Health Net Health Net Ruby 4Medicare Advantage insurance Medical insurance company will rip you off, and they don't care! Nationwide

 My prior Auth is good from 3/30/2015 thru 12/31/2039. So I do not need to get a new one every year. Anytime I call any company about any issues, I always remain calm and I try to be pleasant but sometimes I'm a little short and curt. I do not cuss, yell, scream on the phone because it serves no purpose. I'm upset at the company, not the individual employees. So there was no reason for him to be rude. Yes my pharmacy ran my refill every month and told me the same thing every month. How would they get all of others correct and not just that one AS far as payment, payment was made for 1 month on the 28th of that month, and it was canceled 3 days later. It was not 2 months past due, I owed for 1 month only. Even after they saw it was thier mistake, the woman said oh well it can't be reversed. I called another person who told me that they would only accept a request for it to be redeterm if I payed for 2 months first... But she advised against it cuz she told me she had never seen them reinstate anyone. Unfortunately, I am back with them because I have no other affordable plans in my area. Which is why they think they can do whatever they want. I suspect you work for them. I don't need anyone to explain the policy to me, and I find that insulting. I prob have a higher education than you do. I do however expect if I talk to a company, for them to honor what I had been told... Correct or not.

Ok,

You need a broker or advocate, because you don't understand the process.

For a Medicare Advantage plan to disenroll you you must have not paid for 2 consecutive months.

You may have received a letter telling you they will disenroll you if you don't pay by the end of the second month. If you aren't there yet, pay and keep your coverage.

Your Healthnet plan in Cochise county is $29 per month. The only other option there with Drug coverage is $166. IF you can even get it because unless you have low income, under $1500 per month, you won't qualify got a special election.

They cannot disenroll you until the last day of the second month. Calling them and telling them you'll be late dosent matter, their grace period is 2 months, no longer.

In regards to your drug claim issues, it sounds like your pharmacy isn't calling into the PBM to verify your formulary exception. If your exception is from 2015, you must have your Doctor request it again, every year, if this hasn't been done, they won't pay.

If HealthNet member services is telling you the exception is active, the pharmacy is not doing the work to verify it, find a new pharmacy.

When calling Member Services, if you are angry, impolite or hostile and cursing, they can and will hang-up on you or be hostile right back and are well within their contract with Medicare to do so.

Stay calm, get names, dates and times and tracking numbers.

If you do indeed have an exception on file, you can submit all your receipts for your prescription for reimbursement. If they say no, you can file an Appeal. If they say they will pay, but will not you have a Greivance.

https://www.healthnet.com/portal/shopping/content/iwc/shopping/medicare/file_ag_med_adv.action