Complaints

The complaint text that is displayed might not represent all complaints filed with BBB. 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.

• Initial Complaint

  Date:03/02/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am currently seeing a mental health provider who is both out-of-state and out-of-network, so my Health Net PPO plan is responsible for paying a portion of the costs. I have been paying out of my own pocket for these services, and I have so far spent $2,200 of my own money for dates of service on 12/17/2024, 01/13/2025, 01/16/2025, 01/27/2025, 01/30/2025, 02/03/2025, 02/10/2025, 02/18/2025, 02/24/2025, and 02/26/2025. Health Net has undergone recent changes to their system that has made it extremely difficult for my claims to get processed. In addition to their recent out-of-state coverage changing from the First Health network to the Cigna network, their mental health coverage has also changed from Managed Health Network (MHN) to "Health Net Behavioral Health." Numerous representatives I have spoken to have had difficulty understanding that my claims do NOT go to ***** because my provider is not in-network with *****. In fact, my previous claim with this provider on 12/16/2024 processed quickly on 12/18/2024 (example EOB statement is attached). When I call Health Net about these claims, I have had all my claims "sent back," "reprocessed," "escalated," and undergo all sorts of review processes. I have paid $2,200+ out of my own pocket so far, and Health Net has not provided me with any update on why I have not been reimbursed, even though my PPO plan covers my out-of-network services. I am writing to the BBB because I need this issue to get escalated.

  Business Response

  Date: 03/17/2025

  Health Net has requested that are claims department process and pay the outstanding claims.Additionally, we will inform the member in the Appeals and Grievance letter that; "Going forward, the provider should submit the claims directly to *****. ***** will then forward the claims to Health Net, which will complete the processing"

  Customer Answer

  Date: 03/17/2025

   
  Complaint: 23010378
  
  I am rejecting this response because: I am still awaiting Health Net to process and pay these claims, with the checks going to me and not my provider. Also, my provider is out-of-network and is not contracted with *****. In addition, my provider is also not submitting these claims since I am already paying my provider the full billed amount out-of-pocket. These are member-submitted paper claims that I mail out to Health Net, which I have been told to mail to Health Net and not Cigna.
  
  Sincerely,
  
  **** *******

  Business Response

  Date: 03/19/2025

  The claims have been processed, and payment should be going out to the member within in the next week or two. 

  Customer Answer

  Date: 03/20/2025

   
  Complaint: 23010378
  
  I am rejecting this response because: I can confirm  the claims on 02/24/2025 and 02/26/2025 were reprocessed correctly and payment is going out to me as the member. 

  But, the claims on 12/17/2024, 01/13/2025, 01/16/2025, 01/27/2025, 01/30/2025, 02/03/2025, 02/10/2025, and 02/18/2025, were reprocessed incorrectly. The payments were sent to my provider, rather than myself as the member which I noted in my previous BBB response to the business on 03/17/2025. The provider has told me that he will not cash the checks, nor will he reimburse me for the rendering services. The provider has mentioned to me that Health Net needs to reimburse me as the member. The business has also notified me that a specialized coordinator would get in contact with me to provide an update, but to date, no one has contacted me via phone or email. 
  
  Sincerely,
  
  **** *******

  Business Response

  Date: 03/24/2025

  Reimbursement payments have been issued to the Subscriber you should be receiving payment by next week.
  
  

  Customer Answer

  Date: 03/24/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********. While I have not received any payments yet, nor has an Appeals and Grievance Coordinator provided any resolution to me yet, I find that this resolution is minimally satisfactory to me. I will await these reissued reimbursement checks as promised, as well as further communication from the business.
  
  Sincerely,
  
  **** *******

• Initial Complaint

  Date:01/10/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Health ******************** regarding the denial of coverage. These denials have caused significant financial and emotional distress, and I believe they are unjustified and not in line with the terms of my policy. I believe that Health Net is not adhering to the terms of my policy and is failing to provide coverage for medically necessary and preventive dental treatments.I submitted a treatment request for the following procedures for my teeth, by my dentist, Dr. ******* *******: Pins under cap, Tooth-colored cap (crown). Despite this medical necessity, Health Net denied the request, citing the Medi-***************** of Criteria for Restorative Procedures (D2000-D2999). The reasoning provided was that more than half of the tooth must be damaged, and that my dentists x-rays and notes "did not show" this level of damage. However, my dentist relayed that although it was not the "whole tooth" that the damage would have been threatening to full tooth and my oral H32393532353233**3834H if not fixed immediately. I also requested approval for a preventive dental procedure for tooth #**, which was also denied. The denial was based on the assertion that the treatment was not medically necessary because it was not yet deemed "urgent" enough. However, my dentist, Dr. ******** has indicated that this treatment is medically necessary to prevent further damage and complications to my oral H32393532353233**3834H.Due to the initial claim denial, I have already incurred $1,400 in out-of-pocket expenses for the first procedure. This amount, which should have been covered under my insurance, caused significant financial strain. I am now faced with additional costs for the preventive treatment, which should also be covered. These procedures are essential not only for the preservation of my dental H32393532353233**3834H but also for preventing the need for more costly treatments in the future.I respectfully request that the Better Business Bureau investigate this matter and help facilitate a resolution with Health Net.

  Business Response

  Date: 01/21/2025

  Health Net is currently assisting the member with this matter an appeal has been implemented member is aware. Health net has advised the member to allow 30 business days for the appeal to be completed. 

• Initial Complaint

  Date:12/18/2024

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I just signed up for them through Covered California and it said there are 20 doctors within 10 miles of me. I then paid them, because they require that before selecting a PCP. I then went to select my PCP and there is in fact only 1 doctor within 10 miles of me, and it's a doctor I refuse to go to. I called their customer service and they had no idea what I was talking about, did not help me at all, and said they can't refund me. I need to cancel this plan and get a refund so I can get a different plan with a different company, but cant do it if they don't even acknowledge my plan or payment.

  Business Response

  Date: 01/03/2025

  Health net has issued a refund to the member in the amount of $79.37 which was processed on 12/24/24 back to the same account that the payment was made from.

  Customer Answer

  Date: 01/07/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me, though it is still disappointing that Health Net has falsely represented the number of doctors in my area.  I hope they also fix this as well.
  
  Sincerely,
  
  **** ******

• Initial Complaint

  Date:09/13/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Please see attached

  Business Response

  Date: 09/20/2024

  Dr. ****** did not want to do a complaint in regards to unapproved medication. He would like Health Nets PEER to PEER process to be revised and changed. He believes the process is too long and should be made in a shorter period of time. 

  Customer Answer

  Date: 09/23/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****** ****** Md

• Initial Complaint

  Date:09/10/2024

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My health insurance informed me of an additional health insurance listed under my identity. It is through Ambetter/HealthNet. It is not mine. I and my insurance informed Health Net that it was not mine, is causing access of care difficulties, and requested removal many times. HealthNet has refused to remove the insurance.I am requesting that the complaint and my contact information not be posted as my identity has been stolen.

  Business Response

  Date: 09/20/2024

  Health Net is still working on the members complaint. The member called back Health Net on 9/19/2024 and provided details of the complaint.
  We have sent an email to privacy to research the active enrollment for this member. 

• Initial Complaint

  Date:07/12/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I have called Healthnet to see PCP. When I call every person I talk to tells me they will solve issue but they never do, they just make me wait on the phone for hours. Last week I talked to ******* who assured me she will find a PCP for me to see and will call me this week. This week she called me assigned me to a new PCP, told me that she will call me in one to schedule visit with PCP. So she told me to wait another month to schedule an appointment. She told me I will change your PCP today but you cant make an appointment with this doctor **** I have been calling Healthnet multiple times in the last couple of months I have a record of all the calls I have made and how much time I have spent with Healthnet. Yesterday, she called me from a number that in my call logs says Scam Likely. I tried calling that same number today, it says that number is not in service. Healthnet insurance is a scam, literally my phone shows me that they called me yesterday from a scam number. Today I called the office of new PCP they assigned and they told me the first available app. they have is March 2025. Now I have to call Healthnet again. So far I have been on the phone with Healthnet for hours upon hoursm each time they cannot find any doctor for me to see. All the PCPs they have assigned to me are not accepting new patients. Their website shows lots of doctors, all the doctors I have called, all the offices I have called they are not accepting new patients. I have received an email from Healthnet stating that their website is updated frequently, but in reality their website is not updated at all, they dont actually have any doctors. This is a class action lawsuit waiting to happen. I am a physical therapist myself and I provide medical care to patients everyday and I cannot get medical care. No one is actually accepting this insurance. Just now I was on the phone with Healthnet the guy told me he will help and had me on hold for 35 minutes, then hung up on me.

  Business Response

  Date: 07/23/2024

  Was able to make change members PCP *************** Parnian  effective 8/01/24. Member has been noifited of the outcome. 

• Initial Complaint

  Date:06/27/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 11/14/23 I had a routine mammogram with Valley Radiology Imaging (P.O. **********************************) (#CADB2479221) at which time I paid the provider $225. The next day I submitted a claim to Health Net for reimbursement. Health Net claims they paid Valley Radiology Imaging and wants them to reimburse me. However, **************** claims they never received any payment from Health Net. On 2/12/24 I spoke with "****" from Health Net who said I should have been reimbursed by Health Net but an electronic check had been sent to Valley Radiology Imaging on 12/1/24. "****" was going to look into it and get back to but never did. Reference number is I-125616912. On 6/3/24, I contacted Health Net again and spoke to "******" reference number I-134954566 who said Valley Radiology was paid and they needed to route me a check. ************************ continues to state they have not been paid and to contact Health Net.

  Business Response

  Date: 09/20/2024

  ************************ at ********* at telephone is unable to refund member due to this being a "self-submitted claim" Provider will submit the reimbursement to HealthNet TAT ***** BD. I submitted an admin pay which was processed the member will received the check and updated EOB within 2-3 business days. I was unable to confirm if the member received the check due to no correspondence.

  Customer Answer

  Date: 09/23/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***** *****

• Initial Complaint

  Date:03/18/2024

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On 3/14/2024 I contacted Health Net about my ***************** Premiums, for I did not quite understand the way they were charging me for my insurance. The representative explained the process and said I had to make my premium payments, which on my bill stated I owed $48.36 (mailed 03/01/2024) the rep. ****** I owed $72.54 by end of March (03/31/2024). I explained that I would make a payment for $24.18 (03/14/2024) and would pay remaining balance of $48.26 on 03/22/2024, which would be my my next pay period from my job. She stated that would be fine and to be sure premiums were paid before 03/31/2024.On 03/15/2024 I have a pending charge of $48.36 on my debit account which I did not authorize and with this unauthorized charge , I now do not have enough funds in my debit account to get to and from work the next few days until I get my pay check on Friday 03/22/2024. I cannot afford to loose my job. I explained to the rep. **** I would pay on Friday 3/22/2024 due to my budget.This charge of $48.36 is one I did not authorize and I consider this to be a fraudulent charge and I need my monies released immediately..

  Business Response

  Date: 09/20/2024

  Health Nets ******************* has responded to you inquiry, and we have been advised that the call you made on March 14, 2024 has been reviewed and it was confirmed that the *** representative you spoke with did not review payment history and coverage enrollment spans to identify the reason as to why your payment went up to $48.36 and you were informed that paying $24.18 during that time the suspension will be removed. Please be advised that the *** representative you spoke to has been coached on the importance of setting proper expectations and identifying the need to minimize customer effort through providing accurate information. Additionally, to avoid similar incidents in the future, the *** representative has been coached on the importance of Health Nets promise and commitment in providing compassionate and trusted assistance to our enrollees.We strive to ensure the best possible service and regret if you felt the service, you received was anything less than optimal. Furthermore, Health Nets Membership Accounting and ********************** has responded to our inquiry,and we have been advised that there is no refund due at this time and it was confirmed that you are enrolled with a premium amount of $587.17 and an APTC amount of $561.99 leaving you responsible for an amount of $24.18. You currently have no balance due having been paid through April 30, 2024. In addition, it was confirmed that you are enrolled in automatic payments (autopay). Please accept our apologies for any difficulties you may have encountered. Your feedback is important to us, and we appreciate the time you have taken to share your experiences. This information will help us to improve service to our members.

• Initial Complaint

  Date:02/06/2024

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  We chose health net PPO for our insurance for 2024. We have used the same health care broker for years and she made sure our medical network (****** ************* / ****** Health) was covered and contracted with this insurance. I also called ****** health network to confirm they were contracted. It also lists this network on their website and covered CA. After taking my son to his 1 year well visit and vaccinations, i find out that his doctor is not covered and the reason being (although this verbiage is listed NOWHERE to delineate between the two when advertising or speaking to customer service) is on vs off exchange. I now have a $1600 bill for a routine well visit for my child. It was false advertising and they made me believe that my sonss doctor was covered. I have since gone to your website to read the reviews on health net and ive actually never seen so many 1 star reviews. They are fraudulent and need to be looked into. Ive file an appeal to have my bill paid through healthnet to no avail. I will file a complaint with CDI as well. Its unacceptable what they are doing tk their customers. They should be stopped.

  Business Response

  Date: 03/12/2024

  The claim for the well visit that the member son received on 1/16/2023 was reprocessed and pd by Health Net on 2/28/2024 to the provider of service.  The provider has been notified of the payment and the member should not receive any further bills. 

• Initial Complaint

  Date:12/19/2023

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I am on a health plan with my mother. I turned 26 this year and immediately received a letter that said I had to leave the insurance with my mom because of my age. I was sent the letter in August 2023 and was told that by October 2023 I had to call Health Net and remove myself from this health plan. Health Net is now charging my mom a single payment of $600 because I am no longer in the insurance. How are you going to charge this when the insurance themselves said I could no longer be in this plan ? Please be careful with this insurance they will bill you for no reason!!

  Business Response

  Date: 01/02/2024

  We have made multiple attempts on 12/20/2023, 12/26/2023, and 12/28/2023 to reach the member by email and phone to obtain information regarding this complaint.  We have received no response from the member at this time.  Please have the member reach out to us for further assistance.