Monday 4th of February 2019 01:10:15 AM
We have Humana insurance because one of our employers dropped our BlueCross plan and switched us to Humana in order to avoid a premium hike. From day one of the Humana insurance kicking in, we've had nothing but problems. The very first medical appointment payment was not applied to our deductible because the provider was "out-of-network," yet Humana sent us there in the first place! There are almost no medical providers in Humana's network in our area and those that are, are poorly rated. We had an emergency, 911 sent an ambulance, the ambulance took the family member to the nearest hospital, and Humana denied most of the payment because the ambulance and hospital were both "out-of-network." That isn't even legal!I had a medical crisis a few months ago while living in another state and Humana had no medical providers at all in their network in my state. I waited two months to get into a specialist because I needed a waiver from Humana accepting a specialist as "in-network." I finally got one for the only specialists' clinic in the state that specializes in my condition, but it was for only one visit and nothing else. The specialist and an insurance agent assigned to work on these matters finally managed to get a waiver for this physician for one year and I had necessary testing in his clinic. He said I needed immediate surgical intervention to prevent damage to my heart at best or death at worst. The insurance agent person got the authorizations and verified that the specialist had them. The specialist's office staff said they got the authorization for the physician to do the surgery at his usual hospital, the biggest in the city and state but out of Humana's network. I'd made it clear I would not bankrupt my spouse over medical expenses so I would do nothing without authorizations from Humana. Because I was told all authorizations were in and verified, I went ahead with the procedure.Well, now we are receiving "overdue payment" notices from the hospital, the specialist, and all the behind the scenes people patients don't know about until we receive their bills, totaling $72,000.00. Of course, we've also already paid our co-payments and co-insurance payments. The $72,000.00 is on top of those payments. Humana has paid between $3,000.00 and $4,000.00 and denied everything else as "out-of-network." Also, because they didn't come close to meeting the Usual and Customary standard for the state I was living in when I had the surgery, almost none of what Humana says we owe is being applied to our deductibles!!We did everything we were supposed to do before we sought medical care, and we did everything Humana told us to do to straighten out the problems, but it's made no difference at all. The bills just keep growing higher, and today the specialist's clinic called me and told me that not only is Humana refusing to accept as in-network the hospital it authorized, but now Humana is claiming I never had authorization for the surgical procedure at all! Humana is claiming they never authorized anything but the initial office visit to the specialist!Regarding prescriptions, every single time we go to renew an Rx, for drugs we've taken for years with no problems from an insurance company, Humana denies them and forces our doctors to spend inordinate amounts of time giving Humana far too much of our private information that shouldn't be necessary to establish medical need. Our providers are fed up and my spouse's doctor told him this week that his office will not do it for Humana anymore. My spouse is just out of luck. Now he has to figure out what to do about not having the medication that has given him a normal life and preserved a major organ for the last 20+ years! Humana even denied my cheap, synthetic thyroid hormone medication I've taken for ten years and need for the rest of my life!Now I'm in a different state, with no primary care physician yet, and I don't know who to go because the choices are so poor, and when I need to renew another prescription, Humana hasn't already hassled me over yet, I won't have a doctor to ask to jump through Humana's hoops. After reading the reviews of so many people damaged by Humana, I figure the next thing will be Humana trying to force me to use its pharmacy. At this rate, we won't be able to afford to keep the job that is providing this joke of an insurance plan. It will have gobbled up a year's salary half way through our first year on it! Humana should be fined by the federal government and by all states with laws it is violating, and removed from any and all federal and state government contracts.