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:08/24/2022

  Type:Customer Service 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 happywith my doctors and the insurance as a whole..but the number for customer service ************ on my insurance card...seriously?Everybody has customer service issues, but this goes waaaaaay beyond that. Everytime I call, I cannot hear the rep..its like the phone rings in a basement underwater ( yeah, yeah, covid..work at home ..but this is ridiculous). The reps never give the right info,are poorly trained ( if at all) they can barely speak my language, it's constant apologies.. putting me BACK on hold..and STILL not answering my question. When I've exhausted all efforts and ask to speak to someone ABOVE them..I'm told " no, I cannot help you with that.. " The last time I called, someone picked up, I could hear breathing and background activity and NO ONE answered. I could literally call a 16 year old working at McDonald's and they'd be more helpful. This is so wrong. This is a major insurance company. I can't imagine someone who is very ill and desperately seeking assistance having to deal with this nonsense. Please do something. Hire people who are qualified to do this job! Do not answer with " I can assure you, our employees are extensively trained" because they are NOT.

  Business Response

  Date: 09/30/2022

  Business Response /* (1000, 5, 2022/09/13) */ A formal grievance for this customer service complaint has been opened and is being addressed. The due date for her grievance is 9/17/2022. The member will be provided with the outcome of the grievance on 9/17/2022.

• Initial Complaint

  Date:08/18/2022

  Type:Product 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 late father had a Health Net medicare supplement plan. Following his death, I informed Health Net and canceled his policy. I filled out the forms as instructed and was told that a refund for his unused premium would be sent to me within 3 weeks. More than 10 weeks later, no refund had arrived AND they had also taken another month's premium from his bank account. I contacted them and after much run around was told that they were sorry and that a check would be issued. A check was finally issued, but it was sent to the wrong address and was also made out to my father (not alive). I called back again and talked to a representative who promised to fix the situation and get a check sent to the right address. No check arrived after the promised 3 week wait time. Further calls were made but today, nearly 5 months later, I have just gotten off the phone with them to learn that they still haven't cut or sent a check. I feel like Health Net is making it deliberately difficult for me (and likely others in similar situations) to get refunds after a loved one dies. Probably helps Health Net's bottom line quite significantly. Investigate them.

  Business Response

  Date: 10/19/2022

  Business Response /* (1000, 8, 2022/09/05) */ A check has been issued and was made out to ************* Consumer Response /* (3000, 10, 2022/09/06) */ Company has been in touch and has claimed that they are sending the refund check and that it was sent on 8/25/2022, but as of 9/6/2022 no check has been received. This seems an excessive amount of time. A representative of the company has been following up but I still wonder why it is taking so long and so much effort on my part. I feel that they are potentially defrauding many other consumers who do not possess the time or willpower to follow up on these types of issues. Business Response /* (4000, 13, 2022/09/22) */ The check was re-issued a 2nd time on 9/16/22 in the amount of $811.16. We are just waiting for confirmation from the member that is has been received. Consumer Response /* (4200, 15, 2022/09/23) */ (The consumer indicated he/she DID NOT accept the response from the business.) Healthnet was supposed to provide us with tracking info for the check. They did not. According to the emails I have been exchanging with Healthnet the check was not issued on 9/16/22 but allegedly on 9/20/22. This was based on information I was provided from Healthnet. This has been going on since April. Totally unacceptable service, and the only reason I have received a response from them is because I contacted the BBB and also shamed them on Social Media. I will accept the resolution when the check arrives and has been successfully cashed. Business Response /* (4000, 17, 2022/09/28) */ ****** confirmed the check was received on 9/24/22.

• Initial Complaint

  Date:08/17/2022

  Type:Customer Service 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 11/5/2021, *********** had to be transported from *** primary care physician to the nearest hospital for immediate care. The fire department submitted the claim, even though she was insured via Health Net they refuse to cover the charges. I tried to contact Health Net directly via phone, the representative******* was unable to help, said she was going to transfer me to a manager but only placed me on hold and then hung up.

  Business Response

  Date: 09/23/2022

  Business Response /* (1000, 5, 2022/09/01) */ ********* claims were denied for timely filing. The provider had incorrect insurance information at the time the initial claims were sent to Health Net for processing. Provider sent documentation which showed they had billed the incorrect carrier. The claim was processed 9/1/2022 and is set to pay. The ****** was notified that claim was reprocessed and is satisfied with the outcome.

• Initial Complaint

  Date:06/24/2022

  Type:Customer Service 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.

  ******** Healthnet sent me an email June 3, 2022 canceling my insurance. No reason was provided. Upon calling them the following week, a representative said it was canceled for non-payment. However, all email billing statements I received from Healthnet since February 2022 have been for $0 due, so I do not understand how my policy can be canceled for nonpayment if all my billing statements were for $0. Since I am a freelance entertainment industry employee in the state of **********, I do not work steadily. I obtained my insurance through Healthnet through the open marketplace, and I update my income regularly with Covered **********. They are supposed to provide Healthnet with the amount of my monthly premium. I was told that COVERED ********** had an "issuer error (i.e., they messed up)" and told Healthnet the wrong information, and that's why Healthnet sent statements that said $0 was due between February and June. The premium I was supposed to be paying to Healthnet each month between February and June was supposed to be $89.61/month, not $0. If Covered ** had done their job correctly, I would not be in this situation now. But Healthnet says I now owe $537.66 to retroactively cover all those months (plus July's premium) by 7/16/22 or I will be canceled again. I am currently not working and cannot afford to pay that much at once, and I shouldn't have to because Covered ** made the error. When I contacted Healthnet today, 6/22, and explained that I am not working but that I can set up a payment plan in order to get caught up, the rep said they "do not do payment plans," so I hung up. I am a Type 1 diabetic and I NEED HEALTH INSURANCE TO PAY FOR INSULIN AND DIABETIC SUPPLIES IN ORDER TO SURVIVE. I have had to spend over two weeks and hours on the phone to get my coverage reinstated, and I wasn't even the one who made the mistake in the first place. I have gotten no help or understanding from anyone at Covered ** or Healthnet so I am filing this complaint now.

  Business Response

  Date: 08/10/2022

  Business Response /* (1000, 5, 2022/08/02) */ Research was completed and found that Members premium's were not applied correctly with Covered CA. Therefore the Members invoices reflected the member had a $0 balance. Since this was not the error of the member, a one time payment plan for the member was requested. The payment plan was approved and member agreed to it. Member is aware of the due dates for his premiums. The members policy is active retro back to 1/1/2022. Consumer Response /* (2000, 7, 2022/08/09) */ (The consumer indicated he/she ACCEPTED the response from the business.) I still had to jump through hoops with the ******** rep assigned to setting up the payment plan as well as dealing with her horrible communication skills, or lack thereof, and the web site STILL does not have the correct amount that I owe (reflecting the agreed upon payment plan details), so it is still extremely confusing and I will be going off the paper copy of the payment plan I received when I make my payments. I will be re-opening the claim (or filing a new one) if I have any further issues.

• Initial Complaint

  Date:06/21/2022

  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.

  Last year Health Net was my medical provider. I visited my primary family doctor several times. My family doctor's office is approximately one half mile from my residence. Health Net is not paying my doctor for one of those visits, their reasoning is that I went out of my designated coverage area for that particular visit. When they sent me the information on that particular visit, it's the same address as my family doctor the doctor's name is different but he works out of the same office building. I have explained this on 3 different occasions to 3 different customer service employees. Each one reassured me that there really wasn't a problem and not to worry about it. Today I got a phone call from their complaints dept but I thought it was a marketing caller. I called back and I left a message but I just want them to pay my family doctor what he is owed.

  Business Response

  Date: 07/19/2022

  Business Response /* (1000, 5, 2022/07/07) */ Health Net contacted Dr. ************'s office, the provider member stated receive a bill from, and was informed by ****** the member has no outstanding balance and is not being billed. Member was going to send additional details but the information from the member has not received. Followed up has been completed to the member on 7/6/22 to inform that the additional information on the unpaid claim has not been received.

• Initial Complaint

  Date:05/27/2022

  Type:Customer Service 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.

  Healthnet refused to refill my Rx a few weeks early after my bag got stolen at work because they don't "allow override of Rx because of lost medications." The lost medications were my BP and thyroid pill. I called and explained that I cannot suddenly stop either of those medications and need those refilled but I was told that it was not possible. Healthnet is willing to put their members health at risk. I could have a stoke, heart attack or complications from thyroid issues by suddenly stopping these medications but Healthnet clearly does not care. What a shameful way of dealing with the situation and showing clearly how little they care about their members. I will be changing insurance as soon as possible and I urge you to reconsider before choosing Healthnet.

  Business Response

  Date: 07/26/2022

  Business Response /* (1000, 5, 2022/06/16) */ Health Net has made multiple attempts to contact the member and have been unsuccessful. We have also received a formal grievance on 5/27/2022 from the member. This grievance is still being worked and we will provide a resolution within 30 days of the receipt date. Consumer Response /* (3000, 7, 2022/06/23) */ (The consumer indicated he/she DID NOT accept the response from the business.) Healthnet's grievance process is a joke. Every single time to have dealt with it, they take their time and I think he end it's always a no. It's always a denial of benefits. They don't care about their members. I will be leaving this insurance shortly. The public should know that healthnet has a policy if your medication gets lost or stolen, they will refuse to replace it. You must pay out of pocket for that medication. Business Response /* (4000, 9, 2022/07/08) */ Member was able to obtain Medication on 5/27/22. A one time exception to override 30-day supply for both medications on dos:5/27/22 was completed. Member is responsible for any copayments. CVS Pharmacy was contacted and informed to provide a 30 day supply.

• Initial Complaint

  Date:05/18/2022

  Type:Billing 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.

  At 4 AM on March 25th I was feeling cramps *************************************************************** filling the entire toilet bowl. I called Healthnet around **** ** *** and they advised me to go to the ER immediately. I did that. The ER doctors took ***** tests etc and other measurements and then decided to do a *********** the following morning. There continued to be large amounts of ***** in my stools. I felt Ok and thought I would be discharged after the colonoscopy but the doctors then said that my ***** tests necessitated keeping me in the hospital. They were not able to find the location of where the ***** was coming from. Blood measurements did not improve sufficiently until March 29th when I was finally released. In early April I then got a notice from Healthnet saying that my admission in to the hospital had been denied and so the ******* bill for the hospital stay was being denied. The denial they said was based on the ****************************************************. There had been no great loss of *****, labored breathing or a couple of other criteria they said. I tried unsuccessfully to get an explanation from ******* Hospital as to their reasons for keeping me. I tried frequently and unsuccessfully to talk with Healthnet but for 4 weeks the case officer never returned my calls. I then escalated the process through ****. That seemed to trigger a new case review at Healthnet. However, both of the ongoing reviews were terminated by *** **** and Healthnet once again denied the charges. No reason given for the denials. I finally succeeded in speaking to someone at Healthnet on *** **** and they agreed to open a new case review. I asked Healthnet how it's possible for them to insist that I go to the ER and then deny insurance payment for that. They had no answer to that question or any other one. Because Healthnet does not return calls, it seems unlikely that I'll ever be able to talk with them again.

  Business Response

  Date: 06/23/2022

  Business Response /* (1000, 5, 2022/06/07) */ The claim for this Emergency Visit has been received by Health Net and processed. The member copayment/deductible responsibility is $********. Member requested a EOP for his record. Per the member, he is not disputing the member responsibility he is satisfied with the outcome. Consumer Response /* (2000, 7, 2022/06/22) */ (The consumer indicated he/she ACCEPTED the response from the business.) My total out of pocket cost was only around $***** unless something changes. I don't think it will since it appears that the entire bill is now resolved. I'm happpy with the outcome although I do find it strange that I never once talked with anyone at Healthnet at any point in time who had knowledge of my case. It's mysterious why they have now agreed to pay the insurance. I would like to think that my reasoning is what convinced them but I'm not sure I'll ever know.

• Initial Complaint

  Date:05/17/2022

  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 have coverage with Ambetter Healthnet as of 4/1/22 through my business/ covered **. Even through I'm paying regular premiums and I have an active status through Covered **, Healthnet will not issue me a subscriber ID. I've called healthnet on 4 different occasions and every time I call they transfer me around, hang up on me, or say they have no record I have health insurance. I've called covered ** on 3 different occasions. They are quite helpful. They keep requesting my subscriber ID from Healthnet and Healthnet will not issue it. Not having a subscriber ID makes it nearly impossible to seek medical attention and prove I have any kind of coverage. I would like this rectified immediately so I can use the coverage I'm paying for. It's fraudulent to pay monthly premiums every month and not have any record of coverage. If something is not done about this soon I will be seeking counsel to sue Healthnet.

  Business Response

  Date: 06/24/2022

  Business Response /* (1000, 5, 2022/06/07) */ Health Net contacted*********** to confirm members coverage. HN was advised by Covered CA that members plan termed effective 1/31/22 under. Member new enrollment under her employer group plan became effective as of 4/1/2022 with a new ID number and card being issued.

• Initial Complaint

  Date:05/16/2022

  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 need a specialized physical therapy, and my only in-network provider is no longer accepting patients. I called the number on my insuance card and (after explaining multiple times that the specific therapy I needed is not one provided by all physical therapists but rather by a specialist) the representative told me to have the PT I am seeing file a peer-to-peer authorization. They have tried multiple times to call HealthNet, only to be bounced back and forth literally between the same two phone numbers. I have tried to contact them myself to no avail. All I want is for the peer to peer authorization to be initiated and processed because I cannot afford medical care out of network.

  Business Response

  Date: 08/01/2022

  Business Response /* (1000, 5, 2022/06/09) */ A Peer to Peer was requested by the provider the member was seeing. The suggested Peer to Peer was not completed since there was no denied authorization for the services from the provider. In order for the health plan to request a Peer-to-peer a denied PA would have to be on file. We are working with the members provider to have a PA submitted for review, once this pa is received and received a peer-to-peer can be completed if the pa is denied. I was also able to locate a in-network provider that can assist the member with an open availability I provided member this information an she declined. Consumer Response /* (3000, 7, 2022/06/15) */ (The consumer indicated he/she DID NOT accept the response from the business.) The one provider that HealthNet sent me last week had more than a month wait - to see me in July - and I have been seeking a specialist since *******. Attached you will find documentation from ******* that ******** **********, my main provider, told me they were not accepting new patients and a list of offices they recommended (from which my current specialist was found). Business Response /* (4000, 9, 2022/06/27) */ we have been working with the provider Origin Physical Therapy, who the member wants to see, to obtain an authorization request from them so services can be rendered. We have not received the Prior authorization from this provider yet. WE are in contact with the Member and Provider constantly trying to get the authorization. Consumer Response /* (4200, 11, 2022/07/08) */ (The consumer indicated he/she DID NOT accept the response from the business.) My provider has responded to HealthNet awaiting more information. I am waiting to hear back from HealthNet so that the peer to peer authorization can be processed. Since this complaint is the only way I have ever been able to successfully hear back from HealthNet, I am hoping this will lead to a resolution, but HealthNet has not provided one yet. Business Response /* (4000, 13, 2022/07/18) */ We have been in contact with the members provider and have provided the correct steps on how to request the prior authorization for the members services. Health Net has requested medical records and a corrected authorization request with additional information that was missing on the original authorization request. The requested medical records were received on 7/18/2022 and the provider has advised us that they will re-submit the authorization request by end of day 7/18/2022. We will escalate the processing of the Authorization request once received.

• Initial Complaint

  Date:05/12/2022

  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.

  My daughter was born ******* and I had a really hard time getting her added to my insurance with HealthNet, which she was finally resolved towards the end of the year 2021 and was activated retroactive starting at her birthdate. At the beginning of November 2021, my 7 week old baby got sick and I took her to her pediatrician (11/5/21), having a HealthNet representative on the phone in the waiting room trying to figure out why they have not processed my paperwork and why she was not yet added to my plan As things took a turn for the worse, we got picked up by an ambulance from that doctors office and got transferred to the nearest hospital where she was stabilized to get transported to **** children's hospital, where she was in the PICU for 3 days. On 11/9/2021 we had a follow up visit with the pediatrician to make sure things were moving in the right direction. Earlier this month (May 2022) I received a bill from the pediatricians office, stating that insurance has declined coverage because the visit wasn't pre approved. I got on the phone with HealthNet, where I spoke to a lady that did not understand what I was talking about at all. She kept repeating that I needed to find insurance somewhere else, which is not at all what my concern is.

  Business Response

  Date: 06/24/2022

  Business Response /* (1000, 5, 2022/06/07) */ The newborn was added to the plan effective 12/1/2021, this was after the child had service. The claims for the services that were received in November has been submitted for reprocessing to be covered. Member has been notified of outcome by email