Complaints

• Initial Complaint

  04/29/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  February 26,2024 I was a patient at ***** ***** ************. I had called to make a appointment for a issue with ***** ***** I was seen by the Chiropractor was instructed to come back two days later which I did and got relief bill was sent to Humana for payment. On Saturday April 27 get a statement in mail saying Humana would not pay said claim no where in the Evidence of Coverage is anything saying plan will not pay for manipulation. I am on a fixed income can't pay what Humana for whatever reason won't pay claim. I need new glasses has me concerned are they going to deny that claim also. If they won't pay what they say they will this action will force me to tell others how bad Humana is have read other people's complaints against Humana. People expect a insurance company they have a policy with to pay any and all claims without having to go thru a lengthy appeal process for any claim or claims that are denied. I only go to chiropractor if put lower back out of place. If this claim is denied by Humana have no other chiropractor I trust and can get relief.

  

  Business response

  07/05/2024

  A response has been mailed to the member.

• Initial Complaint

  06/27/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I applied for the Humana health insurance in the beginning of March 2023 and was sent the insurance card number HID#: *********** on 3/10/23. The Humana policy includes $200 spending money on a visa card every month which I never could use. The spending card takes 3 weeks to deliver which is a long time by any measure. I was moving out of the Syracuse location around 3/28/23 and told 4-5 customer service not to sent the spending card to Syracuse and hold on to it until I give them the new location staring 5/1/23. I called Humana customer service by 4/25/23 to let them know my new address : *** **** **** ****** *** **** ****** ** ****** Humana customer service sent maybe 2 spending cards to the Syracuse location in spite of my request which returned to the company. I was not satisfied with Humana customer service performance, ethics, listening ability and cancelled my Humana insurance in April. Therefore my Humana health insurance lasted from 4/1/23 to 4/30/23 during which time I never got my spending card with $200. When I moved in Ilion, NY on 5/1/23 I found the visa spending card number **** **** **** **** *n my mailbox, but it cannot be used since I wasn't a member of Humana. I tried getting my $200 spending card money on 6/23/23 and 6/26/23 by calling customer service Jason and his supervisor a woman, but neither wanted or helped. The supervisor said I wanted an additional spending card , but I wanted the April 223, spending money I never used or received on time because of their bad customer processing and 3 week processing. The visa spending card was part of the policy and it was not delivered. Use this address of Humana Grievance and Appeals: Humana, Grievance and Appeals ********* ****** ***** ********** ** **********

  

  Business response

  07/07/2023

  Please see the attached response.

   

  Thank you

• Initial Complaint

  01/11/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I was at the food bank in Alexandria la a lady approached me and said i could get a card with $2,400 and money every month to spend on a debit card at Walmart and other places I did sign and gave my initials to some things with out reading it and that was a big mistake received a Humana card in the mail and I didn’t know that I was switching from Cigna to Humana as my health provider and because of this most of my Drs don’t take Humana I had asked the lady if it was gonna mess me up with the Drs i see and she said would be better with no copay on Drs and medicine my pain Dr (Dr Dole) doesn’t take Humana I did get on the phone with Medicare and got a new provider through Aetna thank God but they should have told me they were gonna set me up with Humana I was in line at the food bank in my car the lady was talking to me as I advanced to my pick up for food I didn’t get near $2,000 I did get a card for $100 a month which isn’t near what she said I would not have changed to Humana if they were gonna give me a $1,000 a mont my medicine is way more important than money I think they should have something done to them for what they did I’ve had other people tell me that they had the same thing happen to them the way they did is no way to get more people to join Humana thank you I guess nothing will happen to them but I think people should be warned about them I will never sign anything again with out reading the fine print Thanks again ***** ****

  

  Business response

  01/20/2023

  I am writing in response to the inquiry you submitted to Humana on behalf of ***** ****.
  
  Enclosed is a copy of the resolution letter sent to the ***** ****. Please feel free to call me if you have any questions or concerns regarding this matter. I can be reached at ************ **** *******.
  
  
  
  

• Initial Complaint

  12/28/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I initially applied into Humana Gold Plus HMO ******** on or about, application# *********. Mr ****** was very detailed, hence I enrolled. He stated a health flex card of $250 was part of the benefit since I was eligible for year 2022. On 12/5/22 I had not received my healthcare care and called Humana for a status The lead person and was quite knowledgeable. She informed me of my benefits and stated my flex card was pending fulfillment and if don’t arrive by the time of my dentist appt and/or expires prior to usage to call and they can have it role over. My physical exam was scheduled for the 12/6/22 however my Primary was incorrect and one phone call cleared it w/o any hesitation and the agent went above and beyond to ensure I could meet my appt time. Sadly to say the flex card took a different turn, I had a upcoming dental appt and called on 12/23/22 to inquire on the flex card and was met with an least professional agent, she was very matter of fact, insisted that I wait out 21 days(call back Monday because it’s Friday) before I inquire irregardless of the status being “pending fulfillment“. I asked that she read the notes from my prior call to get up to speed. She begin to ask for the case #, date and lead personnel. I again asked because the last person stated to do so. She continued asking for a case #and stated “the last lead person should have provided it to u”. At this point, I asked for a lead personnel because the call was going from bad to worst. The leader personnel responded with similar behaviorism but after I stated how unhappy I was with the whole interaction and I will file a complaint, she became more gracious. Provided me with the prior lead person case#************, her case # ************* and she would also file a complaint on my behalf, but didn’t know where it was going to go. She contradicted prior lead personnel by stating the flex card can not roll over benefits into the next year regardless of the circumstances. I’m so confused!!

  

  Business response

  01/06/2023

  ******* ** **** ************ ********** ****** ******** ******* **** ****** ******** ******* **** ***** ********* **** **** *********** ** *****
  
    ********        

  **** ****                       

                                                                          
  Entity Name:                  Humana Medical Plan, Inc.
  ********* *****         ***** *******                ******** ******            ***** *******                    ****** **** ****       *************
  
  Dear Conciliation Department Better Business Bureau, Inc.,
  
  I am writing in response to the inquiry you submitted to Humana on behalf of ***** ******** 
  
  Enclosed is a copy of the resolution letter sent to the Linda Walters. Please feel free to call me if you have any questions or concerns regarding this matter. I can be reached at ************ **** ********
  
  
  Sincerely,
  
  ****** ***** **************
  Humana Critical Inquiry Department
  
  Enclosure:   Resolution letter
  

  Customer response

  01/07/2023

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
  
  My initial call on December was the most detailed and professional conversation I’ve encountered during my interaction with Humana. However, your account as to the details of this call is not accurate.  There was no mention of “in order to get a new card, your old card would need to be deactivated….” Her details  of the flex card late arrival that I should call and have it “rolled over”. I called 3 days prior to the 21 days just to get a status because I had a fourth coming dental appointment which prompted December 23rd call. On this date your Representative was so unprofessional it warranted me to ask for a supervisor. During my conversation with the supervisor, her demeanor mirrored her subordinates behavior until I expressed my concerns about the conflicting information and filing a complaint. At that point, she became more explanatory and offered to file a complaint on my behalf. At no time “********* was mentioned on neither call or conversations. Nevertheless, I was told the calls were recorded, with that being said, it should provide clarity as to how these interactions were actually conducted. 

  
  

  Lastly, to date January 7, 2023 the flex card for year 2022 nor year 2023 has or been received. My understanding continues to needs clarity “ will the flex card roll over from year 2022 to year 2023, or the benefits will not be fulfilled? Now, The flex card status is again pending a later timeline and a response is pending is what I fully gathered from your response. 

  
  

  I will await another response. 
  
  Regards,
  ***** *******

  

  Business response

  01/19/2023

  ******* *** **** ************ ********** ****** ******** ******* **** ****** ******** ******* **** ***** ********* **** **** *********** ** *****
  
  
  **** ****                         ********                                                                                
  Entity Name:                  Humana Medical Plan, Inc.
  ********* *****         ***** *******                ******** ******            ***** *******                   
  ****** **** ****       *************
  
  
  Dear Conciliation Department Better Business Bureau, Inc.,
  
  I am writing in response to the follow up inquiry you submitted to Humana on behalf o* ***** ******* on January 12, 2023
  
  Enclosed is a copy of the resolution letter sent to the ***** ******** Please feel free to call me if you have any questions or concerns regarding this matter. I can be reached at ************ **** ********
  
  
  Sincerely,
  
  ****** ***** **************
  Humana Critical Inquiry Department
  
  Enclosure:   Resolution letter
  

  Customer response

  01/23/2023

  ** ******* ****** ** ******** **** ***** ********* **** ********** ** *** ********** *********  ** *** ***** *** *** ****** ** ****** ******* ****
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and find that this resolution would be satisfactory to me.  I will wait for the business to perform this action and, if it does, will consider this complaint resolved.
  
  Regards,
  ***** *******  
  

  ---

  
  
   
  

• Initial Complaint

  08/01/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  I am complaining about 2 issues. 1st.- When I enrolled my *** ***** ***** with Humana Gold, I asked several times if they provided Home Health Care more than 40 hours month/year. They said yes. I've been getting the run around for half the year. My *** has beginning of ********, she can't be alone for long periods of time, I work all day. I was allowed to work from home 2 days a week for few months until I got the HH for ***, but my time was up and I had to return to work from premises. Since then, my *** has fallen, has burned herself, I had to take days or hours off to help her. Her psychiatry said that Medicaid pays for the HH so they should be covering for that. My ***'s wellness is in jeopardy and Humana keeps giving me run around even when I sent proof of my ***'s illness. I need Home Health care for my *** ASAP. 2nd.- The transportation company that Humana has imposed upon us is Modivcare. After so many scheduled rides, she had none of them, either they cancelled without notification; left without waiting for an elder person; or they want to communicate through text (an elder passenger who doesn't text). Humana is getting paid from Medicare and Medicaid, which they pay to Modivcare for the service, yet my *** has no service. I want the option to choose a personal transportation company for my ***.

  

  Business response

  08/11/2022

  Please see attached response.

   am writing in response to an inquiry filed with the Better Business Bureau regarding personal care, home health coverage and Modivcare transportation services.
  ***** ***** is a policyholder of a Humana Gold Plus HMO Plan The coverage was effective from January 1, 2022, through the present.
  Upon receipt of this inquiry, your mother’s benefits were reviewed. It was determined that your mother’s home health and personal care benefits were limited to what is
  outlined in the 2022 Evidence of Coverage (EOC). For your review, included in this response is a copy Ms. Weber’s 2022 EOC. It outlines that your ****** has personal home
  care benefits for a maximum of 42 hours per year (Page 77). It also outlines that your mother’s home health benefits combined must total fewer than 8 hours per day and 35
  hours per week (page 65).
  In addition, Ms. ***** has the option to change her policy during the Annual Election Period from October 15 - December 7 annually. Ms. ***** may also contact our Enrollment
  Department at 800-984-9095 to see if she qualifies for a Special Election Period (SEP). Beginning on page 208 in the EOC, it outlines the option to end you mother’s policy.
  Attachment A contains a copy of the 2022 EOC. 

  Customer response

  08/17/2022

  Dear ***** ******

  Let’s review your notes, the notes on page 77 would have been nice to have them before promising by your marketing team services you don’t offer. I never received a copy pf the EOC even though I was told in more than one occasion that it would be mailed to me, 98% I don’t have problems with my mail. I considered very weird that the EOC got lost in the mail more than once. What a coincidence your EOC arrived along your letter!

  The rides you listed, and I copied here

  • 7/27/22- this ride was cancelled as a member no show. NO SHOW OF THE RIDE. IT WAS MY ***’S PLACE; SHE WAS WAITING AND WAITING FOR A CAR THAT NEVER CAME.

  • 7/28/22- roundtrip was completed with no issues. NOT TRUE AT ALL, AGAIN, NO RIDE SHOWED UP. IF SOMEONE IS CHARGING THE INSURANCE COMPANY FOR THIS RIDE, THAT IS TOTALLY ON YOU. ACTUALLY, THE FIRST RIDE SHE ACTUALLY GOT, WAS LAST WEDNESDAY

  • 7/29/22- notes indicate this ride was cancelled per Ms. Weber’s request. YES, AFTER 2 DAYS OF ISSUES, I DID CANCELLED THIS RIDE.

  By the time of this response, 8.16.22  my *** got another ride no show, no call, was sent a lift to pick up from home. They sent a Lift to pick her up from the doctor, it was pouring, *** was soaking wet to no driver accountability, I had to leave work to pick her up.

  Today again 8.17.22, no call, no show. *** lost her treatment. So who's getting accountability for my mother's health?

  On April 6, 2022, you called Humana to inquire about personal care benefits for your mother. The Humana representative advised that your ****** has a $0.00 copayment and provided you with the contact number for Senior Bridge (800-290-9576) for further assistance. YES, REP SAID THAT, AND I CALLED THEM FEW TIMES (HORRIBLE CUSTOMER SERVICE BY THE WAY), BUT ACCORDING TO SENIOR BRIDGE, MY ****** DID NOT QUALIFY FOR THEIR SERVICES. SO, AN ELDER PERSON WITH EARLY ********, WHO GETS DISORIENTED (SHE FELL DOWN FEW TIMES, SHE BURNED HERSELF ONCE), BUT SHE DIDN’T QUALIFY.

   

  In addition, Ms. ***** has the option to change her policy during the Annual Election Period from October 15 - December 7 annually. Ms. ***** may also contact our Enrollment Department at 800-984-9095 to see if she qualifies for a Special Election Period (SEP).

  First is Mrs. ***** thank you. But to enroll again with Humana (which has nothing human to facilitates for the elderly citizens, No thank you. I really feel bad for people who don’t have anyone to be there for them when big corporations take money from the government to fill their CEOs pockets and couldn’t care less about the people who pay for their services. What it doesn’t come from my mother’s pockets now, comes from a lifetime of work paying taxes. It’s not free, it’s not charity. Just remember that you too will be old one day, I really hope you won’t struggle with your health without anybody helping you. Regarding my mother, I will find a better provider for her.

   

  Sincerely,

   

  ****** *******

   

   

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩