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United HealthCare Services

United HealthCare Services, Inc.

9900 Bren Rd E Mn008-T-615
Hopkins, Minnesota
United States - 55343-4402

Customer Service

+1 888 545 5205(Customer Service) 6 5
+1 866 414 1959(Members With Health Plans) 5 2
+1 800 523 5800(Medicare Supplement Plan) 4 2
+1 800 657 8205(Members with Short Term Insurance) 2 1
+1 877 856 2429(Individual Exchange Marketplace Members) 2 1
+1 877 988 9378(TRICARE West Region Beneficiaries) 1 1
+1 833 827 5227(For Employers) 2 1
+1 877 856 2430(SHOP Exchange Marketplace Plans) 1 1
+1 800 496 5881(Medicare - Group Retiree) 3 1
+1 888 842 4571(Brokers & Consultants) 1 1
+1 800 980 5213(Health Insurance for Individuals & Families) 1 2

Complaints & Reviews

inablity to locate home health company for a patient who accepts this insurance — No help for patients who need it.

I am a health care provider who is having problem assisting patient who is in need of home health services. We have exhausted companies in the area who do not take this insurance type. I was told by my front desk that once she phoned the number on back of my patient's insurance card, that there are no case managers assigned to people with this type of insurance and we should continue looking. As a health care professional with an obligation to serve those in need, it sickens me that this insurance company has no resources out there to help them. It seems like no one cares. These patients are being charged to come to doctors appointments and can not be helped. This has to change! Call me at [protected] to see what more can be done for these patients.

Prescription coverage — Payment for health insurance inadvertently sent to prescription address

On March 18, 2020 I called United Health Insurance regarding they have not received my premium payment for health insurance for the months of January, February and March. I checked with my bank and the $192 premium was being sent out but discovered it was mailed to the wrong address. It was inadvertently being mailed to the address for prescription coverage through United HealthCare, which I was also sending a check in the amount of $33.80 for its premium. I requested my money be returned to me so I could pay my health insurance premium. I was told the money was applied to my yearly premium instead. I told them I did not want this to be applied especially since the amount was well over the yearly prescription premium. I was then told they could send me a request for reimbursement which would take about 7-10 days for me to receive and it may or may not be approved, which would take another six weeks. In the meantime, I have three months of health insurance premium due and which will be canceled in 2-3 weeks. I asked to speak to a supervisor but no supervisor was available, evidently they don't stay the entire time they are open for phone calls, so I was informed to call back tomorrow. All I want is to have the money I inadvertently sent to United HealthCare Prescription to transfer those funds to my United HealthCare Health Insurance Plan. The person I spoke to regarding prescription was not aware if this could even be done. I will call again tomorrow and see if I can get this matter resolved. I cannot believe that they didn't try to reach out to advise me I am sending an additional $192 per month!

HealthyBenefitsPlus.com

THIS OTC PROGRAM IS UNBELIEVABLY BAD. I had OTC Essentials last year through UHC and it was easy to navigate, prices were reasonable, myriad products were offered, and there were no added delivery charges, taxes or anything else at all. I could easily choose and order $40 worth of products each quarter without any hassle. All for free. This program has NONE of that.

The products offered here from HealthyBenefitsPlus.com through WalMart are very limited, the prices are exorbitant, home delivery is hardly ever an option, navigation through the web site is almost impossible, and there are unexpected fees added when you go to checkout. Additionally, the site shows numerous duplicates of the same item on the same page. I suppose this is to make it appear as though there are more products available than there really are. I hate Healthy Benefits Plus and will not be using it at all.

Oh -- by the way, there's no way to email United Health Care to send a written complaint. Only the phone number, picked up I'm sure by one of their minions and inevitably lost in space.

Alli Livingston, member UHC: [protected]@gmail.com 3/1/2020

rude rep

I contacted United Health Care on 12/28/2020 around 9:50am @ [protected], spoke with Rep Lynn. The rep was very rude. When he first pick up the line, he didn't say anything. I asked for the reason of denial and he stated what UHC was requesting.I asked did I have to mail it or fax, he stated mail. I then went to ask him for the claim number so that I could notate it in my notes for future reference and he shouted Oh MY GOD. I requested to speak supervisor pertaining this call and he wouldn't allow me to speak to anyone. He then stated that all supervisors where in meetings. I asked for REP ID he wouldn't give me any information. This is very unprofessional and unacceptable type of behavior for any company.

we need to get paid.

As a mental health treatment provider, We provided treatment services to a client of united health care in April and may of 2017. It is now 2020 and we are still waiting to get paid for those services. After two successful appeals and promises to be paid in 60 days, the latest letter was dated 8/23/2019 and yet we are still waiting to get paid. This is absolutely unbelievable, I have had to stop treating clients as we continue to await payment. Our company name is Transnet Home Group we are located in greensboro, nc. We need to get paid.

we need to get paid.
we need to get paid.
we need to get paid.
we need to get paid.
we need to get paid.
we need to get paid.

Insurance drug coverage

I am on United Healthcare through my employer—I don't have a choice. I have been seeing a doctor for 6+ years and have been on the same dosage of a medication for 5+ years. I see my doctor every month and have been very stable on this dosage. At no time has UHC contested it or refused to fill it until January 2020, when they suddenly declined the prescription saying that there was no medical research for the dosage. My doctor appealed but to no avail. UHC will cover a smaller dosage and I have tried it this month (February 2020) but it is not sufficient. It works when I am taking it, but I am losing 4 hours a day when I cannot work effectively or even do chores efficiently due to the missed dose. I simply do not understand why my doctor's continual care and recommendation is not taken into account or why this prescription would suddenly be challenged after five years of approval. I can only assume that it is a money-saving maneuver and that many UHC insurees are suddenly finding their medications challenged in 2020. I would NEVER recommend UHC to anyone who has a choice. My only choice is to pay for the full dosage myself. I can't have part covered and pay for the rest.

web/technical/customer service

A month ago I lost ALL capabilities to login to my UHC portal. I could see OLD plans, but was unable to see my New plan. ( by the way I use to be able to prior to 2020).

I have called over 10x requesting help with this.
1. I get customer service, who sends me to web/technical help.
2. web tech keeps me on the phone for 45 mins to tell me they can't help me and they have escalated my concern. They keep telling me it is a web issue
3. They send me a secure message to UHC- which I HAVE NO ACCESS TO.
4. I call customer service again to tell them I can't see the message.
5. They send me over to web/technical, who proceeds to OPEN A NEW TICKET and we have been doing this for over a month.
6. they assure me that any messages will be sent to my personal email- which they don't do
7. and I have to keep calling because web/tech will not call and we repeat the cycle again and again.

I have medical claims that I NEED to see. It is ridiculous that I am unable to login and see my NEW PLAN which has been in place since Sept 1, 2019. No one seems to know what they are doing. This needs to stop. I really need someone to help me get into my portal. It is stupid that I can't see my benefits, or look for a doctor ( which I need to do). Please I just want access to my medical records.

mental health treatment claim

It has been over three years since services were provided and I am still awaiting payment even after several appeals overturning the original denial and promising payment within 60 days its been over 6 months since receiving these letters and still no payment. When I call I get consistently transferred over and over. I then get sent to another appeals process even though one was successfully completed on the exact same claims and again letters promising to pay within 60 days with no payment. I have all the letters from uhc with corresponding case numbers. My company name is Transnet Home Group business lic # [protected]. My name is Trent Thomas and I can be reached at [protected]

mental health treatment claim
mental health treatment claim
mental health treatment claim
mental health treatment claim
mental health treatment claim
mental health treatment claim
mental health treatment claim

denial of last day of hospitalization.

I had a total knee replacement 12/17/19. Unfortunately, I had life threatening complications and had to be transfused for major blood loss. Went home 12/23/19. On 12/24/19 developed a fever, increase swelling in leg with large hematoma, went to ER as was told by MD ‘s office. Admitted 12/24/19-12/28/19. I was transfused again to get Hemoglobin above 7 on 12/26/19. Hematologist insisted on being hospitalized for at least 48 hrs to see if further transfusion is needed. I developed a fever and an infection on 12/27/19 and received IV antibiotics due to past history of resistance bacteria to this infection in the past and allergic to Rocephin. Per Infectious disease, they wanted to see the sensitivities of the positive culture that was reported on 12/28/19 to make sure I receive the correct outpatient antibiotic and also be monitored for 2 hours after being given an oral 1st generation cephalosporin to make sure I did not have an anaphylactic reaction. Well United Healthcare denied 12/27-12/28/19 saying I should of been changed to observation because I wasn't bleeding, dizzy and normal BP. I was still on oxygen and weaned the am of 12/28/19 also. I was dizzy as I had to be helped to the bathroom at all times and an alarm was on the bed if I tried to get up. I was still severely anemic but barely above 7 Hgb so didn't need another transfusion. This is the 3 rd denial in less than 1 year from UHC for Care. This is time consuming and inappropriate to question several specialists with the same recommendation to stay to 12/28/19. I was probably discharged to early initially and saved them a day of charges. I have never experienced this with past insurances. As a Physician, I find it unprofessional for them to question specialist and other providers care and recommendations when they have not seen the record, obtained a History and exam of the patient nor review their vitals nor labs, etc. They saved my life and UHC doesn't seem to care what type of care was given just the cost that matters.

denied medical claims

There are several claims that UMR is denying. One of the claims was processed and they have now taken that one back that they paid and requested monies be returned to them. Prior to me having me a sleep study, the facility called the benefits number to see if there were any pre-authorization or any pre-determination requirements. They were advised that neither of those were required. Now that the sleep study has been done, the insurance company is denying the claim. I had to have a CPAP tritation study due to the diagnosis of severe obstructive sleep apnea and the insurance originally paid that claim. Since I have been fighting the decision to deny the first sleep study, they have now retracted paying for the 2nd sleep study so they are denying that claim as well. This is leading into if they do not justify paying the claims for the diagnosis they cannot justify paying for the medical equipment needed which puts my life in jeopardy. I have appealed the denied claim for the first sleep study and I have received the letter stating they are upholding the denial. I have also spent a lot of time since October on the phone with the insurance company trying to resolve this matter. I even called and talked to the insurance company with the facility that submitted the claims as well. I have a lot of documentation that needs to be reviewed and a formal investigation opened. I have made all the attempts that I can to resolve this matter with them and they are refusing to do anything. If they had told the facility what was required prior to scheduling the study, the facility could have provided the necessary information. Because they facility was not told that anything was required, they had the green light to schedule the study. There are multiple calls on file with the health insurance company where the facility has called to see what the requirements are for a sleep study and on all of those calls the facility is told that nothing is required. Now I have approximately $15,000 dollars in medical bills not including the continued added bills for the medical equipment. The insurance company provided the facility false information and now they are trying to hold me responsible. I need action taken immediately.

refusal to fill a rescue inhaler for a child

United healthcare deny on rescue inhaler ordered by Doctor
Inbox
C
Colleen Sweet
to opmc
8 hours agoDetails
Hello,

My daughter was prescribed by the doctor a rescue inhaler after several times she had to be helped to the nurses office during the school day.
After attending a Cornell Vet program on Saturday November 2nd, her shirt was washed and dried and she forgot the inhaler in the pocket. It was broken.
I called the doctor Saturday evening, they sent a request to the CVS to get a new one.
The CVS said that United Healthcare refused to provide a new inhaler until the 13th of November. The doctor contacted United Healthcare and they still refused to provide the necessary rescue inhaler ordered by the doctor.
I called United Healthcare on Sunday morning the 3rd, and spent 4 hours on the phone and was told it would take 48 hours to fix the problem.
My daughter ended up in the nurse on Monday morning at school having to be helped to the nurses office with a horrible wheezing attack and the nurse called me to come to the nurses office. She asked why she did not have the rescue inhaler ordered by the doctor.
I was told this is neglecting the needs of my child.
I called the doctor's office at the time. They said that United Healthcare had been contacted by them on Sunday morning to provide a new inhaler.
I called United Healthcare again on Monday the 4th after my child had to leave school. They said they would contact their own doctor who had never seen my child, and they would see if they could let her had the rescue inhaler.
Tuesday November 5th, they still did nothing to get the inhaler.
She had another attack.
I called the Doctor who told me an urgent request for the inhaler ordered by the doctor was placed several times to United Healthcare.
I called CVS pharmacy and they said that United Healthcare refused to provide a new inhaler until the 13th of November.
I called United Healthcare again on Tuesday the 5th.
I was told that they were working on it.
Still no rescue inhaler after several times my 13 year old was denied the medicine yet again by United Healthcare.
Wednesday the 6th I was told after calling again that they would allow her to get it that day and to go to the CVS pharmacy and they said that the rescue inhaler would be there.
I went to the CVS pharmacy and they said that the still refused to provide a new inhaler until the 13th of November.
I called United Healthcare again on Wednesday the 6th I was told that they were working on it.
Still no inhaler, and my daughter once again ended up in the nurses office.
She was sent home wheezing.
I called United Healthcare again.
They said it should be authorized soon.
Finally after 4 hours on the phone and having the Doctor call them and the CVS pharmacy call them they allowed the inhaler ordered by the doctor to be processed on Thursday the 7th at 4:15pm.
My child went without the inhaler ordered by the doctor for 6 days!
Because United Healthcare refused to provide a new inhaler ordered by the doctor.
This is abusive and neglecting the needs of my child.
I would like to file a complaint with the NY state of health.
Can you tell me how I can do this?
Thank You for your time.

umr denied full coverage health care

I was bit by a dog and had gone to Henderson Nevada emergency room where I waited 3 hours to see a practitioner and not a doctor and they gave me a tetanus shot and 1 tylenol 800mg. My full coverage UMR denied the hospital bill of $8000 for a tetanus shot and 1 pill of tylenol 800mg. My full coverage also provides my dental and I am able to get 2 cleaning per year with my coverage but I guess they just didn't want to pay the $8000 tylenol and the tetanus shot. Henderson Hospital has now threaten to take me to collections if I don't pay the $8000, I am not sure what I should do. I didn't even get stitches. Should I just let it go to collections? honestly I didn't know that tylenol was that expensive...

they won't approve the hours that you work for people so you can get paid.

The lady that handles things for acts like she doesn't care if the workers get paid or not its not out of her pocket. She is not very friendly and she doesn't do what she says she will do, doesn't come and see you when she tells you she will be there. Tell one lie after another to cover up what she does. She keeps blameing someone else. Then she tells another one. NOT HAPPY WITH UNITED HEALTH CARE AT ALL!!!

rx coverage

I have been dealing with the same pharmacy for years and now they won't fill my rx because UMR prefers that I use their pharmacies. Trouble is no one ever told me this and when I try to contact UMR it is just an endless series of automated prompts. This is life and death for people that count on their meds to keep them healthy. I guess that UMR or Orlando health does not give a crap about my well being.I will be making an example of them on the internet, social media and to everyone I talk to. I am out of meds and I guess I am just supposed to die now so they don't have to pay anything.

prescription plan

I have been a United Healthcare customer for eleven (11) years with two (2) plans; Supplemental and Prescription. I have always paid my monthly premiums on each plan in full and on time. In 2019 I moved from Pennsylvania to New Jersey and placed a Change of Address with United Healthcare using a form that was in the coupon payment book from United Healthcare. I also had a Change of Address form with the US Postal Service. I continued to make monthly payments to United Healthcare for my supplemental plan using the coupons in the payment book. The prescription plan payments were dependent on a monthly payment notice that was mailed to me by United Healthcare. When I moved in July 2019 there was a problem with receiving mail at my new address due to issues with the US Postal Service that were not resolved until September 2019. These issues can be confirmed by the Middlesex, NJ 08846 Postmaster who was instrumental in resolving the problems for me. With the confusion of relocating and the mail issues I did not realize that I was not receiving my United Healthcare monthly invoice for my Prescription Plan until I was informed by my pharmacy that my prescription plan would no longer pay for my numerous drugs. When I contacted United Healthcare regarding this matter they informed me that the invoice was (a) not forwardable because United Healthcare did not allow forwarding and (b)that changing my address with the United Healthcare supplemental program did not change it for the prescription program. United Healthcare maintains separate data bases for each venue. I am a 76 year old consumer who had no idea that this was United Healthcare procedure. My prescription plan was canceled ninety (90) days (October 1) after non-payment. After two (2) days of lengthy conversation, including misinformation from the United Healthcare customer service in the Philippines I was informed that I was "out of luck" until the next enrollment period (October 15, 2019) when I can enroll for effective January 1, 2020. Until that time all my prescription refills would be paid out of pocket without regardless of the issues as detailed above or the fact that the lack of all my drugs are life threatening. And what is very interesting is that in several other residential moves that I have made in the last seven (7) years from from Florida to New Jersey. within New Jersey and New Jersey to Pennsylvania I have never had this problem. If I had to provide a change of address for my prescription plan to United Healthcare and have no record of doing so, how did they know I moved? Is this a new procedure/policy to drop me from the program so they can force me to come back at a higher monthly premium? Is this another "scam" by the insurance company to increase profits? I will need to consider drugs over food from now until January 1, 2020 but only those drugs (insulin, blood thinners, heart medication) and others that I need to survive and rely on food banks, family and friends for food UNLESS this complaint will provide a solution.

Edward E Benson
80A Middlesex Village
Middlesex, NJ 08846

customer service/prior auth/overseas call centers

I could literally put through hundreds of such complaints due the utter incompetence of your overseas service call centers. They have zero understanding of american insurance or...

dental provider relations

I am a dentist proving services to your members in Illinois. We have changed ownership 3 months ago [protected]. I have submitted a letter with a w-9 form to your dental customer service unit since your office doesn't have a provider relations department directly. I just off the phone with a representative, and a supervisor my TIN # STILL IS NOT ENTERED AND MY CLAIMS ARE NOT BEING PAID. Who and when is someone going to take responsibility to help providers with problems?

Cordially,

Steve Slominski DDS
Golf River Dental, Des Plaines, IL
[protected]

false teeth

i recieved surgery nov 22nd, ll my teeth ere extracted later in he evening i spiked a fever and a rash called the emergency number all night.the next 2 days they were out of the...

hiring manager it director olivia olivarez response following receipt of interview thank you note

Following 23 Sept interview with IT Director Olivia Olivarez and team members Theresa, Cynthia and her boss Jim I sent a thank you note. Since Olivia Olivarez had not provided a...

clients info from a former employee of clearview exterior

Information from a survallance. Back log from the implant on my business phone client personal info, pharmarcutical info. Client addresses medications. If these document do not...

fsa

I have had two knee surgeries, have an injured shoulder and have been rear-ended 7 times. I was getting a synvisc injection for my knee to help relieve the pain & make it easier to walk. UHC is giving me a hard time now getting another injection even though its been over a year. I found a place that does cryotherapy. I called UHC FSA & was told it was covered. The cryotherapy place said they have many patients that come there & use their FSA. I turned in the first receipt & was reimbursed. The second receipt was denied & I was told my doctor has to write a letter. I can't even get into see my doctor for over two months. I can't take cortisone shots because I'm diabetic. I beginning to wonder why I'm paying for insurance...they don't want to pay for anything.

bipap equipment supplied by apira

Richard & bonnie rader 71 algonquian street, aurora, colorado, 80018, ph-[protected], [protected]@gmail.com 08-18-2019 Apria healthcare P.o. box 802017 Chicago, il...

coverage ms infusion

I receive Ocrevus infusions twice a year for MS. United Healthcare is making it impossible for me to receive my treatment. Right before my last infusion at an MS center they said they would no longer cover infusions done at the center. This caused my infusion to be late. I received the next infusion at home by a home health care nurse. It was a complete disaster, no protocol followed, infusion was done incorrectly. I will never again allow a home healthcare nurse in my home. My infusion is due now, for the past month I've been dealing with UHC issues again. Infusion centers in my area do not accept the pharmacy UHC requires to supply meds.So, once again, my infusion will be late at best. How is it that they can override physicians and put lives in danger. This is so wrong! I am a paying customer and have been for over 32 years. What gives UHC the right to mess up my treatment and cause me unnecessary pain ?? I'm filing complaints wherever I can. They have no right!!!

Health Plan of NevadaI am complaining about the insurance discrepancy did to my account.

I always had health insurance since my son born. In the month of April 2019, my insurance deactivated because health insurance co. Send my application to Medicaid. I just called them to change my address and automatically send my application to Medicaid, I confirmed with them during this process my son insurance will be active and their answer was your sons insurance will be active. At the end of the month of April, got to know that my son insurance deactivated for that month. I had doctors visit on that month and they are sending me bills for lab tests. I can't afford that bills. This complain is against market place and health plan of Nevada for cheated on me for my insurance.

unethical behaviour, payments not received and medical record denials

Our company continues to have issues with claim payment of high end custom rehab. Before we ever submit the claim we always obtain a prior authorization. This authorization is a...

customer service / cobra

My member ID is [protected] - I have been trying to get information about my status and what I need to provide to be an active member once again after paying for COBRA last week through Discovery Benefits. I've been sent to can't tell you how many different places and no one, I mean no one will help me. [protected] is my number. Look up the contacts.

claims

In March my husband retired and starting the first of April I went on cobra. I knew it would be a problem. I was going to PT at the time. I received my cobra card the end of April and gave it to the PT office. They had already billed several claims under my husbands insurance. To make a long story short, I still have 2 unpaid claims. I have called UMR for several months and have been told we will take care of it. It is now July 18th and they are still unpaid but I can do nothing. Just hope I don't get turned over to collections

horrible customer service!!!

I received a letter in the mail about 3 months ago stating I have to stick with one pharmacy, and that I could call within 30 days of getting the letter to have my pharmacy...

medical coverage through work

So back in September 25 of 2018 I signed up for heath care through work and it was for UmR. I needed the coverage for a procedure i was looking to get done. After my first premium payment I called umr customer service to make sure it was covered. the procedure was not going to covered but i figured The lab work could be so i asked to be sure. I explained this to the agent including what the lab work was for and that it was for a procedure not covered by umr and they said it wouldn't be a problem it would be covered 100 percent. So i had the blood work done and that was it. Now i would not have gotten the blood work done if i wasn't told the company would cover the procedure. Months later the bill came in from lab corp. I called umr and they said it was denied due to the diagnostic code. I was royally pissed since I was told it wouldn't be an issue. I called lab corp whose said i should call my doctor. Now admittedly I did not call because the reason for the lab visit was accurate. But when i called umr again to explain this to a supervisor I was getting the run around. I finally got a supervisor who said and i quote "We will pay the bill by changing the diagnostic code and it should take a few weeks they also said we need to contact lab corp." I was elated and thought it was done.
a few months later another bill. I contacted lab corp and they said no contact was made. they also said what umr said they would do was illegal. I contacted customer service again and they agreed it was illegal but never said they did anything wrong. I called them out for lying to me and got nothing.
Now after all my calls no agents let me know an appeal was possible. A few days later after accuse them of lying and illegal crap, they alerted me to the possible appeal. I have been forced to pay this bill now out of pocket while waiting on a second appeal. I think what would be fair is umr refunding this payment to me.

health care insurance fraud??

My doctor submitted a prescription for my. They received this on June 20th witch was a Thursday. United Heath care needed more information for prior authorization. There was a 2 day weekend included they closed my case on June 24th really only giving my doctor 2 days to reply they closed the case on June 24th. They claim the doctor has 14 days to reply before they close the request. This is a Tier 4 drug and it should be covered. They will not cover it. Terrable Insurance I would suggest going with a different insurance even if it cost more.

drug coverage cancelled, but still receive bills for unpaid months

Used Medicare.gov to compare drug plans for ongoing coverage for 2019. Review indicated UHC offered my drug coverage. Selected UHC. January 10, 2019 went to Costco pharmacy to pick up prescription, but was told that UHC would not cover it. Called UHC customer service on 1/10/19 & was told the drug was "non formulary." Since this drug is the only one I take, I told the ultra-rude representative to cancel my coverage. Still receive invoices & now they are using a bill collection service. Never used the drug plan, so why am I receiving bills? Learned two things: Never trust a representative that is rude. Follow-up why account wasn't cancelled as promised.

nasty rep

I don't care what color your skin is or the accent in your tone. When you're helping someone in customer service you MUST put yourself in the customers shoes. I HAD THE NASTIEST RUDEST AFRICAN WOMAN AS A REP TODAY (6/21/19). She is EXTREMELY lucky she stated her name fast AND hung up on me because I was ready to record the whole convo and ask for a manager. I asked for help to get my meds even tho my insurance is supposed to be renewed in July. INSTEAD of explaining the situation to me and looking for alternatives to help me, she began talking over me and not only that when I asked her for something after she had been rude the whole time on the phone has the audacity to tell me to say "thank you". Thank god, I am a changed person because last year I would've gotten her fired on the spot. But seriously united healthcare needs NICE UNDERSTANDLE ABLE TO WORK WITH WHOEVER reps ASAP! Or by 2020 I expect the company will have to close due to unprofessionalism. I will see to it!

  • St
    Steve Tllsdaleys Jun 24, 2019

    And yet you posted an ignorant and arrogant response "Seriously, I think we should save the healthcare for people who know how to learn about the world past the end of their driveway." Priceless!

    -1 Votes

aarp medicarerx plan

This is not a frivolous complaint but a very serious one, written out of frustration and anger. I have literarily spent hours on the phone with United Healthcare AARP Medicare RX representatives, simply trying to obtain what is due to me per the prescription plan I have paid premiums on for years. The problem is relatively simple. But the lack of clear communication, proper customer service, and basic record keeping in the part of this company is nothing less than shocking. I am convinced now that my specific problem will never be addressed with competence, let alone solved. This will literally cost me hundreds of dollars and immeasurable stress.

As stated, the problem itself is fairly simple. I needed to get a medicine that I have taken for more than 30 years. Due to manufacturing problems, it was unavailable in the U.S. for many months, so I obtained it through a pharmacy in Europe. Now it is available in the U.S. again but only through two distributors. So I had to find a pharmacy that could guarantee a supply because they worked with those distributors. However, when I picked up the meds, my coverage through United Healthcare was denied. The total for the prescription came to $599.62. I could not afford such a huge amount to I opted to take half of the prescription on the spot and the balance later on.

I called United Healthcare to find out why there was no coverage at all. The representative tried to be helpful but explained that the particular drugstore I went through was not "NDC" approved or certified, or words to that effect. She also mentioned that under normal circumstances, this medicine would indeed be covered. So I found another drugstore that could obtain the medicine and also honor my insurance in the future.

Since the medicine is supposed to be covered, the representative said she would send me reimbursement forms, which she did. She also said she would call me again to see if things were okay, but she didn't.

I filled out all the forms according to the instructions and furnished receipts. A few days later I received my response. I was sent $161.73 as reimbursement for ½ of the prescription. Zero for the second half. The reason given was that it was refilled too soon after the initial prescription. This, of course was blatantly wrong. There was only ONE prescription. NO refills. I could only afford to pay for half of it at the time and picked up the second half weeks later. Very strangely, no one I speak to at United Healthcare seems to understand this simple premise. ONE prescription, paid for in TWO payments. Yet again and again it has been perceived as a refill.

I called United again and the young woman told me I could fill out forms for an appeal. I refused to do that. Why should I, knowing that the same response would likely come back? I insisted on speaking to a supervisor. After initial difficulty grasping the simple scenario, the next person finally did understand, I believe. But the records he had to refer to seem to show little detail and few facts about all that had transpired so far. This is a theme that seems to run through all communication with United Healthcare to date. Whatever records they have on hand seem to contain very little information about the customer they are speaking with.

This employee said he would look into it but I never heard from him again. So I called the "special" number he gave me and got to speak with a new person. By now, between being on hold and actually explaining the situation, I had spent at least three hours on the phone and gotten nowhere.

I called again and started from scratch a few days later. I wound up talking to yet another supervisor. She was helpful and promised to stay on top of my "case" and return my call within 24 hours. To her credit, she did get back to me, albeit six hours late. Her call was just to inform me that they were still working on my "case, " but no decision had been reached.

How difficult is this? What decision? How much clearer can the situation be? I simply broke up my payments to the drugstore for ONE prescription. And then I was reimbursed for ½ a prescription and penalized because of a falsehood—that it was refilled too soon when in fact it was never "refilled" at all.

I told this particular woman that my problem was now going to get worse because I need to have the prescription refilled, this time at a Walgreen's, which does take this insurance. The problem? They are going to charge me $434.74 in order to meet the deductible. This deductible has clearly already been met by my earlier prescription yet United is treating it as if I had never had any earlier prescription at all.

The woman said she would stay on top of my case and call me back the next day. Several days have passed and I have heard nothing. I refilled my prescription through Walgreen's and was charged the total deductible as if I had never paid for any prescription to date. This came to $434.74 dollars.

Bottom line? I have shelled out over $1034 for two prescriptions I have been reimbursed $161.73 to date. WHAT INSURANCE COMPANY PAYS THIS LITTLE. THIS VIOLATES THE PLAN AGREEMENT I SIGNED UP FOR WHICH OFFERED TO PAY MUCH MORE.

Obviously, I have a problem. But I now know that United Healthcare's run much deeper. Their inability to keep and maintain adequate member records, their lack of internal communication and genuine customer service indicate issues that are pervasive and endemic. The stress of dealing with them on the phone has become intolerable.

UPDATE:

After complaining to the Better Business Bureau and other agencies through the letter above, I received a call from a woman named Casey from United Healthcare. She was polite and explained to me what had happened with my case— No. STOO4286AD. Apparently the various submissions for payment had crossed paths, causing some confusion. Ultimately I WAS OWED payment for the second half of the initial prescription—another $161.73. The first refill, from Walgreens was high to cover the deductible for the year. I agreed in principle, happy to receive something, anything back. She gave me her phone number so I could contact a real person. [protected]).

A few days later I received THREE copies of an identical letter dated June 6, from SUZY NUNEZ, Appeal Rep. This letter stated that "We decided to overturn the denial." I would be paid within 30 days, the letters said. EUREKA! After countless hours on the phone and computer it looked like I might actually get what was coming to me— a whopping $161 dollars!

On the same day received what seemed to be an unsigned follow-up letter, dated June 8, from Casey's department. It reviewed what was discussed and stated that they were filing a claim for me. No harm done. Everything finally settled. No quite…

The next day I received another letter —Notice of Denial of Medicare Part D Prescription Drug Coverage. Herein, my claim was denied once again, even though Ms. Nunez wrote and told me that the denial had been overturned. Again, the information in this notice was incorrect and back to square one where I had started. All the information failed to relate to the initial prescription, a single script for 30 days. Not two for the month.

I will be more than happy to provide this information and documentation to anyone who is interested. No matter how you look at it, an insurance company that only pays $161 out of more than $1000 paid by a patient should be considered criminal. The cost comparisons of different plans provided by Medicare showed that significantly more should be paid. This is an outright violation of their contract with me as a patient and customer and I will now aggressively seek others in the same boat in the hopes of initiating a class action suit against this incompetent company and its fraudulent practices.

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