Humana Insurance Company Complaint
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HUMANA (Insurance Company) is INHUMANE - Medicare Part D (drug coverage)
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My father (I have power of attorney) who is almost 90 years old was hospitalized for four and a half months. During this entire time he did not return to his assisted living program where he lives alone (I live in New York and he lives in Florida). As a result a number of his bills went unpaid during this time period. When he returned to his assisted living facility and a nurse tried to order his drugs the pharmacy informed the nurse that his Medicare Part D coverage through Humana was dropped for non-payment of premiums. I was contacted by the assisted living facility and immediately paid his outstanding bill with Humana but they refused to reinstate him despite having paid the bill. I wrote a letter of appeal to the Humana Grievance and Appeal Department explaining why my father was unable to pay his bill on time. The response was a denial stating that they sent three letters asking for payment to his address. This totally ignored the letter I had written. After much difficulty I contacted the person who wrote the letter of denial (She had given a phone number to contact her with a non-working extension). She had no memory of the case and preceded to read my appeal while I waited on the phone. Then she said other pages (of what I had mailed) were missing including a letter from his assisited living facility stating the time he was not there for medical reasons. I faxed the information to her. I kept tryng to contact her repeatedly after that to no avail. Then I get a letter in the mail denying reinstatment on the erroneous basis that he either permanently moved out of the service area or was away from the service area for more than six months. This was a totally bogus explanation again with the same incorrect phone number. Next I found out who this representative's supervisor was and I spoke to her. She said she would review the facts. A few days later I get a call from a third person who told me that the second letter of denial was a mistake. Of course I am thinking the next sentence would be that my dad would be reinstated. Instead this person tells me that this is the last day of the enrollment period (December 31) and that he would have to sign-up today to have insurance. Of course that was not reenrollment for 2008 (which would force Humana to pay for four and half months of drugs) but rather to enroll in their drug plan for 2009. When I asked for clarification it was clear he was not being reenrolled.
It seems to me that Humana's denial is morally reprehensible as well as being a breach of contract. What right does this company have to drop the insurance on an elderly person who was hospitalized and unable to pay his bills during his absence from home with no one to take care of his bills in his absense. Bills which infact were later paid! In case you are wondering both my sister and I have asked my father repeatedly to come up North to be close to his children but apparently he just doesn't want to burdren us.
This case is totally documented and I think would make a good human interest story. I hope you can pick this up so that this big insurance company without a heart can get some bad publicity. I call this company INHUMANA.
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Reader Comments:
Posted by lafiore on 07/29/2009
Write the White House, I did. Yesterday, my daughter tried to fill the prescription under my plan, which I’ve had for years and it was denied. I have no money to obtain it ($700) and no time to seek other options. It is life threatening to stop this medicine abruptly and Humana, Social Security and Medicare has been made aware of it. I have no medication and I’m one day late taking it. To date, everyone is passing the buck and no one is taking responsibility for what has occurred. Worse yet, no one is fixing the problem so that I can promptly receive my medication.
Apparently something happened when my disability review took place, initiating an error with my premium deductions. Without notice from Humana, my insurance was terminated. Although an urgent and critical request placed last night by Social Security, a Human representative and Medicare I can still not receive an answer as to how I am going to get my medicine. Once again, I cannot stop the medicine without life threatening consequences, and I have no money or time to obtain other resources to obtain my medications.
I have been lied to by Humana, put off by Humana and treated rudely. I was told yesterday that I requested to terminate my policy with them on June 30th, 2009. When I asked for documentation proving that I did this, I was then told that my premiums weren’t paid. I am at an impasse with Humana, Medicare and Social Security.
Since this was precipitated by my original complaint regarding the SSA, I feel that I have no other option than to ask you for help. A Humana CSR yelled at me last night telling me to go to the emergency room and that by the time the situation is fixed, Humana would then pay for the ER claim. The problem is that this is a part D policy. When I tried arguing with her about it, she just yelled at me, “listen to me!” The Humana CSR finally realized that I have PART D insurance coverage -- and said (after speaking with me for 20 minutes) “Oh, I thought you were a Medicare Advantage Customer.” She had apparently put in a critical request to some department, which no one can contact and had to seek the approval of her supervisor to do so. However, no one seems to know anything about that today when I contacted Humana.
Humana is not a stranger to these types of practices. From the onset of my policy, and although I opted for auto-deduction from my SSD check, they sent payment books, cancelation notices yet when I inquired about them, they told me to “disregard them.” Finally, one day when I tried to fill a RX, it was denied. Apparently Medicare or whoever was responsible for sending my premiums had some sort of delay which caused a cancellation. I was told by Medicare that while the insured who is participating in auto-deduction is enrolled in the same, Humana is not allowed to bill the customer, nor can they cancel the policy. This happened at least two years ago and was straightened out.
I have been disconnected twice today by Humana when I asked for a supervisor. I called Medicare who said they would not send in another urgent request to fix my policy and override the current status of my coverage which is “terminated.” I am now awaiting a call from Social Security who told me yesterday that it would be fixed and to keep checking with Humana and Medicare. I’m sick and feel that I have no choice then to go the emergency room, which will force me to incur more medical bills that I cannot afford to pay. I’m scared as I’ve been told by my doctor and my pharmacist not to stop this medication abruptly.
I would appreciate you passing this on to my President, because I see this as a waste of resources and direct abuse from Humana, who will have a record profit year, I’m sure. Humana should not be able to simply terminate someone’s policy without notice. As well, social security confirmed that I was sent a letter from them stating that my disability would continue and provided the new amount of my benefit which reflected the deduction of both by Medicare and Part D insurance premiums. I had no way of knowing that the premium wasn’t being deducted from my benefit amount.
Time is of the essence and I can’t get an answer from Humana except the same one, “Your policy terminated.” No one can get me to the department that handles “critical requests.” I do not have the intentions of incurring any emergency room bills that I cannot pay for, simply because of Humana’s mistakes. Please, I know Humana is no stranger to railroading their customers. I will send a copy of this to my Insurance commissioner, however, as I’ve stated, time is of the essence and I cannot go without my medication. What should I do and will these insurance companies ever be regulated? Further, know one knows what the other one is doing--- SSA, Medicare and Humana should all be able to work together to solve these problems. I still don’t know who is responsible for taking that premium out or cancelling the same and how this ever happened. Once again, everyone is passing the buck, while I’m sick, awaiting an answer regarding a life threatening matter.
Posted by ayranorun on 01/30/2010
Having relatives there and living there for over 7 years with my family, I can tell the German health care system works well. They have it since 1880! Nobody is denied because of preexisting conditions. The American public is fed lies so they will fear health care reform. Fight and demand for our right for health care.
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