• Report: #1042906

Complaint Review: WELL CARE HMO WITH MEDICARE

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  • Submitted: Fri, April 12, 2013
  • Updated: Thu, May 23, 2013

  • Reported By: BeenThereDoneThat — PalmettoBay Village Miami Florida
WELL CARE HMO WITH MEDICARE
Nationwide United States of America

WELL CARE HMO WITH MEDICARE WellCare Health HMO Medicare Supplement WellCare HMO denies benefits by delay . Tampa , Nationwide

*General Comment: There is No Such Thing as Security

*General Comment: Sour Grapes Knees & Hips

*Author of original report: YOU NEED A NEW INSURANCE COMPANY

*Author of original report: $5 a month is $60 per year No Matter How you Count it

*UPDATE Employee: WellCare

*Consumer Comment: Educate Yourself About Medicare Benefits

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Well Care has promised in writing that I have $ 5 each month benefits OTC, that is $60 per year.  They refuse to give me this when I call, and instead allow only the $5 monthly cap, that excludes me for most of the products they offer.  Most products are over $5 so it effectively cuts me out of being able to use this benefit unless I want a new tooth brush every month or cotton balls, and the like.  $5 does not cover much else. 

 Aso, they are saying I have a $200 co pay for injections for my knee, bone on bone, and I can not afford that.  I was told that I would have no co pays , ZERO  co pays except for the ER at a hospital, with my plan with Well Care, the Dividend plan, but, BUT they are willing to approve surgery knee replacement surgery, plus the surgeon, plus the wheel chair and the therapy for this problem, at least $80,000 dollars cost but not to let me have the injections for my knee instead !

 I Do  NOT want knee replacement surgery.  Not.  I want the less invasive injections for my condition, even if it has to be done every 6 months.  I Do NOt want knee replacement surgery. NO. Well Care is denying my the alternative less expensive treatment of injections and trying to charge me a $200 co pay .  I was clearly told that I had No Co Pays with my plan when I signed up with this scam insurance company Well are.   They have been in the news for years, why are you, the Insurance Commissioner of Florida,  not making them stop this fraud ?  

 The fines imposed a few years back seems to have done nothing to stop them for the abuses they practice.   

This report was posted on Ripoff Report on 04/12/2013 09:46 PM and is a permanent record located here: http://www.ripoffreport.com/r/WELL-CARE-HMO-WITH-MEDICARE/nationwide/WELL-CARE-HMO-WITH-MEDICARE-WellCare-Health-HMO-Medicare-Supplement-WellCare-HMO-denies-b-1042906. 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:
2Author 4Consumer 0Employee/Owner
Updates & Rebuttals

#1 General Comment

There is No Such Thing as Security

AUTHOR: MiamiGoldenGirl - ()

I don't care if my name and address are written in permanent marker on the bathroom walls.  Well Care has all the information on me already for all to see, and I am made to repeat it every time I might call, or even if I am called at home by Well Care, that one really got me.  Regina Rosa   305 - 232 - 7672  ( 232 - ROSA ) the same telephone that you already have on the record. 

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#2 General Comment

Sour Grapes Knees & Hips

AUTHOR: MiamiGoldenGirl - ()

These injections are not cortozone, and they are widely successful in most patients.   I go to an old people's clinic here  in Miami, that only takes medicare patients, and there is a constant parade of old women and men with knee replacements who are virtually disabled now, in wheel chairs, and in horrible pain.  I see them every time without exception that I do or take my brother to his clinic, same, same thing.   My high school girl friend and I went on a road trip in 2008, I drove, to Maine and she had a horrible time.  She had knee replacements and when she fell down, and she did a lot, she could not get up unleess some one came to pull her up to her feet.  That is horrible.  I need the cushions replaced so I do not have the bone on bone condition that I have now, but I don't need a suicide operation of knee replacements.   I have seen nothing good in anybody who has had them,   WEll Care is being stupid, not me.  They promised me no co pays when I singed up with them.   You have a serious case of Sour Grapes.   Good Luck to you.  

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#3 Author of original report

YOU NEED A NEW INSURANCE COMPANY

AUTHOR: BeenThereDoneThat - ()

Unless you are lying about your insurance company,  you are very not smart ( stupid ? ) to stay with the one you describe.  What can I tell you ?  Look for a better company.   It sounds like you are grateful for what ever crumbs are tossed your way, letting the mega rich companies get more rich at your expense.  I am not. 
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#4 Author of original report

$5 a month is $60 per year No Matter How you Count it

AUTHOR: BeenThereDoneThat - ()

That is not a '' good deal '' and Well Care has effectively now blocked us from claiming this amount as guaranteed in the contract.   Considering the thousands, tens of thousands of members who now can not claim most of the over the counter items that they need and can use, this is tens of thousands of dollars that Well Care now is not providing as they promised to provide.   This was once $25 each month and Well Care has diluted it down to now this measly $5 a month and now refuse to honor even this amount.   Dont tell me about other plans,  they have nothing to do with the fraud that Well Care is playing on its clients.  Well Care has been in the news and is infamous in the industry, well know at the doctors offices also by the way and in the news papers.  This is shameful.  Purely shameful.   

You go have knee replacement therapy,  and good luck.   I took a road trip with a high school friend who had this surgery and every time she fell down, we had to call strangers to help her get up, she could not bend her knees.  Gee, thanks for your ignorant adivice.   If there is any chance the injections work, it needs to be taken and tried.   You are reporting as a Lacky for a fraudlent HMO Well care,  and you are way off target in your response.   

Well Care owes me what they promised me  $5 a month is $60 a year, and not in only little foolish items that cost under $5 when restricted to the monthly value.   Well Care again is making a killing with this ploy to get people to sign up with them so their execs can take more junkets to Las Vegas and dance on the tables there in expensive hotels,  

Well Care has a horrible reputation,  I am searching for other HMO's and I also care for several elderly people , that I signed up with Well Care and I plan also to change them when I do.   
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#5 UPDATE Employee

WellCare

AUTHOR: WellCare Health Plans - ()

My name is Josh and I am the Social Media Manager for WellCare Health Plans. We are so sorry to hear about your frustrations. Please email us at SocialHelp@wellcare.com with your name and a phone number where we can best reach you, and someone should be in touch with you shortly. For your security and to protect your privacy, please be sure not to include any other personal information (such as your address or member ID number) in your email.
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#6 Consumer Comment

Educate Yourself About Medicare Benefits

AUTHOR: West - ()

I can't understand your complaint. You get $5 per month to use on anything over the counter--use it or lose it, right? That sounds like a good deal that not all of us get--at least I don't get that with my insurance company. One month you can buy a toothbrush, the next month you can buy some vitamins, and on. Why aren't you using it and just letting it go to waste? If you are getting something extra, take it instead of complaining about it.

Also, if you you have pain with your knee, you know you have to get the knee replacement surgery. I just had my hip replaced. You said your insurance company will cover the cost of the whole surgery. I had a co-pay so you are better off than me. Those cortozone injections only cover up the problem and they don't work for everyone. If you want your problem solved, you need the surgery. You are lucky that you would only have a $200 co-pay for those injections. Because they don't always work and most insurance companies don't cover them at all--at least mine doesn't. But again, if you have a problem with your knee, you need to get it fixed otherwise you will always be in pain and always have something to complain about.
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