Humana
Reviews and Complaints

Endangering client’s health care - humana (Medicare) rx drug plan - profits from pain 4/26/2017 1:25 pm

I have had humana as my drug rx plan in ny for several years and now in florida since moving here a year ago.in ny it was determined by 3 specialists, that I am allergic to preservatives in eyedrops (It caused me severe blepharitis) and then the anti-inflammatory drugs to resolve this caused permanent vision damage to both my eyes. I have to use unpreserved eye drops to avoid vision loss. All the eye doctors I saw notified human of my sensitivity to preservatives and the need for unpreserved medications (I too am an eye doctor). Humana then authorized the (Not on the formulary) drops at a $45.00 copay each purchased month’s supply (After a yearly first purchase of $125.00).

I called today to get a price on the drops in florida, as recommended by my physician who thought she might be able to save me money by not using my drug plan. I was told by your rep [protected] that all the past reports my doctors filed were of no value. I was told that I had to start the process over and get new doctors to request this exception because it was a new year (Each year). You did not promise to make an exception in any case. I was also told the drug is not on your formulary and I would have to pay full price. The walmart discount prices is $175.84 for a month’s supply. It sells for over $200 / mo supply. It is illogical (And unethical) to ask me to go through the doctor request process each year. When your representative said I would have to do this I asked to speak to a supervisor since allergies don’t go a way. He then played the same trick all "annoyed" providers do and said he would transfer my call to customer services who would help. He promptly disconnected us. (He had my phone number and if he wished to call back he could have).

I am a retired doctor, I understand how you play games by forcing doctors to do unnecessary time consuming paperwork and phone work so that you can stop patients who need exceptions from getting the meds they need and for which they have paid your insurance fees for years. Sure you tell the patients it is their doctor’s responsibility to contact your service department as if it would take just a moment or two. When I was a practicing doctor, I would have been doing this all day! Doctors are paid poorly enough already and now you add to the injury by making them do unnecessary paperwork or spend time on the phone with your company (Which hangs up on them too) which is not possible for them to do today. It is a neat little way of deceiving your patients. You tell them ask your doctors to get an exception and put the blame on the doctor.

Having a formulary that allows you to negotiate for a lower price with a drug company is not a bad idea. However when a patient needs a drug not available on your formulary and when there is no alternative on our formulary, making them jump through hoops to deny services is unethical. We as patients, all know the stories of suffering senior citizens who live in pain because they cannot afford the medicines they pay their plans for. The medicines they can get from canada pharmacy cheaper than with their drug plans.

As patients, you take our money in premiums with false promises of care and then deny service for greater profits. Nothing could be more unethical other than directly causing injury to your clients by stabbing them with a knife or shooting them. You get away with it indirectly, without putting a knife in them, by denying services. I wonder how this would read on the internet? I gave you 24 hours to set this straight in writing and then I waited w weeks. On 4/26/2017 I then sent my email to your customer services and received no response. Today is 5/9/2017 if you intended to respond, 2 weeks was clearly enough time. This clearly paints a picture of the ethics behind your services and your concern for your clients. Dr joseph a ross

5/30/2017 — the human drug plan rip-off only gets worse.

My eye doctor prescribed a second med for me today. Unpreserved again because I am allergic as documented. This drug was also denied. Now she is going to write to them to see if they can get it approved. Meanwhile the records for several years show (At their company) that I am allergic and that does not change.

Today my wife needs and eyedrop for post surgical care. The drop is called prednisone. When she went to pick it up today they charged her an $80.00 co-pay. I went online to canadian pharmacy to see what it would cost without insurance. The price in us dollars is $27.00 and it is the same product from the same company, allergan. Get this straight now: with insurance $80.00 without insurance $27.00 ……….. How ethical is this? I looked at humana’s ratings online.

Rating: 1.2 stars out of - ‎367 votes

In 2014 I had cervical spinal fusion, thank God I had Excellus then. Now my employer switched to a Humana PPO. After the surgery I was left with severe nerve pain in my arms and hand, also I have lost dexterity in my hands. My doctor prescribed lidocaine patches for pain. Humana denied it, the doctor wrote a certificate of medical necessity, they denied it. I filed an appeal they denied it.The only medication they will allow me for the pain is lidocaine ointment in a 30 gram tube for a 30 day supply, when you get sample toothpaste from the dentist that is 27 grams. The amount of lidocaine they allow lasts about 5 days. With out the lidocaine I have had to increase the amount of Ativan that I take, the amount of Neurontin that I'm on and add 2 arthritis strength tylenol. I've had two doctors tell me this worries them because I'm heavily sedated, but it is the only way I can sleep without the patches. I also have asthma and I wasn't able to use an inhaler when I have an attack. I told my allergist and he said that there was one brand that people with poor dexterity could use, Humana denied it. I called them on the phone, an awful experience. You often get a poor connection, I've even had to hange up and call back, also you have to give information such as name, address, d.o.bo. and your Humana id number to everyone you talk to. They denied me the inhailer and would only a generic brand that I have trouble opening. As a result of nerve damage, I have difficulty walking, and I have major balance issues. I have to use a cane. One of my doctots prescribed orthodics to help with my balance, Humana denied them. I called Humana they denied it again. I am currently seeing a podiotrist, when I asked him about Humana his exact words "They suck." I am also seeing a pain management doctor, when I asked her about Humana she said "I only have trouble with two insurance companies, Humana, they are the worst and Fidelis.

April 21, 2017 my husbands primary insurance and Humana BOTH agreed that no prior authorization was necessary to implant a pain pump for his stage IV metastatic cancer pain.
April 24, as my husband was being wheeled in for surgery Humana called the Dr and said he did indeed have to do the trial. We debated and then the Dr did the spinal block to test the medications efficacy.
It is now April 28 and Humana has decided to deny the pain pump even though the Doctor himself has called and asked for an expedited appeal.
In essence, they are torturing my husband by denying appropriate pain control.
This is not the first time we have gone rounds about prior authorizations since my husband's diagnoses March 6 2017. It took two months for chemo to be approved. This is absolutely inhumane and needs to be addressed.
I called Humana today after the Dr office called me and was told it was because the diagnosis of neoplasm pain was insufficient. Why couldn't they have told that to the Dr office the last 4 days in the more than dozen times they have called?!
I ended up speaking with almost half a dozen people whom all spoke with multiple departments and still got nowhere. In fact, they disconnected me and told me my phone call was unable to be completed.

As of today 4/19/2017 I have spent more than four hours speaking with a variety of people in different departments to try and understand why a Tier Reduction Request was denied and what to do about it, since the letter was rather vague. It should be a simple question to answer: exactly what further information is needed and on what form. I have gotten several incorrect pieces of information, been switched to other departments who also didn't seem to know what to do, misinformed by a supervisor about what form to use and hung up on by another person when I voiced my frustration.
I have been really shocked by the level of either incompetence or misinformation of your representatives about a request that was already approved in the past by Humana.
Carolynn Maltas
H45330576
[protected]

My doctor finds a blood pressure med that works for me and was keeping my bp in good numbers. So when I go fill my olmesartan medoxomil I was turned away. It seems that humana knows my health needs better than my personal doctor. Blood pressure is not a game that you should play with when a doctor knows what is working for me. My doctor filled out your proper paper work and humana wants me to try other medications instead of what can keep me alive! It is obvious that you are big business and do not care about the patient or his family; you just care about making the most profit you can at any risk! Now there is a appeal procedure that I must take to prove that my doctor is right and that the humana jury is wrong! (Really)!
All in the meantime I go without bp meds, but hey thats ok with humana because they dont care about how your health is, they just care about the bottom dollar.

Sorry but this is how I see your company now.
Thanks for putting my health at risk...

Good Day my name is Shamel Byrd I am an RMA with Novant Heart and Vascular, and I have a complaint/request. When we receive these Prior Authorization for the patients the fax we receive from your office only has patients first and last name and Human Member ID, which is not very helpful on our part when we are trying to locate who the patient is. This leaves us typing in the patient first and last name and have to go threw each patient in hopes to luck up on the patient who the letter may correspond with. If we call your 800 number the customer service rep will not help us with finding out who this patient is as well so now the patients medication is now on hold because we have to find out who this patient is, we can not look up a patient in our system threw there Humana ID number . If you send a letter for a John Doe could you image how may john doe I have to go threw to find out which one this letter is for. I would really like to know if a date of birth could be added to these letters even if you guys add the patients address we can even look it up that way but they way you guys are sending out these letters are not helpful for us or the patients. I really would appreciate your help in this matter thank you so much in advance.

Sincerely,

Shamel Byrd
[protected]

Humana has wrongfully miss represented my insurance as a "network" instead of the only one I would have ever agreed to since I just went through a lengthy above the knee amputation just months before, ppo plan.

Per your later dated may 16, 2026, "i enrolled in the ppo plan which was august 1, 2015 not january 1, 2016.

This has been my worse nightmar! It has stopped my progress to over come the prothesis because of all these unpaid medical bills & added stress!S & as of last friday are went into collection status which is running my credit!
I have been so overwhelmed & stressed with the extra stress of people calling for there money that I had to go to er 3-4 times with panick attacks! It took me months to figure all this out & have been too upset to call & could not talk. I spent days trying to get help on all this. I finally mailed them a leter & assumed it was handled since ms jennifer guynes, insurance broker for humana, give me her word that it was fixed.
§
See attached - copy of letter dated may 11 2916
See attached - copy of my calender log for july 29, 2015 telling humana ppo only

I wish to make a complaint about Humana and my Medicare Supplement Insurance Plan F. Humana cancelled my Plan F as of October 31, 2016 due to non-payment when in fact they did receive the payment before October 31, 2016. I was told I could reinstate the Plan F if I sent in another payment. I immediately sent in a second payment and was told the Plan F was reinstated. I found out later that the Plan F was never reinstated and was stilled considered cancelled as of October 31, 2016. There was never any communication from Humana about anything regarding the cancellation or what happened to the two payments I sent them. Upon called Humana again I found out after a lot of aggravation and dealing with some very rude customer care representatives that my two payments were credited to me and were just hanging out for two m months and were not applied to my Flan F payments. I asked for them to send me a check for the two payments. They said they would refund my money. It has been over a week and still no check from them. I called again today and was told that the refund is still being processed. How long must you wait for a premium refund when they mess up and you have to pay your premium asap to them. I will wait a few more days and them will have to contact an attorney because it seems to me that they are trying to steel money from me at point. I wonder if their need for money is because the deal for them to be bought by Aetna fell through. I was told by a licensed medicare supplement agent recently never to deal with Humana again.

My sister-in-law has Humana from Exchange. She enrolled 12/19/2016 and paid her premium. We also have a confirmation letter stating the details of her plan yet, she is still not recognized in their system. She has multiple health needs medications. So far we have had to pay out of pocket for her appointments. I have spent at minimum, 17 hours on the phone with Humana and the Exchange since 1/1/17 and each time I am told "the problem is fixed, but it will take 24-48 Hours for the Upload to take effect". We wait the requested time, and nothing is fixed.

She is scheduled for cataract surgery this coming Wednesday, which we cannot afford to pay out of pocket for.

However, Humana was able to find her in the system to generate her next premium bill, which is due 2/1/17. Yet she is still not able to be found in the system by her doctors so that she can have her medical expenses covered. I have filed a complaint with the National Insurance Commission. We are desperate for Humana to fix this problem. We do not know what else to do.

We thought others might be having a similar problem. Just another big problem with ObamaCare.

Everyone I have talked to has been polite and respectful.

1) When I purchased the policy 008 PPO beginning 1-1-17, I was originally told tier 3 drugs have no co-pay. Wrong. Tier 3 has co-pay. Book I received after 1-20-17 shows a co-pay. I called, they can't tell me why. I have all of the notes and name of person who told me no co-pay, Ashley. We went over each and every medication I take, and only 2 Tier 4 should have a co-pay. Now I am stuck.

2) 1/1917 I tried to fill out their online NEW prescription info to get started on my meds. Not only does it not make sense, and has bad grammar, it does not work. I called to ask what one of the questions means and spent 1 hr 20 min on the phone, passed around 4 times, and no one could answer the question. I must say, #3 Deardra, was awesome and stayed on the phone with me through the conversation with #4. #4 had poor English skills, and was not understanding Deardra's questions. She too was frustrated because no one could answer my question. #4 said it was an IT issue, and referred me to them. #3 Deardra IS with IT! Deardra asked for a supervisor and was never put through. I had to disconnect because I had an appointment. I went on line and put in a request for someone to call me on Monday.
Deardra gave me a # for complaints. Called it, is a contact lens place.

1/23 Received a call back. She was wonderful, and I cannot find my notes with her name on it. It seems you CANNOT enter NEW prescriptions on line when you are a new customer. Website needs to say that. You have to do it over the phone. All of my prescriptions were given over the phone, they send to my Dr's for approval. Wonderful. But this took another 59 minutes on the phone. Glad I am retired. I gave her my c/c # because my one prescription was going to cost me. No shock there! See 1)

2) 1/25 Received an e-mail asking me to confirm my ship to address and need c/c info. Um, c/c info was right there in the e-mail, I just confirmed my c/c # and my ship to address.

3) 1/26 Received an automated phone call, woke me up, stating that they needed my c/c # to pre-pay for a prescription before they could ship. I hung up. Now I am getting upset. They called me again later, and I talked to John. Very nice. He said needed my c/c#, oops, yes, he sees it on my account. They need permission to ship. I already did that. He fixed it. He does not know why my on line entry did not fix it. We went over info again, and I should only get the e-mail if needed.

4) Looked in my book about the co-pay. Says no co pay for Tier 3. Called pharmacy and got Angela. My book shows 2 different things, and I have to pay the co-pay. She was very polite too. I asked for complaint #, she came back after a 4 minute hold and told me they only take letters, and gave me address in Cincinnati. I told her I received a phone # from Deardra, but I must have written down a digit wrong. She said she was told they only take letters. Another 15 minutes of my life I can't get back.

I am done! I won't renew with Humana next year.

I hope the medical side is better. Have not used it yet.

When looking for a complaint # online, I found this site. Would love someone to contact me.

Called to find out why multiple line items were denied for duplicate when they were not duplicates. The first initial call was with a Yuri Y. And I had already done the research and she confirmed it was a duplicate in error, HCPC were completely different, she asked me to submit medical records I then asked to speak to a supervisor. She said fine and hung up the phone.

I called back and straight asked to a supervisor but a Rio stated that he would connect me to a supervisor but first he needed pt info. I gave it to him and he proceeded to put me on hold. I assumed he was gathering information to put me thou with a supervisor, instead he returned and stated he agreed that they were denied in error and HCPC's were in fact not the same. He still wanted me to submit medical records. I asked again to speak with a supervisor and he said please hold. They did not put me on hold. He straight just disconnected the call.

Called again x2 but could not get thou. on the 3rd attempt a Dominic answered and connected me with a Jeff/ Supervisor. I have been on hold for 1 claim, 35 minutes now while he is review our contract. This is ridiculous. I have told him I have more line items that were denied in error and he said he understood but needed to review the provider contract. At this rate it is taking way too much of my time and theirs. This is why HUMANA has a bad rep with its customers and providers.

I've had Humana for about 5 yrs. The only reason I stick with them is because they provide rides to doctors' appointments. Until 2 yrs. Ago we got 12 r/t but this year they reduced it to 6 r/t per year. I like to attend the annual meetings because they are supposed to answer our questions, however, they send "sales people". This yr. we met at a small restaurant in Las Vegas where we sat like sardines while the "salesman" talked about how great Humana is & the bus boys made so much noise with the dishes, cups & glasses that we could hardly hear the salesman in addition to the customers talking loudly. The salesman said "The gov't gives us lots of money for your medical care", I asked him how many rides would we get in 2017 & he replied "6 r/t", I replied "you just said that the gov't gives you lots of money, couldn't Humana add a few more trips? especially for us who don't have cars & the summer heat in LV is oppresive?" But he walked away w/o answering. I asked him if he could recommend a gynecologist & he said "no". Today I found out why, no gynecologist in this town of hicks with the worst medical care in the whole country for the 4th yr. In a row takes Humana Gold Plus HMO. I asked him if the customer service was located in the U.S. Or other country, he said "well, recently we moved the cust. svc. To other countries", I said "for the last 5 yrs. every time I call or send an email they are routed to the Philippines & me & the rest of the insureds get no proper answers, their emails are written in such a poor English that we have to guess what they are trying to say, plus, they give us the wrong answers every single time. Going to the local Humana office is useless as well, starting with the receptionists & after a long wait we are seen by totally incompetent people.

on 12-21-16 I called to speak to an agent (he said his name was Daniel S.). The reference number is [protected]...My parents are 85 yrs old and I am the caregiver on their account. This man would not talk to me stating that I may only "receive" certain information. He actually made me get my parents on the phone. They have no idea what is going on...We pay 1 check a month for both policies. They sent a letter saying my mothers payment (H40612843)was not sent in and that my father (H57350201) had a credit on his account of the exact amount of my mother policy...All I called for was to straighten it out...You record your phone calls for "Quality Assurance"...well listen to it. Its as disgrace that when you call back you probably get the same customer service office that you orginally got. I had no idea that Humana has so many complaints for customer service. I went on the website...If anyone there is really in the complaints department who care about Humana customers, you need to reach out to people. I am truly sickened by the smug way your customer service is...They leave you on hold to further piss you off. Shame on you Humana.

Gottlieb hospital NPI [protected] Tax ID [protected]

RE: patient ID H44999284 Angel Martinez DOB 8/21/1946

I called in for surgical authorization for Dr. Marcus Quek for date of surgery on 11/15/2016

I used the automated service and entered all the necessary info as requested and it was verified as I went along the automated system, then I was automatically transferred to your agent Raeso at 9:15 am on 11/14/16. She made me go thru all the info again because none of my automated info was retained. I spent almost 50 min on the phone with agent Raeso attempting to get authorization for our patients surgical outpatient procedure. I am calling from a busy physician office and I am angry that I wasted almost one hour of my time! What is going on? What is the point of an automated system if it doesn't work and then a MD office needs to repeat the entire requested info back to an Humana agent? I asked the agent the the customer complaint phone number and was given [protected], then I pressed #2 for specialist and was promptly disconnected. This happened twice today 11/14/16 Ugg
Linda Bauman
Loyola/Gottlieb Urology
2160 S. First Ave
[protected]
Maywood, IL 60153

I am filing a grievance about Humana for the decision of disenrolled me as of 10/31/2016. I reside in Pennsylvania in the service area; where in the Evidence of Coverage booklet does it state "I can not visit immediate family members in any state for any period of time."!

I have requested numerous times over the last two (2) months for the 2017 Evidence of Coverage Booklet. At present, I still have not received the booklet.

Please reconsider the decision made on 10/31/16 to activate my Humana Medicare Advantage Coverage immediately.

On 10/15/16 Humana scheduled transportation for my father to take him to and from his medical appointment (15 miles away). They picked him up around 7am and told him that someone would be there to pick him up after his appointment to take him home. When his appointment was over, he called Humana and the representative told him that they would dispatch a ride for him. He waited over 2 hours and no one showed up and no one called to find out if the transportation ever showed up or anything. this is the second time this has happened to my dad with Humana's Ride Assist. I called to file a complaint on 10/17/16 and briefly spoke to a rep that gave me the confirmation information about the drop offs and then transferred me to the section where I can find out why no one called and why the computer records say that they completed the service. I was placed on hold for over an hour and no one ever came to the phone. I hung up after an hour and 21 minuets because I was at work and had to go to a meting. Whomever was setting up the dispatch calls for Ride Assist on 10/15/16 was dishonest because the Humana rep said that the system reflects that the ride to return home was accepted and the service was provided. Whomever they provided a ride to was not my father because he ended up walking in the rain and a stranger gave him a ride home. This is a damn shame. My father 77 years old. The first time, my father had to wait over three hours and the transportation never showed up so I picked him up and then someone called him after 7pm to say they were on their way to pick him up to take him home. Does Humana think this a funny? I cant understand how this happens not only once but twice, and no one communicates with the person who is receiving the service. Something has to be done because the next step is going to include legal action. Thank God my father was unharmed and didn't pass out. Humana, you need to get it together and make sure your dispatcher system is functioning properly (I was on hold for 1 hr and 21 min).

First off, do NOT let them deduct your premium from your social security benefit! You have been warned. When we moved from one state to another my wife could not find anyone to go to in the new state. When we called Humana we were basically told "sorry, tough luck" and since it wasn't open enrollment we couldn't disenroll. They kept taking the premium out of my wife's doc check. When we commented that due to low income we qualified for state aid HUMANA THEMSELVES told us we could disenroll due to "low income subsidy but we had to complete one of their forms, which we did. After that and several phone calls we were told they would stop deducting premiums in Apiril 1st. Imagine our anger and surprise to find it continued through July. We eventually had to call Medicare directly and have Medicare FORCIBLY disenroll us. We had DOUBLE COVERAGE for 4 months and it is clear that Humana is doing everything possible to avoid refunding premium. They go as far to say they can't refund because we "used the plan". EXCUSE ME, But had you disenrolled us when we first requested there would not have been coverage. WE CANCELLED YOUR PLAN BUT YOU KEPT ON DEDUCTING PREMIUM FROM a low income senior's social security check. THAT, is "Medicare Enrollment Fraud".

I got dental from Humana ON July 2016.I had a probelm in my one of the tooth. I went to human net work doctor Mr. Edward A. Mucha on August 1, 2016 .
He took X-ray and found several problems. Humana Insurance needed pre treatment estimate for authorization for any payment.

I called human dental asked me to send the estimate.
On Aug.15 I faxed DR. Mucha's estimate fx no1-[protected] and also mailed the estimate TO .claim P.O.Box 14283 Lexington, Ky...40512
called on Aug.15, they said they never received it. I sent fx [protected] they said never received. I sent again on Aug.24. to Staffeney [protected] and requested to call me as soon as she received it. She did call and confirmed it. I called on Sept.7, 2016 . they said it is sent to system to process. When I call on Sept.16, 2016. Mr. Jay told me sytem never received it and his going to send it today and call me on Monday Sept.19, 2016.
I have spent lots of time on phone . I have all the records. And much more to say

I was seen at the cancer center today my HGB is 7.1 My oncologist gave an order for 2 blood transfusions. These 2 transfusions are desperately needed. I called customer service to ask why it is going to take 48 plus hours to receive approval for these two transfusions. An African American female answered the phone. Her first name is Danielle she was rude nasty and hung up when I questioned her. She stated it was out of network so no authorization. I response you do not have a Cancer Center in network that can provide the treatment needed for my cancer. Her response was you can't have authorization. My response is : so you are going to let a man die because you won't give authorization. I ask to speak to a supervisor she said they are at lunch it was 1:38 PM. I ask for her name she replied I don't give out that information. However I wrote her first name down when she answered the phone. I ask for an ID number then since she refused to give me her last name. She hung up ! WHAT RUDE NASTY PEOPLE YOU HAVE WORKING FOR HUMANA! PLUS YOU WILL NOT PROVIDE NEEDED CARE TO SAVE A PERSONS LIFE! I am reporting this to the federal insurance commission. Plus putting it all over the internet.

Would not pay anything for my sons leg braces and the policy we pay for is a comprehensive commercial policy. The braces were $286 dollars and needed because his knees were out of alignment and he was having trouble walking.
The orthopedic doctor called Humana on my behalf and verbally asked for them to reconsider. A Humana representative said if I could get the doctor to call that would use that as an appeal. Human still refused to pay. The school system (Blount County Schools) in East Tennessee that was using Humana was tired of it's employees getting claims denied and dropped Humana as of Jan. 1, 2016. I think the public should no that there are way better options out there for insurance companies that will pay for medicals services than Humana .