 5 minutes and then the phone just hung up on me.

I was calling from a providers office and if its this difficult and frustrating to get through to anyone than I cannot imagine what your clients have to endure when they call your line.

Personally one of the worse experiences I have ever had to endure when calling an insurance company for such a simple matter.

prescription plan

I changed my supplemental plan to Humana in January 2019 Prior to 5/23/19
A Humana representative called me to ask if they could assist me with changing my RX pharmacy to Humana (mail order for Amlodipin 5mg and Rosuvastatin 5mg), because they could save me money with a 90 day plan instead of 30 day. This meant I would not have a co-pay with the 90 day RX(s) for these two medications. I agreed to the changes. The representative stated she would handle the changes, and she would send a RX to my primary doctor to request the 90 day supply (one of my medication at my pharmacy was already a 90 day supply). On 5/23/19 they sent my first mail order for a 30 day supply of my medication with a co-pay. I called Humana and spoke with another representative for over 30 minutes along with one of the pharmacist at Humana Pharmacy. I thought the matter was straighten out then; but apparently not, because I still have the same problem today. I even went to my primary clinic (nurse practioner) and informed him of the issue of the RX prior to 5/30/19 ( I had already called to inform him of the matter prior to this date). Then I reminded him of the RX on 5/30/19. He gave me a written RX and said he was sending one to Humana pharmacy. Yet, I received another 30 day supply with a co-pay from Humana this week. I called them back today to report the problem, and went through the long explanations with them regarding the problem a third time. And The pharmacist I spoke with today, by the name Ola, repeated the wrong Fred's pharmacy address, in my area to me, which they probably had wrong in the computer? That could be a part of the problems? I don't nowhat their problem is! My point is, I could have stayed with my local pharmacy without all the issues I have experienced with Humana's Pharmacy over the last month. Saving the money was not as frustrating to me as dealing with the pharmacy with Humana!!! I did not ask for this problem. It appears to be a lack of communication. Now I have a 30 day supply of medications of both of my prescriptions instead of the 90 day that I do not want from them!!!
That was the sole purpose of changing my pharmacy to Humana Pharmacy! I could have gotten this medication here at home for that matter. Now the pharmacy does not want to take responsibility for their actions! I could have Faxed the RX, but the original representative I spoke with informed me, "No, I needed to do nothing!" It is most annoying to me! And as far as I can see right now, it still may not be corrected! But I did call my clinic again this PM and reported the problem. They have received the Fax from Humana the 3rd time!!! I need to return these RX(s) and get my right RX(s) sent out to me!! ID H62254171

  • Updated by JennettaR · Jun 12, 2019

    No update necessary! See complaint above!

gold plus (hmo) policy

My wife, Patricia A. Nelson member No. H64486787, is having issues with receiving her benefits from the policy. She filed for the policy in December 2018, stating that her birth date was 01/01/1953 and wanted the policy to be in force as of 01/01/2019. Application, as per information of our agent, was lost by Humana. Application was refiled 2 times. On February 1, 2019 she received a letter stating that she was covered as of January 1, 2019. However when she received her member card it states date of issue as 2/1/2019.
She submitted an order for over-the-counter med ans products in February. We have not received a conformation regarding that order. She submitted another order in March for the 2nd quarter. Received conformation and finally received a portion of her order. I called regarding this and was told "She is only entitle to $45.00 per quarter and the order was over that." Her policy states she is due $75.00. In speaking to the agent, I found that they did not have her correct information in the computer. My wife's information was mixed with another client who lives in Madison, WV. I connected my agent, he contacted Humana and it was fixed. Then we started receiving EOB and claim denial forms from providers in West Virginia. I called them. They have the correct information for their client. The EOB and denials have wife's Humana number on the.
I have now received a claim denial for services provided in Joplin, MO which are valid, but Humana has denied them with this statement "This service is not covered because it was performed after your Humana Health Care Plan had ended". Letter dated May 22, 2019, service date May 15, 2019.
I called customer service again today ( call log # [protected] and [protected]) regarding these problems. Again told we will get it fixed.
Currently my wife's over-the-counter med orders are on hold until this is fixed. Also need to have the denial of claim to Mercy Clinic in Joplin addressed.
We are very disappointed in the service we have received from your company. Today I filed a complaint with the Missouri Department of Insurance regarding your lack of interest in our issues.

Humana Pharmacy — my order

I am Bobbie Givens. I placed an order the first of April with this pharmacy. I never received the order. This is not the first time that this has happened. I phoned them and wa...

hmo policy

My sister purchased a Humana HMO policy a few years ago. She was in a terrible fall in January 2018 and sustained a head injury and was on life support for two months. While on life support Tristar medical center reached out to Humana for assistance with coverage of skilled nursing care. Humana denied the claim and stated she would not improve. Fortunately, she woke up from the coma after two months and said a few words. To make matters worse Humana once again denied her assistance for skilled nursing care. We have been told by an Ombudsman that we and others who have experienced this have a case for fraud and should complain to our state's Attorney General office. ...Contact Ann Mikkelsen Assistant Attorney General in the Consumer Protection and Advocate Division: [protected] or Ann.[protected]@ag.tn.gov

· Contact Commissioner Julie Mix McPeak at Commerce and Insurance. [protected] or Julie.[protected]@tn.gov

billing

I got a bill after I went to another company that had better coverage then Humana then I got billed for286.00 that humana did not pay My coverage was for me to pay 40 on doctor visit and I paid it but humana did ont pay there share they are trying to make me pay 286.00 this is their bill and not mine and I get extra help because I am poor to poor to pay this amount! Nancy Sylvain account #1126951 statement date 4/02/19 please do something about this Medicare was informed and they said you need to take care of this.

local network identification

A simple way to find which Doctors, clinic, and hospital are in the Humana network for a zip code. I have spent over 5 hours on the phone and internet to get an answer. Now I don't trust my findings, as its not explained very clear.
If open enrollment was now I would cancel and go to some plan, who cares!!!
It would be very easy, to have a site, that is easy to find and get to!!!

humana medicare

Maria Margarita Gutierrez 83, dementia, Alzheimer, disable with Hospice at home.
In September 2018 Humana exchange to medicaid Lon term, after that send a letter and stop service in HUMANA GOLD CARD for 1 mont, No medicine, No food, No primary doctor, after One Mont send to my Wife a new card Gold Plus (HMO SNP. To day March/ 28/ 2019, send a similar letter, same DATE 28/09/2018 and stop for second time all service, Primary Doctor, Medicine, and Food, I contact Humana Medicare for give my Wife all service.
My Wife Margarita have Medicare, Medicaid and not have food, we have very low Income, is impossible paid a food, medicine, and paid for a primary Doctor, please help my wife.

Santos Di Martino ( Husband ) [protected]@yahoo.com
5120 Town N Country Blvd, Tampa FL. 33615

unethical behavior

I would like to post a complaint to your offshore representatives. They are very rude and doesn't seem to have a guideline whenever answering calls. It always took me 5 calls just to get accurate information. I also cannot get in your survey because they will not hang up and will just route you back on queue which is an obvious manipulation of metrics.

enrollment on the web

For the past couple of weeks I've been trying to get my granddaughter's registered at the website.
Elizabeth McClure Elli SSN [protected]
Humana H [protected] DOB 04/01/2019. I have made numerous phone calls I need to get hold of a website analyst so that I can get my granddaughter's registered and get on your website my name is Gary McClure [protected]. Please check the phone log for this account you will see I made numerous calls and have become very frustrated and aggravated please help Gary McClure [protected]

  • Ta
    Taylor Butler Apr 09, 2019

    Elizabeth,

    Delete this post immediately! Looking through the comments I could see her SSN, member number and DOB in the open. Get this off here so her identity doesn't get stolen.

    0 Votes

comp benefits dental

Dont trust anything you hear over the phone from them. I tried cancelling my account over the phone with them two months ago and was very kindly told that it was cancelled and everything was taken care of. Nope my account has been debitted and credited for the last two months. I cant get them to stop my automatic payments. I call them about it and get the run around. Aweful customer service.

change in claims processing for in-network dentist

17338 On behalf of Dr. Mitchell Tseu(tax id [protected]) Recent claims have been processed as an out of network provider Dr. Mitchell Tseu is an in network provider with Humana According...

the number doctors call for authorization

My PCP referred me to a Pulmonary Specialist. The Specialist ordered oxygen for me. When the specialist called Humana for authorization she was told that the PCP had to get the...