ComplaintsforHumana, Inc.

• Initial Complaint

  05/14/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I was told that if I change my policy from Humana hmo to Humana ******* ***, Humana would pay my full amount of my ********. It's been going on 6 month's. I have called 2 or 3 times a month and all I keep getting is the Run Around? I have talked to ****** ******** and ********, they tell me someone is lying to me that Humana Florida is not paying the full amount?

  

  Business response

  05/23/2024

  See attached response from the company.

  Customer response

  05/23/2024

  
  Complaint: ********
  
  I am rejecting this response because:
  My ******** was $164.90 in 2023, my ******** is $174.70 for 2024. I have contacted ****** ********, ******** and Humana Florida. I'm still getting the run around, if we do not get this straightened up soon, I will be changing from Humana to a different company in 2025. Sincerely
  Sincerely,
  
  ****** ******

  

  Business response

  06/03/2024

  See attached response from the business.

• Initial Complaint

  05/06/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Reference: #************ Claim Number: *************** On November 22, 2023, I visited a dental office recommended by Humana for a crown procedure. The office staff assured me, both verbally and in writing, that the procedure would be covered within my 2023 insurance limit. Subsequently, on January 11, 2024, a Humana representative confirmed in a recorded conversation that I was fully covered for two dentures under my 2024 insurance plan. Based on this information, I proceeded to schedule an appointment for denture impressions. However, I later discovered that the crown claim had been processed as part of my 2024 coverage, which was inconsistent with the initial assurance. I have since engaged with multiple Humana representatives to resolve this issue. On January 25, 2024, a supervisor assured me that the matter had been addressed and that the two dentures would be fully covered. To my dismay, I later found that I was still responsible for an unexpected denture expense of $852. This discrepancy is not only inconsistent but also unfair. I had placed my trust in Humana’s recommendations and assurances, and I diligently pursued a resolution, only to be left with a financial burden due to errors that were beyond my control. Had I been properly informed about the impact of the crown claim on my 2024 coverage, I would have made a different decision regarding the partial dentures, especially considering their non-urgent nature. I am a disabled senior retiree who has always trusted Humana to honor its commitments. I had to pay $825 to the dentist. Therefore, I respectfully request that Humana reimburse the $852 to me as soon as possible.

  

  Business response

  05/15/2024

  Please see attached response from the Company.

  Customer response

  05/17/2024

  
  Complaint: ********
  
  I am rejecting this response because it starkly contradicts the explicit, recorded affirmations of
  complete coverage, as provided by several Humana representatives, including a supervisor.
  
  Sincerely,
  
  ******** **

  

  Business response

  05/28/2024

  See attached response from the company.

• Initial Complaint

  05/01/2024

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  My Medicare Advantage Plan is with Humana and their pharmacy is *********** Each quarter my plan provides $150.00 OTC Benefit. On April 1st, I ordered a number of items including 4 boxes of ***** brand Panty Liners - Long at a cost of $8.00 each. I received my box of supplies on April 3rd but they gave me small panty liners (very light) ******* brand. I phoned ********** and one of their CS agents basically said there was a 50-50 chance of them making it right. I told them that was unacceptable. On April 6th they sent out a replacement and again I got the ******* liners. Called ********** again. They sent out another shipment which they shipped on April 11th. For the third time I received the ******* liners. Spoke with ********** on April 15th and they said they would ship out the right liners but allow them two weeks. On April 29th called ********** as I didn't receive anything and was informed that they no longer used that supplier. All these phone conversations and no one said that before. They will not credit my OTC account with $32.00. By the way, the ***** Panty liners - Long are still showing up on their order website.

  

  Business response

  05/10/2024

  Attached is the response to complaint ********

  Customer response

  05/13/2024

  
  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,
  
  ****** *****

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

• Initial Complaint

  04/17/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  Claims no ******** and claim number ******** were processed. I never received the checks and Humans refused to issue replacement checks. Customer service is absolutely no help. It has been 4 months since checks were mailed out. The checks have not been cashed as of Humana but they will not re issue new checks. I pay my monthly premium on time.

  

  Business response

  04/30/2024

  See attached response from the business.

  Customer response

  04/30/2024

  
  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.
  Thank you so much for your help. I really appreciate this. 
  Sincerely,
  
  ***** ********

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

• Initial Complaint

  04/11/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Humana dental through ****** changed policy starting 1 Apr with with no way to opt opt. My gamily can no longer see their dentist which is about 10 minutes from my house. Humana changed their in-coverage radius from 30 to 50 miles mid cycle. Humana is now making my family drive 50 MILES to see a new dentist. This is causing a serious lapse in dental coverage since we now have to schedule new patient care 12 months out instead of having their regular appointments next month. As a member I cannot stop or change my policy mid cycle, and I was assured through ****** Humana could not change the policy on their end either. The changes made to my policy in Apr cause my children and wife to go without dental care and lets Humana not honoelr their contractnof 6 month checkups due to new patient enrollment times. Humana is also making me miss work to drive my kids 50 miles to see a dentist. If I am unable to schedule all 8 of my children and my wife, at the same time, this change in policy costs me 18 days of missed work per year. I make about $30/hr. 30×8×18=$4,320 per year ($30/hr x 8 hrs x 18 days of missed work) Hunama cannot make this type of change mid-cycle. I have no wat to opt out of Humana at this point. I have to wait for open enrollment in mid-November for a new policy to take effect on 1 Jan. This is not the only problem with Humana and I want out! I have other dental coverage through sooner care and VA so My entire family is still under care and there will be lapse in coverage.

  

  Business response

  04/30/2024

  See attached response from the business.

  Customer response

  04/30/2024

  
  Complaint: ********
  
  I am rejecting this response because:  I have fixed the errors pointed out by the Humana representitive.  
  
  Sincerely,
  
  ***** *******

  

  Business response

  05/14/2024

  See attached response from the company.

  Customer response

  05/14/2024

  
  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.  Hummanahas admitted their mistake in writing and eventhough every person I speak with over the phone is still unaware this change does not apply to ****** plans (as stated in the response from Humanna) the letter sent to me states my requests will be honored.
  
  Sincerely,
  
  ***** ******* 

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

• Initial Complaint

  04/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  On January 18, 2024 I contacted Humana Dental Insurance Company to get an estimate (they call it a predetermination) for a routine dental visit since my dentist is out-of-network. My dentist supplied the exact insurance codes and charges to Humana. On February 26, 2024 Humana informed me that the predetermination showed that Humana would pay 100% of my dental visit. I wanted documentation in writing that showed I would owe nothing and had the representative email me the predetermination EOB showing that I would owe nothing (attached). The agent also gave me a case reference number of *************. In the notes for the call she documents that I was told repeatedly that I would owe nothing. I went to the dentist on March 25, 2024 and had the exact procedures as submitted in the predetermination. The dentist billed the exact same amounts from the predetermination. The claim was processed on March 31, 2024 and showed that I owe $52. I called on April 1, 2024 and spoke to an agent who could see that I had been told I would owe nothing (see case reference number above) but said I would need to complete the Grievance Form in order to get the claim corrected. As a member I have spent hours on the phone with Humana and the dentist office to ensure that the predetermination would be correct. I was assured repeatedly by Humana that I would owe nothing. Yet the claim was processed in conflict with the predetermination despite the predetermination having the exact same information. What good is getting a predetermination if the claim gets processed with a different result despite the information being the same? I would appreciate Humana honoring the information provided to me by correcting the claim to show that I should owe nothing and refund me the complete amount I paid upfront to the dentist which was $376. Sincerely, ****** *******

  

  Business response

  06/03/2024

  See attached response from the company.

  Customer response

  06/03/2024

  
  Complaint: ********
  
  I am rejecting this response because:

  Humana is correct that the predetermination was initially denied in January since it was submitted as if it was a bill for service yet I had not visited the dentist yet.. However, I spent many hours in February getting the predetermination resubmitted to get an accurate estimate. I have a series of emails between that intial denial in January and the resubmitted predetermination that was ultimately received on February 26 which showed that I would owe nothing. Humana is incorrect that I was informed correctly. I called multiple times and spoke to multiple agents who could review the call logs and see that I was informed repeatedly that I would owe nothing. Humana's "review of the call log" is hogwash if they say I was informed correctly. It's clear that this issue will not be resolved to my satisfaction but I appreciate the BBB's effort. It's only $50 and I've spent dozens of hours on a project that should have been simple - to get an estimate for a routine cleaning at my dentist. Fortunately I now know not to trust Humana, despite getting information in writing, so will switch insurance companies for 2025. 
  
  Sincerely,
  
  ****** *******

  

  Business response

  06/12/2024

  See attached response from the company.

  Customer response

  06/14/2024

  
  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,
  
  ****** *******

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

• Initial Complaint

  04/05/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  On April 4th, 2024 I contacted Humana to switch insurance types. I was transferred to an agent and the call begin at 3:42 pm. We spoke for 2 hours and 4 minutes. The agent was professional, patient and thoroughly answered the questions I had. At the end of the call, he had to read me some information and I had to agree by saying my full name and that yes, I agreed. During the end of the call when he was reading the information I had to agree with, there was a point where he said I had the right to request the audio (or transcription, I'm not sure how that would have been delivered) of the call. I actually stopped him and asked if I'd heard that correctly and he assured me I did. He admitted, though, that he'd never heard of anyone asking for that information before. I asked how I'd go about getting it and he said it would likely be communicated to me once I received the confirmation email from Humana of my insurance switch. I did get that confirmation email and no mention of being able to access it. I emailed him this afternoon and asked how to get it, and he said "They send a consent to your electronic signature in your paperwork. I found out they do not send a complete transcript of the whole conversation." That is absolutely NOT what I heard when we spoke. That's not what was said. My concern is I can't confirm or prove anything that was communicated to me should there be an issue with the policy switch that I've begun. The calls are absolutely recorded and the information is as much mine as it is Humana's. I want a copy of the 2 hour audio file or a transcript. I will absolutely go higher than the BBB if this doesn't get resolved here. And if there is a dispute as to what was said to me, REFER TO THE ENDING STATEMENT THAT WAS READ TO ME. THAT STATEMENT WAS IN THERE (but of course I can't prove that at the moment). This is very concerning. I will not drop this. Let's be smart and civil.

  

  Business response

  05/10/2024

  Due to privacy concerns, the response was sent directly to the member, *** ******

• Initial Complaint

  03/28/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  Between August and September of 2022 I used the service ls of ******* , Buford Ga I clearly told them, SEVERAL TIMES, that I wasn’t Authorizing anything done that wasn’t covered by Humana Dental plan. Around the middle of December 2022 I received a bill for over $400 dollars from the ******* and since was holidays time I waited until Jan/2023 to contact Humana Dental to see if they can help me. They said that they were going to mail me a form to put an appeal with grievances and appeal but it never came. Also they “ forgot “ to mention that the frame time was 60 days… which is was already expired but they let me believe that I was still on time. But June/2023 I mailed some information to the grievances and appeal but they didn’t contacted me so I called again so I had to file the appeal through my email. Months later Humana sent me a “ referral “ with KEPRO in Florida which is useless too . I called Humana Dental today… and “ Tory “ supposedly a Manager… hanged up my call . They show not care and I feel like I need help from somebody else but Humana or ******* .

  

  Business response

  04/25/2024

  please see attached. 

  Customer response

  04/30/2024

  
  Complaint: ********
  
  I am rejecting this response because:
  I am not sure what all these paperwork “ means “ . If the Dental plan insurance covered the fillings… WHY ******* is still harrasing me ? Why they didn’t told me that this was paid when I went like 3 weeks ago ? Why I was referred to KEPRO by Humana ? I spoke with someone in Humana dental plan couple weeks ago … and she said that they were mailing me a paper with this information that supposedly was mailed to me in 2023 .? All I want is to know Where I am standing up because ******* blames Humana Dental insurance and Humana wasn’t helping me or listening my situation. 
  Sincerely,
  
  ******** ******

  

  Business response

  05/07/2024

  See attached respond from the business.

• Initial Complaint

  03/19/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  On March 14, 2024 I placed an order on the ********** ******** app for ********* and potassium citrate and was quoted a price of$675.02 with the stipulation under the quote that prices could change once they reviewed your pharmacy policy. The next day I went on the same app and it showed that the order was being processed and would cost me$225.29. I thought that was accurate because I could have met my deductible and that’s the price I pay for the remainder of the year. I checked my checking account and found they had deducted $675.02 from my account. It was pending. I contacted the and they informed me I hadn’t met my deductible and the cost would be $675.02. I then asked why the discrepancy between their app and the bank statement. They couldn’t explain. I asked them to cancel the order at this time because of the discrepancy and he wasn’t sure he could. The bank is unable to do anything at this time till it goes through then I can dispute. I called Humana ******** ** who is the insurance carrier for my drugs. They apologized for the discrepancy and said they would forward to a grievance committee for review. I had this problem at the beginning of last year and someone from their IT department contacted me. Nothing has been done to correct the discrepancies from their app. I ask that they only charge me the $225.29 as quoted on the app today and that they fix their discrepancy.

  

  Business response

  04/15/2024

  See attached response from the company.

• Initial Complaint

  03/13/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  On March 8 I received one of my medications by mail. I was puzzled because I never signed up for mail in prescriptions. I called Humana to find out what was going on. Humana did not have anyone that could help me or resolve it. They gave me the number to their mail in pharmacy called ********** ******** **** I called ********** and they stated my doctor sent them the prescription to fill. I said never would he do that and I stated that I have never used mail in pharmacy and never will. I stated that I did not give permission for ********** to remove my prescription from *********. The rep did not want to help me. I called my doctors office to verify that they did not transfer my prescription from ********* to **********. The nurse looked and stated that no they did not. I called ********* and spoke with the pharmacist the pharmacist found a note about a ****** from ********** called and told ********* that I agreed to have my prescription transfered to ********** mail in pharmacy. This is a lie. I never talked to ********** to have my prescription transfered from ********* (that I have been with for years) with them. I am shocked that ********** allow employees to lie against customers and to steal prescriptions from customers accounts with *********. Humana needs to know what ********** has done and to investigate this pharmacy.

  

  Business response

  03/20/2024

  Upon receipt of this inquiry, a thorough review of the issue was completed. It was determined that ********** Pharmacy Resolution Department reviewed the telephone call from January 22, 2024. You were requesting to have paperless statements from Humana, and no medication names were discussed during that telephone call. A request was sent to leadership to review regarding the ** Enrollment representative requesting the prescription when you did not request to have any prescriptions with ********** Pharmacy. It is disheartening to hear about the problems you encountered through interactions with our company. Every one of our members are important. Feedback like yours helps us focus on areas where we can improve. On March 20, 2024, Humana mailed you a more detailed letter regarding your complaint to your mailing address on file.

  Customer response

  03/21/2024

  
  Complaint: ********
  
  I am rejecting this response because ********** and Humana did not address removing my name and prescription from this mail in pharmacy. If my information is not removed from this mail in pharmacy with a letter to confirm this then you give me no choice but to reach out to a regulatory complaint intake and allow them to look into why an employer lied and took away my prescription and assist in reaching out to ********** to inquire why this issue was not resolved. 
  
  Sincerely,
  
  ******** *****

  

  Business response

  03/25/2024

  A response has been mailed to the member.

  Customer response

  03/26/2024

  Complaint: ********
  
  I am rejecting this response because: The letter I received dated March 20 2024 is the same letter on response and it does not say my prescription was removed from ********** mail in pharmacy. The letter does not resolve this issue or state that ********** will remove my prescription from this unauthorized mail in pharmacy system program. This unauthorized transfer to mail in pharmacy puts my health at risk because of the fact that usps cannot promise prescription will not get stolen out of my mail and cannot guarantee it would arrive in time before my prescription runs out. Those are the reasons why I would NEVER use a mail in prescription program! So ********** is refusing to remove my prescription from this unauthorized transfer? So should I reach out to a state regulatory third party? I also received a welcome letter from ********** on March 25.. Again....Remove my information prescription from this program and remove me from ********** mailing.
  
  Sincerely,
  
  ******** *****

   

  
  Complaint: ********
  
  I am rejecting this response because:
  
  Sincerely,
  
  ******** *****

  Customer response

  03/27/2024

  
  Complaint: ********
  
  I am rejecting this response because: The letter I received dated March 20 2024 is the same letter on response and it does not say my prescription was removed from ********** mail in pharmacy. The letter does not resolve this issue or state that ********** will remove my prescription from this unauthorized mail in pharmacy system program. This unauthorized transfer to mail in pharmacy puts my health at risk because of the fact that usps cannot promise prescription will not get stolen out of my mail and cannot guarantee it would arrive in time before my prescription runs out. Those are the reasons why I would NEVER use a mail in prescription program! So ********** is refusing to remove my prescription from this unauthorized transfer? So should I reach out to a state regulatory third party? I also received a welcome letter from ********** on March 25.. Again....Remove my information prescription from this program and remove me from ********** mailing.
  
  Sincerely,
  
  ******** *****

  

  Business response

  03/29/2024

  A response has been mailed to the member.

  Customer response

  04/05/2024

  
  Better Business Bureau:
  
  I received correspondence letter response today April 5 2024  dated March 25 2024  that states my prescription pantoprazole has been inactivated from ********** pharmacy mail order and also my information on March 8 made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  ******** *****
  ******** *****

  ***If you are interested in supporting the BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent via Venmo to @bbbcefky or mail your donation to BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

*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. ↩