• Report: #415936

Complaint Review: Humana Insurance

  • Submitted: Sun, January 25, 2009
  • Updated: Tue, March 16, 2010

  • Reported By:Clearlake California
Humana Insurance
www.humana-medicare.com Nationwide U.S.A.

Humana medicare Don't use Medicare Plan D Humana Nationwide

*UPDATE Employee: That call is taped

*Consumer Comment: Complaints department would help

*Consumer Suggestion: Not cool

*Consumer Suggestion: Not cool

*Consumer Suggestion: Not cool

*Consumer Suggestion: Not cool

*Consumer Comment: Read the OP

*Consumer Suggestion: G and A

*Consumer Comment: Nice try

*Consumer Suggestion: Benefit info

*Consumer Comment: No

*Consumer Suggestion: Not the carrier's fault, again

*Consumer Comment: They didn't

*Consumer Comment: They didn't

*Consumer Suggestion: They do.

*Consumer Comment: Why can't they just mail the info?

*Consumer Suggestion: Isolated incident

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After reading the horror-show words written by a poster re her 81 year old mother and how Humana showed itself as nothing but a major rip-off, I wanted to post a warning to Medicare-dependent people re Humana.

Don't use it. That's it, plain and simple.

When Medicare was supposedly so broken it had to be repaired by the infamous Plan D...which Plan was, by the way, written by Big Pharma and that fact doesn't exactly make me feel all warm & cozy ---

I had to try to call all numbers in the Medicare and You coffee table size book to find one insurer that operated in Lake County CA.

Got to Humana, phoned there and asked that information be sent to me so that I could decide 1) whether Humana covers the area where I live and 2) whether there would be huge deductibles, co-pays, etc.

The Young & Dumb who caught my phone call said Of course he'd be glad to send me info. Asked me my name, age, exact date of birth...all while I'm trying to get him to understand I'm just asking that info be mailed to me and trying to persuade him to let me give him mailing address.

He's clicking away on his computer keyboard, and I heard him mutter the word "Enroll." "Excuse me," I said. "Did you just enroll me in Humana when all I asked you for was plan information?" "Oh," he said, "that clicking on 'Enroll' is just something we have to do in order to send out info."

"I see. Please un-enroll me and if you would send me prospective subscriber information I'd appreciate it."

This happened at least two years ago and I have yet to receive ONE piece of mail from Humana.

Watch this company. It's a rip-off. At the very least it should teach its' employees to lie convincingly and not use such insultingly transparent excuses for such behavior...that's if lying is a requirement for employees.

Ca215
Clearlake, California
U.S.A.

This report was posted on Ripoff Report on 01/25/2009 09:41 AM and is a permanent record located here: http://www.ripoffreport.com/r/Humana-Insurance/nationwide/Humana-medicare-Dont-use-Medicare-Plan-D-Humana-Nationwide-415936. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.

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REBUTTALS & REPLIES:
0Author 17Consumer 0Employee/Owner
Updates & Rebuttals

#1 UPDATE Employee

That call is taped

AUTHOR: Humanarep - (USA)

This report is a bit hard to understand, but if someone at my company enrolled you when you said not to, that person needs to be terminated. I'd suggest calling a supervisor so they can pull the tape and verify if the employee did something wrong.

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#2 Consumer Comment

Complaints department would help

AUTHOR: Franzg - (U.S.A.)

This problem would never have appeared on ROR, if Humana had a legitimate complaints department to handle matters of quality control.

Now there is a Humana employee running around loose, enrolling potential clients against their will to make a "commission". I am the Law is right that this is "not cool".

Not only is it "not cool", it is downright frightening. If Humana cannot control its employees, imagine what it is doing with our money!

Please Humana, PLEASE open a complaints department. Healthcare is in crisis mode, and we are in a recession. This stuff needs to stop. Please HELP!!
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#3 Consumer Suggestion

Not cool

AUTHOR: I Am The Law - (U.S.A.)

I do agree with Franzg in this case... for once.

The rep the author was talking to probably enrolled the person to get a commission or a quota. Not cool. (Assuming that the author's story is 100% true.)

But, I'm done arguing with Franzg, so if he wants to post a rebuttal of some sort, that's fine.
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#4 Consumer Suggestion

Not cool

AUTHOR: I Am The Law - (U.S.A.)

I do agree with Franzg in this case... for once.

The rep the author was talking to probably enrolled the person to get a commission or a quota. Not cool. (Assuming that the author's story is 100% true.)

But, I'm done arguing with Franzg, so if he wants to post a rebuttal of some sort, that's fine.
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#5 Consumer Suggestion

Not cool

AUTHOR: I Am The Law - (U.S.A.)

I do agree with Franzg in this case... for once.

The rep the author was talking to probably enrolled the person to get a commission or a quota. Not cool. (Assuming that the author's story is 100% true.)

But, I'm done arguing with Franzg, so if he wants to post a rebuttal of some sort, that's fine.
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#6 Consumer Suggestion

Not cool

AUTHOR: I Am The Law - (U.S.A.)

I do agree with Franzg in this case... for once.

The rep the author was talking to probably enrolled the person to get a commission or a quota. Not cool. (Assuming that the author's story is 100% true.)

But, I'm done arguing with Franzg, so if he wants to post a rebuttal of some sort, that's fine.
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#7 Consumer Comment

Read the OP

AUTHOR: Franzg - (U.S.A.)

Humana enrolled person against his will

Humana unwilling or unable to mail requested information.

Humana has poor customer service, and no interest in quality improvement.

Are you actually requesting that everyone who has a complaint with a Humana employee or with an employee's phone etiquette file a written appeal letter? I would think that quite irresponsible to clog up the appeals process for claims with complaints about customer service.

However, it sounds like that is what you want.

Humana better get another PO box, because I would expect quite a few letters after reading all these ripoff reports.
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#8 Consumer Suggestion

G and A

AUTHOR: I Am The Law - (U.S.A.)

Franzg, if you need to file a grievance with Humana, the address is Humana Grievance and Appeals, PO BOX 14546 Lexington, KY 40512. Remember, legally, all appeals must be done in writing. By the way, did you ever write your Congressperson and complain about that?
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#9 Consumer Comment

Nice try

AUTHOR: Franzg - (U.S.A.)

No

Sorry, but the original post is about someone who requested information about coverage, and instead got enrolled by a Humana employee.

In addition, Humana failed to send the requested information.

I think opening a complaints department would help with quality control and customer satisfaction.
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#10 Consumer Suggestion

Benefit info

AUTHOR: I Am The Law - (U.S.A.)

Franzg is actually suggesting that Humana doesn't disclose benefit information to its members. That is the definition of laughable. Please don't pay attention to this person because he works for a rival insurance company.

Come clean, Franzg.
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#11 Consumer Comment

No

AUTHOR: Franzg - (U.S.A.)

Sorry, but the original post is about someone who requested information about coverage. I don't think they were inquiring about their employer.

I don't know why you keep bringing up the silly rules and "certificates". There were no "certificates" involved with this complaint.

This is about a person who was enrolled in Humana by an employee of Humana after requesting coverage information. The person got upset, and asked to be "unenrolled". Information was never sent.

Seems if Humana opened a complaints department, they could squash these little misunderstandings before they get posted on Ripoff Report.
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#12 Consumer Suggestion

Not the carrier's fault, again

AUTHOR: I Am The Law - (U.S.A.)

Granted, claims can be corrected by a provider a year later, yes, that's true, but it's not like the carrier can turn away a corrected claim. I'm sure Humana themselves may misprocess a claim from time to time as well and correct it later. What do you want them to do; let the claim sit in an incorrect status? That is illegal, my man. Claims must process according to that certificate. (DOI guidelines) And, for the millionth time, the employer is responsible for providing benefit info before the employee decides to sign up with the plan or not. I'll agree, I can't verify if all employers are doing that or doing it well, but still, it's not Humana's fault. Besides, the certificate is listed online as well as in the employee's benefit office. How else did you want Humana to convey the certificate information? Hold an employee down and tattoo it on their hand? Perhaps it would be to your satisfaction to have a Humana rep follow member's to their doctor's appointments and critique every action? Would that do it for you?
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#13 Consumer Comment

They didn't

AUTHOR: Franzg - (U.S.A.)

Geez, in this case, they did not.

Humana still denies claims it may tout to cover in its legal "certificate". Some over a year later. It is done by automated computer. As long as it documents it properly, it is "legal".

Why not allow the public to know what is covered before seeing the physician; like this person on ripoff report wanted?

Why not open a complaints department (like at Target), so these "isolated incidents" don't occur. Seems like this potential Humana client would have been much happier, and would not have posted on Ripoff Report.
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#14 Consumer Comment

They didn't

AUTHOR: Franzg - (U.S.A.)

Geez, in this case, they did not.

Humana still denies claims it may tout to cover in its legal "certificate". Some over a year later. It is done by automated computer. As long as it documents it properly, it is "legal".

Why not allow the public to know what is covered before seeing the physician; like this person on ripoff report wanted?

Why not open a complaints department (like at Target), so these "isolated incidents" don't occur. Seems like this potential Humana client would have been much happier, and would not have posted on Ripoff Report.
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#15 Consumer Suggestion

They do.

AUTHOR: I Am The Law - (U.S.A.)

Um, ok Franzg, you think insurance carriers don't disclose BENEFIT information to perspective members now? You honestly think people would buy a policy without knowing what it covers? It's called a certificate of coverage, my man. That's where the benefit information is along with any limitations and exclusions. I'm sure they could get a paper copy or check Humana's website. Geez, man, come on.
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#16 Consumer Comment

Why can't they just mail the info?

AUTHOR: Franzg - (U.S.A.)

And why do they use a "top secret" automated computer to deny medical bills?

Why not have a little disclosure on what will be covered, how much. and what the co-pay will be? Why not give the consumer access to automated computer so we can avoid the debt of denial?

My advice is to find a competent and trustworthy physician to care for your health. And above all, inquire about the best way to pay for your needed services.
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#17 Consumer Suggestion

Isolated incident

AUTHOR: I Am The Law - (U.S.A.)

This seems like an isolated incident to me. Humana has the highest rated customer satisfaction of any health insurance company in America. Even your best companies can be tainted by one bad customer experience. I think you're carrying your complaint to far by blasting them on the internet. I had a rude cashier at Target one time, but I still shop there because it's a good store and I won't let one crazy cashier ruin that for me.
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