Wednesday, July 11, 2007

Insurance - Humana is a Cold-Hearted Company!


For the past week I have been battling with Humana -- and USD #000 (my district) over insurance. God, what a screw up!

I enrolled in April. For USD #000 each year you have to re-enroll to have continued health coverage. You can do it online and everybody in my building had trouble with the on-line enrollment process. I had to communicate with the district's insurance coordinator five times before I got it -- partly because I was adding Will into the mix for some of the insurance and I was adding dental to my own policy (I had the broken tooth and knew how expensive that would be).

So, got enrolled, got back notification I had enrolled.

In USD #000 coverage ends June 30th and new coverage begins July 1.

I saw my new (and hopefully liked) doctor last week of June. Got all the new scripts, except for one that was determined I needed AFTER the blood work came back. They sent that one in the mail -- but doctoring in the new millennium has new techniques and so when I realized I had only a 30 day script, I e-mailed the office to get a 90 day script because Humana gives a month's free if you fill in big numbers. The doctor's office called in to my pharmacy the new script -- and I went to pick it up.

Which is when I discovered I had no insurance coverage, according to Walgreen’s. To be honest, I was initially ticked at Walgreen’s. Of course, I had coverage. But after the second visit, when I was inside (not the pick-window) and they called Humana, I heard Humana announce that my coverage had been terminated.

Not -- non-renewed -- T E R M I N A T E D!!!!!!

I flew home and called USD #000. All I could think was that I had somehow flubbed the enrollment process and . . . but no. USD #000 confirmed I had medical, dental, vision, and life insurance. So, I said to USD #000 -- what's the deal? They suggested I call Humana and on their part, they would look into the situation.

Oh, lord. Humana is the company from hell. It's this huge stone wall one can't get through. It took me forever to figure out how to get a real live person on the phone. I logged into the web site, using my password, and was immediately notified that I had "NO ACTIVE COVERAGE." When I finally got a person on the phone, I got disconnected. Eventually I got another live person and was told, "No, you have no coverage. It was terminated June 30th. So sorry. Can't help you. Goodbye."

So began phone calls and numerous e-mails -- and as I investigated further, I discovered that my doctor's bill of $225 for the last week of June had also been rejected, because -- Humana couldn't verify who my insurance coverage had been with previously (it was Humana, f*ckers, the construction company had Humana and when I changed employment they simply kept my same number and transferred the policy).

Meanwhile I couldn't get the medication. One day goes by. I continually check on line to see if the situation has been rectified. USD #000 notifies me they are checking -- and they provide multiple e-mails to prove they are trying to find out what happened. Two days go by. Three days go by. Etc.

Eventually, USD #000 notifies me that Humana has notified them they had an error loading "some" employees into their system. USD #000 demands a complete audit of the system. Humana discovers that approximately a dozen were load incorrectly and I'm one of the dozen. But now EVERYTHING is fixed and I have full coverage.

Back to Walgreen’s to get medication. Nope, no coverage. Walgreen’s calls Humana and they say they've never heard of me. We call USD #000 and alert them. More folks get involved.

I send more irate e-mails: "This is what's wrong with our health care system in the United States."

More days go by.

Finally, USD #000 notifies me that they think everything is resolved. On-line it now shows me active on the Humana site. Because I had complained in every single e-mail that my doctor's claim has been denied -- I find that it is now paid (big sigh of relief -- who wants their brand new doctor to think they've lied about insurance?). Walgreen's calls to say they have my prescription ready for pick-up.

And this morning, I get the coup de grace -- an e-mail (finally -- this is the ONLY communication I've had with them) from Humana that says, "We understand you have complained about a break in your coverage. We have reviewed your files and we show that you have had coverage from 09/01/06 through 06/30/07 and under the new policy from 07/01/07 to 06/30/08. This is continuous coverage. Please do not complain again when everything has been perfect for you and we have never made a mistake. You are an idiot." -- or something that read like that.

I thought I would bust a gasket!

In retrospect, USD #000 was wonderful. They were responsive and calm and persistent. They communicated with me daily. I was VERY pleased.

Humana on the other hand is the company from H E L L and if you can avoid ever having their insurance, please do so. Tell everyone! Humana sucks the BIG ONE!

Imagine . . .the nerve of implying that I'm the idiot . . .


Anonymous said...

I worked for Humana.

At the same time you had issues the whole rewriting system was being overhauled to "increase production" and it has essentially sucked any semblence of decent customer care out of the business.

The ONLY way you will get anywhere with them is if you call repeatedly (several times a day) and start letter campaigns. Humana designed the system so that workers are timed. The sooner they pass on a file they more their production is up so many lazy, unethical or brown-nosers will just pass the problem over to someone else. I seen it happen EVERYDAY.

Moreover, Humana isn't too hip on hiring employees, they fill up with temps because they are too cheap to give insurance and a living wage to people. They force mandatory over time on these temps, give them substandard training and are so understaffed that files will sit in a process que for up to a week.

Humana also belongs to the MIB corporation. So ANY problem you have is being encoded and shared with many other insurance companies, that way you get black balled when you go to apply. The insurance industry in America is horrible. I would know, I work for it.

But the people get what the people demand...

Anonymous said...

Humana is the worst insurance company I know! You are right that their customer service ranks down with satan from hell! I have been told so many wrong things from them verbally and in writing that I am sick of putting up with it. But, because our plan is through ERISA, we cannot complain to the Dept. of Insurance. I encourage everyone who can to complain to the Dept. of Insurance and their local government (Senator and Representative) so more folks will take notice about how Humana rips folks off. Their motto seems to be to try to cherry-pick the healthy and not pay for claims for those who are sick. I'd be better off without insurance because I am getting bankrupted with it. I say, TO HELL WITH HUMANA! I curse all Humana and their employees to!

Anonymous said...

I just got back from the pharmacist. They refused to pay for one of my prescriptions for the second month in a row. This prescription is $205!!!/month. They took the other one which, without insurance, is $15. They let me have the $10 copay but left me hanging with forking out $205. It turns out that they only allow a copay for one pill a day. You're screwed if you have to take more than one. This is a cheap ass insurance and I don't know whether to be pissed at Humana or my cheap as shit company for taking us off of BCBS for the much cheaper Humana. My company is a non for profit. You'd think that they would at least want to take care of their employees since they pay lower wages. I'd love to grab these people at Humana and shake the Shit out of them.

Andy Mills said...

I am currently going through the worst ordeal ever with Humana. I moved to a new area and had to call them for recommendations of doctors to see...and then they rejected the bills and said i was responsible. After a month or so of yelling at them and going back and forth they fixed that part...and are now making me pay for the blood work that was done at my doctors visits. They sent me to a normal every day Dr...for a normal check up...and because he sends his blood work to a hospital to be done...they hold me responsible. What kind of normal person goes in for their check up with the thought that they should ask the Dr. just where he has his blood work done???? Ridiculous...and they are saying I will owe close to $500....for them to check my cholesterol....I will never ever EVER use Humana again. Terrible...

Anonymous said...

Humana should be sued and left bankrupt for the way they treat their customers. I was paying over 300 a month in premiums. (I'm 22 so that's really outrageous!) My personal favorite part was the extra 20-30 a month I was paying for medication coverage. I got a script for an antibiotic. Took it to my pharmacy, I had a 55 dollar copay! I asked them how much the drug was... 60 dollars without insurance. So they paid 5 dollars. Then.... I find out that a doctor's appointment was denied coverage because of a diagnoses. I called the doctor's office. The diagnoses was one that I was already paying a 10% rider on my premium for! Humana is full of crooks who will do nothing but shell out two and three dollars for your appointments (yeah they're denied coverage was something pathetic like $10. My copay takes up the rest of the bill). It's ridiculous and unethical.

Anonymous said...

HUMANA SUCKS AND I HAVE JUST ABOUT THE SAME EXPERIENCE AS ALL THE ABOVE. I remember the day i signed up for Humana and my thinking was "o.k. - it is handled and i've got good coverage". It has gone downhill fast since then and i can go to wal mart ang get their advertised $4.00 generic rx plan and be almost identical to the services i get from humana. I have'nt gone to my dr. much so i don't have any experience there but, i'm sure from what i hear - it is not much better. How does our government let people like this stay in business ? They suck and are a rip off. Stay away from humana

Anonymous said...

My experience with HUMANA -which is said to cover 100% of my emergency hospitalization- to remove two stones completely obstructing bilateral ureters, has denied all my claims. When I inquired about their rationale: My PCP must provide all certification and/or referrals prior to your obtaining services or you usually won’t recieve any benefits coverage. It’s a GD emergency VISIT! How do I get an PCP to refer me to an ER for a visit I didn’t plan? DENIED COVERAGE to the tune of $30,000. And here’s the kicker: I am an RN at the hospital I was admitted to. HUMANA, YOU ARE THE SCUM OF THE EARTH.

Anonymous said...

Humana is a hosebag company and anyone that thinks for-profit health care has never had to use their benefits.

I was diagnosed with type II diabetes in April. My PCP has been excellent, put me on Metformin and a new drug called Byetta (which works) and my A1C was 9.3 when diagnosed and three months later it's down to 6.2. My average fasting blood glucose is down to 100 versus 300+.

But the dickheads at Humana refuse to pay for any Byetta (which is $298 for a 30 day supply) and when my PCP tried to switch me to Janumet (another new diabetes drug that works similar to Byetta) their screwing around not wanting to pay.

I really hate them. I have diabetes, I am compliant, I am managing it well. When I see their commercials I am tempted to projectile vomit on my TV "guidance when you need it most." What a crock. I hope these people who deny these claims get diagnosed with the same diseases they deny medication for so these pricks know how it feels. I have diabetes. I am not asking for a script for BOTOX. Jerks.

They are a worthless organization run by money hungry pigs who deserve to pay for their crimes.

Anonymous said...

My problems started when Humana bought Cariten , the coverage supplied by my workplace . My daughter needed surgery for GERD ,the Humana wanted one procedure ,the surgeon wanted to do another .He said that if he did the procedure they wanted , he'd end up having to undo it and do the one he wanted to do ,because in his opinion their idea wouldn't work . I guess Humana has these magic doctors (who they won't give you the name of) that can better diagnois a patient without examining them than a doctor who has . I appealed twice and was denied coverage because the surgeon had said in his report that his procedure would cause weight loss which would also be a benefit for her . My policy has an exclusion for weight loss surgery and they are using the secondary benefit of weight loss as an excuse to deny coverage . My daughter's weight is caused by a thyroid disorder ,not an appetite . The GERD has gotten to the point to where she has been inhaling stomach acid and damaged her lungs causing a chronic cough . I had to pay the 21,500.00 for the procedure out of my pocket and filed a complaint with the state . Since then I have had doctors charged back for tests and procedures they have done as far back as eight months ago and have trouble getting anything paid at all anymore as retaliation from them . The humorous thing is the procedure they wanted to do costs 5000.00 more than the one the doctor performed and has a 35% failure rate . when you call the "customer service " line all you get is a lie to get you off the phone , there's never a supervisor available to talk to either. I've heard the local office will be closing at the beginning of the year , I hope after they're all unemployed they never find another job and lose everything they own and if they do I hope they end up with Humana Insurance and get sick and get the treatment I have gotten for the last 6 months . I have called all my representatives and congressmen and met with one and told them that whatever healthcare bill they pass , just make sure it closes Humana down and have asked the Governor to ban them from doing business in the state . Stay away from these jerks at all costs unless you just like throwing your money away .

Anonymous said...

I used to work for Humana and the same way they treat customers they treat employees. I was subject to discrimination, sexual harrassment and if you attempt to report it you will get fired. I tried everything to get management and even corporate to start an investigation and nothing ever happened. Dog eat Dog. They are the worst company to do business with or to work for. Dont say you were not warned.

Cheap Life Insurance said...

and the recommendations of the doctors on call for proposals was to see … and then they were rejected by the invoices and said, I was responsible. A month or so and going back and forth, they shout, they shall be drawn up in accordance with this part. After … and are now making me pay for my blood work that verification visits were carried out at the doctors.

Anonymous said...

I completely agree with many who've posted on here. I used to work for Humana too and when I was laid off due to the downsizing from the economy, as I was told ;)I actually rejoiced. My direct supervisor said, "I'm Sorry," and I looked her in the face and laughed and said, "don't be sorry, this is the worst company I have ever worked for. You treat people like crap." She kind of "smiled" in what appeared to be acknowledgement, with no malice what-so-ever and wished me "best of luck," under her breath and sent me on my way. I secretly think she agreed with me but of course wouldn't say anything to save her job.

Anonymous is right: they suck the life out of you. They want their own profit and all you are is a number and profit, if you work for them or if you are a client. I too experienced sexual harassment there and I kept exact dates and documentation of each of three incidents, and even had a sound file of the married creep hitting on me.

When I presented my evidence though, upper management and H.R. treated me like I was the problem. They DON'T care about you. Since I left I found no less than three other women that experienced this as well before they voluntarily left, were dismissed, or experienced economic downsizing as did I.

Humana will do everything to use you and lose you, not to mention the girls there that get premiere positions because they are sleeping with the executives. That's part of the reason why their management stinks too. If you can perform in bed, you get the job (not that you'd even be good management material due to real management skills ;). I often wondered: "Do these women really value themselves at all?" Good girls that say "no," are marked, targeted and expunged. That's why when you report sexual harrassment they don't like it, because you're breaking up the psychopathology of management and their fun of using others.

IT IS A HORRIBLE PLACE. Don't ever buy their insurance and don't work there. Don't say you haven't been warned.

Anonymous said...

I actually work for a branch of humana and lets just say on average, that most calls i take all day are complaints....humana is ruthless and will use any and all means of denying you if they can get away with it, their insurance is shoddy and cheap (just like the basic structure of their company), their customer service is a joke, half the time when i call into humana on behalf of a customer I GET DISCONNECTED! wtf?! if you can afford it regence value care through blue cross is pretty good...but to humana? they can burn in hell for what they do to people

Anonymous said...

Our company recently changed to Humana. I have to change my doctor to the ones in there network. The thing that really chafes me is Humana had denied paying for some of my medications because they want lower cost alternatives. Humana should quit trying to be my doctor and pay for what the doctor says I need.

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