Complaint Review: Humana

Humana refuses to open a complaints department.  Humana unfairly "drops" clients, and refuses to reinstate in timely fashion.

Well Franzg, that's fine if you want to be like that. All I see here is someone that didn't pay their bill and they got dropped. Pretty cut and dry to me. I won't continue to have a battle of wits with an unarmed person. 

Why do you hate my company so much? Let me guess... It's probably something dumb like you have a $25 copay for office visits and that makes you mad so you think your immature lies and whining online is going to change something. So sad.

"When I checked my checking accounts, I saw a payment was made on Feburary 4th which is around when my payments are usually withdrawn. Because I've been extremely tired from my treatment I didn't trace everything back in detail. On March 6th I checked my account again and was curious why Humana hadn't withdrawn Marches payment.

I was told that my account was canceled for non-payment. My last mayment (sic) was for January which didn't debit against my account until Febuary!

After several calls. I was told I wouldn't find out if I'd be reinstated until May 4th. There is an "investigation" going on.

In the mean time I canceled my last 2 chemo treatments. It's been impossible to sleep worrying. My family and I have never been without health insurance.

Sounds like a problem with customer service to me.

Perhaps Humana should pay a little more attention to its clients- being that Humana is even worse than ATT in customer service.

Franzg, I did read the report. There was no mention in it that Humana wouldn't reaccept the member; only that they had to reapply. Again, I sympathize with the situation, but any business will cancel you for non payment.  

Humana is still whining about ATT- WTF is its problem?

Well, I'm sorry that  ATT overdrew your account. I'm very sorry about your health issues as well. I do hope you're doing better.

Still, I don't understand the arguing here. Any business will cancel you if you don't pay them for their services. I'm not trying to be mean and I'm not saying that because I work for Humana; that's just a fact. You shouldn't be angry with Humana. It seems to me that you should be posting a ripoffreport on ATT since they caused this whole mess.

Humana has poor customer service, and it is a ripoff.

Franzg, you and I have been arguing the simple fact that this person is not paying attention to their bills for quite some time. I'm right, you're wrong. This isn't Humana's fault. You'll grasp at anything and try to pin it on Humana, won't you?

So, I'm done with you. You're the type of person that has such a fragile ego, you can't stand it when someone proves you wrong. So, you don't have to worry about me trying to educate you anymore, because I'm just not going to respond to you, you stubborn little troll.

Good luck sitting in your mommy's basement coming up with new corporate conspiracy theories.

I think most consumers get a warning if they miss a payment.

If I am even late on my light bill, I get a warning and a "disconnection notice"

If I miss a mortgage payment I get a "foreclosure notice"

If I am late on my phone bill, I usually get some phone calls, and a disconnection notice.

Have a little common sense and stop wasting time and bandwidth. Client clearly tried to pay in early March (30 days after Feb. payment succeeded).

Humana saved money by dumping client with no warning. I guess you consider this "good customer service". I think it is a ripoff.

I stand corrected :-) I generally agree with your posts and take them more seriously than say, something written by Rita, Karl, or Charles.

Franzg, you said, "The OP is clearly stating the grievance is about not being warned or called until AFTER being canceled".

Um, ok, let's think about this. How could Humana know they weren't going to get paid until the due date had already passed? Do you expect Humana to have fortune tellers on staff? In other words, you can't tell someone that they're delinquent on their bills until the due date passes. Duh.

However, this thread is about Humana. Perhaps OP filed ROR against AT&T already. I hope they did. If phone bill caused overdraft, maybe OP can't afford fancy lawyer to sue large corporation like AT&T. The problem about Humana is clearly stated in the original complaint-

"I was told that my account was canceled for non-payment. My last mayment(sic) was for January which didn't debit against my account until Febuary(sic)!

I don't know why I hadn't been called. I did recieve(sic) mail after the fact warning me. I offered to pay for Febuary(sic) on March. After all it was only the first week of March but they said I had to apply for reinstatement. That it should only take a week or two.

After several calls. I was told I wouldn't find out if I'd be reinstated until May 4th. There is an 'investigation' going on."

The OP is clearly stating the grievance is about not being warned or called until AFTER being canceled.

Healthcare is a little more important than cellphones and cablevision, especially if you have cancer. Perhaps Humana has caused more physical and mental anguish than AT&T, even though AT&T caused original screw up.

I, personally, would love to see AT&T get beaten up in court. The OP is merely expressing a common problem with Humana- Inadequate customer relations, and unwillingness to reinstate clients using insurance. If one looks at the dollars and cents, Humana made a bundle by canceling the client, and I believe that Humana willingly did this to save a bundle by delaying reinstatement.

Jeanski, I was really cheering your last blog until I got to these two statements...

"..Once AT&T settles, she can then go after Humana. It will be a long process, but I think any jury would truly sympathize." (Quit bit of info: Civil cases don't have juries.)

and

"...Previous posters have correctly identified Humana as just following standard business protocol in dropping the OP's policy. Sad, unethical, and not good customer relations, but legal neverthless".

I thought "Finally, someone is blaming the right party (AT&T) for starting this whole situation". Imagine my disappointment when you turned on an innocent party just like the previous bloggers.

I don't understand why everyone is making Humana out to be the bad guy here. FACT: AT&T's error caused the Humana auto-draft to fail.
FACT:The member neglected to make sure her bill was paid.
FACT:Humana sent out a notice saying she was cancelled. The member had to reapply since it was over 30 days.

Where is the problem? I don't care what kind of business it is, they will cancel you if you don't pay them. Is this new information to you? Why would you advise sueing Humana? I would imagine Caroline's other creditors were effected just like Humana was, so would you advise sueing them, as well? Humana did nothing wrong. They cancelled a policy they weren't getting paid for. Period. The reason they didn't get paid is irrelevant. It's not, as you say "sad, unethical, and not good customer relations", it's business. Put yourself in Humana's shoes. I guarantee if you had a business and someone wasn't paying you for your services, you'd stop servicing them just like Humana stopped servicing Caroline. Then let's see what you'd say when that same customer would post a ROR about you on this site. Sounds a bit unfair, huh?

If a lawsuit would start up because of this whole situation, the correct defendant should be AT&T, and AT&T only. AT&T should work with Caroline to pay any expense she incurred because of their error.

By the way, I don't see one person on this post assigning any kind of blame to the member. It's their responsibility to make sure those payments go through, NOT HUMANA'S. This is why so many people are in financial trouble nowadays; they simply don't pay attention.

"And to the poster who said that right-wingers use 'irregardless'.... low blow. I suspect there are just as many uneducated lefties as righties."

Look who they vote for.

Seems like everyone is bypassing the fact that the OP has identified AT&T as the real culprit. According to the OP: "AT and T incorrectly withdrew a huge amount of money from my account which caused my auto draft with Humana to be returned." That puts the problem squarely in AT&T's lap. So why not sue them? That's what the courts are for. I am not a litigious person by nature but this seems like a legitimate case of someone being royally screwed. Once AT&T settles, he can then go after Humana. It will be a long process, but I think any jury would truly sympathize. At the very least, AT&T is likely to settle out of court and the OP will be able to pay for medical care until he is reinstated. Previous posters have correctly identified Humana as just following standard business protocol in dropping the OP's policy. Sad, unethical, and not good customer relations, but legal neverthless.

And to the poster who said that right-wingers use "irregardless".... low blow. I suspect there are just as many uneducated lefties as righties.

Seems like everyone is bypassing the fact that the OP has identified AT&T as the real culprit. According to the OP: "AT and T incorrectly withdrew a huge amount of money from my account which caused my auto draft with Humana to be returned." That puts the problem squarely in AT&T's lap. So why not sue them? That's what the courts are for. I am not a litigious person by nature but this seems like a legitimate case of someone being royally screwed. Once AT&T settles, he can then go after Humana. It will be a long process, but I think any jury would truly sympathize. At the very least, AT&T is likely to settle out of court and the OP will be able to pay for medical care until he is reinstated. Previous posters have correctly identified Humana as just following standard business protocol in dropping the OP's policy. Sad, unethical, and not good customer relations, but legal neverthless.

And to the poster who said that right-wingers use "irregardless".... low blow. I suspect there are just as many uneducated lefties as righties.

Seems like everyone is bypassing the fact that the OP has identified AT&T as the real culprit. According to the OP: "AT and T incorrectly withdrew a huge amount of money from my account which caused my auto draft with Humana to be returned." That puts the problem squarely in AT&T's lap. So why not sue them? That's what the courts are for. I am not a litigious person by nature but this seems like a legitimate case of someone being royally screwed. Once AT&T settles, he can then go after Humana. It will be a long process, but I think any jury would truly sympathize. At the very least, AT&T is likely to settle out of court and the OP will be able to pay for medical care until he is reinstated. Previous posters have correctly identified Humana as just following standard business protocol in dropping the OP's policy. Sad, unethical, and not good customer relations, but legal neverthless.

And to the poster who said that right-wingers use "irregardless".... low blow. I suspect there are just as many uneducated lefties as righties.

I don't feel like investigating whether AT&T messed up. Or whether the client should have been cancelled for so long.

I really think this could have been handled more ethically and more professionally by Humana.

I still do not know whether this client has been reinstated.

To Franzg:

Ok, my bad, I thought that the member was reinstated in March, not May. I misread the month. Congrats, you busted me. Get smug about it next time.

Despite my error, this is still 100% member fault. The member allowed AT&T access to their bank account and it came back to bite them. Humana didn't get paid and they cancelled her: bottom line. It doesn't matter how it happened. Why would you not expect them to cancel her? Since you're self-employed, I'd think you could respect the fact that no payments mean no service.

It's time people take responsibility for making sure their bills are paid on time. People, you have only yourself to blame. Considering the myriad of ways a person has at their disposal nowadays to check and make sure that a bill was paid, there is NO EXCUSE for people letting situations like this happen to them. Humana, as a courtesy, sent out a non-payment letter to the patient. You can't say Humana didn't tell her her policy was cancelled.

So, Humana didn't get paid (member fault), they cancelled her, sent her a letter stating that she was cancelled, the member had to reapply since they didn't bother to check to make sure their bills were paid for over 30 days.

Man, you'll take any situation to spout your venom at Humana, won't you? Hey, there's a hole in the ozone, would you like to blame that on them as well?

The fact remains that Humana was unwilling or unable to reinstate this client.

You really should read entire complaint: "I don't know why I hadn't been called. I did recieve(sic) mail after the fact warning me. I offered to pay for Febuary(sic) on March. After all it was only the first week of March but they said I had to apply for reinstatement. That it should only take a week or two.

After several calls. I was told I wouldn't find out if I'd be reinstated until May 4th. There is an 'investigation' going on."

I guess I believe that there is something wrong with Humana. I guess you feel that Feb- May 4 is only 62 days. You think it is entirely the clients fault. So be it.

I really do honestly feel that the $640 billion a year (plus $25 billion bailout from economic stimulus package for 2009) could yield better customer service. This client could have been serviced more efficiently and professionally.

All you seem to care about is what is "in print" and whether this type of incompetence is legal or not. That way, you can "win".

It seems the client always "loses" these discussions. Humana always "wins". I also think there is something wrong with that. American consumers have a very potent influence on our economy, and this type of mistreatment and belief system ("legal ripoffs") has hurt us dearly in recent months. Intelligent dialogue would be helpful in these types of cases.

A complaints dept. or "customer hotline" would also help.

The fact remains, Franzg, Humana didn't get paid for their services, so the member's policy was cancelled. It's the patient responsibility to make sure their bills are paid. Your political rantings have no bearing here and this has nothing to do with your unfounded hatred of Humana. You don't pay for something, you don't get service. This isn't rocket science.

You lost, move on.

This thread is not about our cellphones- it is about heathcare.

Humana sucks. They did not reinstate the OP (as far as I can tell) in a timely fashion.

40-50 million Americans remain uninsured because of managed care "policies and procedures".

If you actually read the complaint, Humana failed to withdraw the money or contact the client. AT&T is not to blame for Humana's failure to contact Humana's client, or to make payment arrangements.

If you hate AT&T so much, go file your own complaint. I hate AT&T as well. Does that make you feel better?

This complaint is another example of Humana's poor customer service, and also illustrates the plight of managed care victims who are merely trying to pay their bills.

Dumping this client in this manner was uncalled for, and could easily have been handled more professionally.

Humana has very poor customer service, and it sucks.

Franzg, you are the master of misdirected anger.

So, let's run through the facts, again, about this particular case:

FACT: AT&T withdrew money from the patient's account and refused to credit it back. This caused the Humana auto-payment to not go through. Humana cancelled the auto-draft for future billing. The patient neglected to confirm that Humana was paid for their services. So, Franzg, you're blaming the fact that Humana didn't get paid on Humana, instead of AT&T and the patient?

Humana is a business, not a charity. If they don't get paid for their services, they'll cancel you just like any other business. Why shouldn't they? It's the member's responsibility to make sure that their bills are paid. If you don't pay your electric bill, the power company shuts off your electric. If you don't pay your phone bill, the phone company will shut off your phone. If you don't pay your car payment, they repo your car. If you don't pay your health insurance company, they cancel your policy. This isn't rocket science.

FACT: Auto-withdrawals must be signed up for. There are rules that you agree to when you sign that authorization form. It basically says that if they try to pull a payment out and your account is short, they cancel the auto-draft. Why shouldn't they? Attempting to pull money from a depleted bank account multiple times would probably make the account holder incur multiple non-sufficient funds fees on their account. Humana is doing the member a favor by cancelling the auto-drafts for that very reason. What's a NSF fee at a bank, nowadays? $35 or so? Again, it's the member's responsibility to make sure their bills are paid. As for Humana calling the member to tell them their payment didn't go through, it's absurd to think that a business would call every single person that didn't pay their bill. That'd be literally tens of thousands of calls per day Humana would have to make. They'd have to hire a whole new department, just for this task. This would cause your premiums to go up. Talk about driving up unneccesary expenses. Humana did send out a written notice to the member as a courtesy to inform her that they didn't receive a payment.

FACT: The author was put back on the policy within 63 days, so any pre-existing clause the policy may contain doesn't apply. As for the chemo treatments being disrupted, well, it was the member's discretion to not go to the treatments during the short time that there was no coverage.

Humana isn't the bad guy here. It's just another person who wants to blame their own negligence on someone else.

"You said, 'There is no crisis at all. The reason costs have increased is because of 'insurance'. Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the 'insurance' was paying.'"

True.

"REBUTTAL: First off, 'there is no healthcare crisis?' Absolutely 100% false. Turn on the news, read a newpaper, or Google it, there IS a healthcare crisis in America. I can't even imagine why you'd say that there isn't. That's like claiming that the sun isn't hot."

Wrong. Google global warming. Do the same for global cooling. I remember in the 1970's, we were told we were heading into an ice-age. Just because some people believe in something means nothing. My kids all believed in Santa Claus and the Easter Bunny. They got smarter as they grew up.

BTW...That sun thingy? That's exactly what controls the temperature on this planet. Good choice, there.

"Second, the real reason health care expenses continue to rise is because, simply, providers are greedy."

That must be the reason I get taken care of cheaper. They are sooooo greedy, they provide me with equal care for way less money. The reason is simple. They don't have the paperwork, nor the wait for payment.

"You need their services and they're going to try to get as much money as they can. I've never seen a poor doctor, have you? I ought to know considering my current position. If you eliminated the insurance carrier's ability to control prices for services, you'd be stuck with a monster bill, which I could almost guarantee you couldn't pay, especially if it was for something major like a surgery or extended inpatient stay. Read up on how many bankruptcies there are in America due to medical bills."

HA! I remember my general practitioner making house-calls. No monster bills at all. He charged what the market would bear, and that was it. He retired very wealthy. And amazingly, he did it without screwing any of his patients over.

"Third, the only reason you've been paying 1/3 of the billable amount for your out of pocket expenses is because that is simply a courtesy some providers have. It's a settlement, basically. It's not a standard. Even if a provider extended this courtesy to you for major services, 33% of an inpatient stay or surgery charge is still a heck of a lot of money. If you want to gamble with your financial future like that, whatever, it's a free country."

It sure is. I have never paid the full whack at a Doctor's office...anywhere. In my mind, that tells me my way is the best way.

"Here's a scenario for you. Let's say you need a kidney transplant. The average cost for this is roughly $250,000. Mind you, that's not including ancillary services and providers. So, let's say you get your one-third settlement going again. (Yeah, right.) One-third of that is $82,500. So, by all means, pay out of pocket. I hope you have a large bank account."

Nah. But I could get the loan if I needed it. I'd still be ahead of the game after taxes.

"Personally, a surgery I underwent was billed at over $75,000. My final cost (exlcuding my premiums) was $400. (This is my deductible) So, how is this a rip-off?"

How much? Add up all of the money you wasted on your "insurance" premiums. This counts toward your total out of pocket. My sister and her husband paid over $3600/year for more than 15 years on health "insurance". That's well over $54000 when you add in the deductibles and co-pays. I had my house in NC built for far less in 1986. Health "insurance" isn't even insurance. It's more of a prepayment plan for most people. The vast majority never use the amount of money they pay in. YOU know this. It is how insurance companies make money. You don't make money by charging LESS than you expect the "insured" to use.

"Finally, you said, 'If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen.'"

True!

"REBUTTAL: Is this a serious comment? People from other countries come to America for healthcare because most countries don't have the same facilities, technology and medical standards that we have."

Exactly. And why is that? Simple. It is because we have a free market system that allows Doctors to charge money for profit. It sure as hell is not because we have "insurance" companies.

"As for people going outside of America to get care, this happens constantly."

Name one person we can all find info on. I want to know the type of care they recieved that was superior to what they could get here.

"Many people do this to avoid FDA restrictions, to undergo an experimental procedure, or to obtain non-FDA approved drugs."

You are twisting things. Buying meds in Canada is not the same as recieving medical care. The drugs are subsidized by the Canadian Govt. If the US Govt did the same thing, we'd all get to pay over50% of our incomes to them...just like the Canadians do. Add it all up, and the drugs are not cheap to Canadians. We simply use a loophole to buy them, and get them shipped to us. In reality, this practice is very illegal, and you know it.

"Robert, seriously. Were you drinking when you typed your last blog?"

Nah...but I like the way you think.

So why on earth won't Humana cover their client?

I guess Humana is too retarded to follow their own "guidelines."

Humana sucks.

Franzg,

Pregnancy, by law, can never be considered pre-existing. As for other conditions considered to be pre-existing by the members policy, as long as the person wasn't totally uninsured (they can be insured with any carrier) for longer than 63 days, a pre-ex clause in the Humana policy won't be a problem.

OP can't get covered. OP needs cancer treatment. OP must pay out of pocket. Humana, previous insurer, rejects OP's pleas for reinstatement. OP is "too ill". Please read thread.

Thank god some doctors are willing to take discount. OP would be dead.

Humana should reinstate. OP had "pre-existing insurance" before OP had cancer. Greedy doctor is not the issue here.

Being that Humana takes 50 cents for each dollar going to its clients' healthcare, I would advise re-evaluating the "greedy doctor" theory. Could Humana be the pesky blood sucking leech feeding on the greediness of doctors? Could Humana's 50% parasitic relationship with providers driving up the cost of healthcare? I think it is entirely possible.

Not all of us can afford health insurance. Many are uninsured. That is the real crisis in healthcare. It is not "bankruptcies". Taxpayers are shelling out $640 billion (plus $25 billion bailout) this year for healthcare. Yet 40%-50% remain uninsured. It is because of managed care companies like Humana, offering "bare bones" policies at high prices. If you are ill or pregnant, don't even think about being insured by Humana. Humana will not insure you.

Maybe Humana would be a good "choice", especially if you are healthy and wealthy. The rest of us need another option.

Please Humana, please reinstate the OP. At least until another option is available. After that, Humana should be free to dump her again.

Ah, a new player to the game: Robert.

Robert, your last blog was perhaps that most opposite thing to common sense I've ever heard. Now, before you start in with the "Well, who are you to act like such an expert?" bit, I'll tell you upfront that I am a 12 year manager of a billing and coding department for a major Chicago hospital.... just wanted to get that fact out there for your consideration.

You said, "There is no crisis at all. The reason costs have increased is because of 'insurance'. Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the 'insurance' was paying."

REBUTTAL: First off, "there is no healthcare crisis?" Absolutely 100% false. Turn on the news, read a newpaper, or Google it, there IS a healthcare crisis in America. I can't even imagine why you'd say that there isn't. That's like claiming that the sun isn't hot.

Second, the real reason health care expenses continue to rise is because, simply, providers are greedy. You need their services and they're going to try to get as much money as they can. I've never seen a poor doctor, have you? I ought to know considering my current position. If you eliminated the insurance carrier's ability to control prices for services, you'd be stuck with a monster bill, which I could almost guarantee you couldn't pay, especially if it was for something major like a surgery or extended inpatient stay. Read up on how many bankruptcies there are in America due to medical bills.


Third, the only reason you've been paying 1/3 of the billable amount for your out of pocket expenses is because that is simply a courtesy some providers have. It's a settlement, basically. It's not a standard. Even if a provider extended this courtesy to you for major services, 33% of an inpatient stay or surgery charge is still a heck of a lot of money. If you want to gamble with your financial future like that, whatever, it's a free country.

Here's a scenario for you. Let's say you need a kidney transplant. The average cost for this is roughly $250,000. Mind you, that's not including ancillary services and providers. So, let's say you get your one-third settlement going again. (Yeah, right.) One-third of that is $82,500. So, by all means, pay out of pocket. I hope you have a large bank account.

Personally, a surgery I underwent was billed at over $75,000. My final cost (exlcuding my premiums) was $400. (This is my deductible) So, how is this a rip-off?

Finally, you said, "If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen."

REBUTTAL: Is this a serious comment? People from other countries come to America for healthcare because most countries don't have the same facilities, technology and medical standards that we have. As for people going outside of America to get care, this happens constantly. Many people do this to avoid FDA restrictions, to undergo an experimental procedure, or to obtain non-FDA approved drugs.

Robert, seriously. Were you drinking when you typed your last blog?

Ah, a new player to the game: Robert.

Robert, your last blog was perhaps that most opposite thing to common sense I've ever heard. Now, before you start in with the "Well, who are you to act like such an expert?" bit, I'll tell you upfront that I am a 12 year manager of a billing and coding department for a major Chicago hospital.... just wanted to get that fact out there for your consideration.

You said, "There is no crisis at all. The reason costs have increased is because of 'insurance'. Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the 'insurance' was paying."

REBUTTAL: First off, "there is no healthcare crisis?" Absolutely 100% false. Turn on the news, read a newpaper, or Google it, there IS a healthcare crisis in America. I can't even imagine why you'd say that there isn't. That's like claiming that the sun isn't hot.

Second, the real reason health care expenses continue to rise is because, simply, providers are greedy. You need their services and they're going to try to get as much money as they can. I've never seen a poor doctor, have you? I ought to know considering my current position. If you eliminated the insurance carrier's ability to control prices for services, you'd be stuck with a monster bill, which I could almost guarantee you couldn't pay, especially if it was for something major like a surgery or extended inpatient stay. Read up on how many bankruptcies there are in America due to medical bills.


Third, the only reason you've been paying 1/3 of the billable amount for your out of pocket expenses is because that is simply a courtesy some providers have. It's a settlement, basically. It's not a standard. Even if a provider extended this courtesy to you for major services, 33% of an inpatient stay or surgery charge is still a heck of a lot of money. If you want to gamble with your financial future like that, whatever, it's a free country.

Here's a scenario for you. Let's say you need a kidney transplant. The average cost for this is roughly $250,000. Mind you, that's not including ancillary services and providers. So, let's say you get your one-third settlement going again. (Yeah, right.) One-third of that is $82,500. So, by all means, pay out of pocket. I hope you have a large bank account.

Personally, a surgery I underwent was billed at over $75,000. My final cost (exlcuding my premiums) was $400. (This is my deductible) So, how is this a rip-off?

Finally, you said, "If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen."

REBUTTAL: Is this a serious comment? People from other countries come to America for healthcare because most countries don't have the same facilities, technology and medical standards that we have. As for people going outside of America to get care, this happens constantly. Many people do this to avoid FDA restrictions, to undergo an experimental procedure, or to obtain non-FDA approved drugs.

Robert, seriously. Were you drinking when you typed your last blog?

Ah, a new player to the game: Robert.

Robert, your last blog was perhaps that most opposite thing to common sense I've ever heard. Now, before you start in with the "Well, who are you to act like such an expert?" bit, I'll tell you upfront that I am a 12 year manager of a billing and coding department for a major Chicago hospital.... just wanted to get that fact out there for your consideration.

You said, "There is no crisis at all. The reason costs have increased is because of 'insurance'. Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the 'insurance' was paying."

REBUTTAL: First off, "there is no healthcare crisis?" Absolutely 100% false. Turn on the news, read a newpaper, or Google it, there IS a healthcare crisis in America. I can't even imagine why you'd say that there isn't. That's like claiming that the sun isn't hot.

Second, the real reason health care expenses continue to rise is because, simply, providers are greedy. You need their services and they're going to try to get as much money as they can. I've never seen a poor doctor, have you? I ought to know considering my current position. If you eliminated the insurance carrier's ability to control prices for services, you'd be stuck with a monster bill, which I could almost guarantee you couldn't pay, especially if it was for something major like a surgery or extended inpatient stay. Read up on how many bankruptcies there are in America due to medical bills.


Third, the only reason you've been paying 1/3 of the billable amount for your out of pocket expenses is because that is simply a courtesy some providers have. It's a settlement, basically. It's not a standard. Even if a provider extended this courtesy to you for major services, 33% of an inpatient stay or surgery charge is still a heck of a lot of money. If you want to gamble with your financial future like that, whatever, it's a free country.

Here's a scenario for you. Let's say you need a kidney transplant. The average cost for this is roughly $250,000. Mind you, that's not including ancillary services and providers. So, let's say you get your one-third settlement going again. (Yeah, right.) One-third of that is $82,500. So, by all means, pay out of pocket. I hope you have a large bank account.

Personally, a surgery I underwent was billed at over $75,000. My final cost (exlcuding my premiums) was $400. (This is my deductible) So, how is this a rip-off?

Finally, you said, "If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen."

REBUTTAL: Is this a serious comment? People from other countries come to America for healthcare because most countries don't have the same facilities, technology and medical standards that we have. As for people going outside of America to get care, this happens constantly. Many people do this to avoid FDA restrictions, to undergo an experimental procedure, or to obtain non-FDA approved drugs.

Robert, seriously. Were you drinking when you typed your last blog?

Ah, a new player to the game: Robert.

Robert, your last blog was perhaps that most opposite thing to common sense I've ever heard. Now, before you start in with the "Well, who are you to act like such an expert?" bit, I'll tell you upfront that I am a 12 year manager of a billing and coding department for a major Chicago hospital.... just wanted to get that fact out there for your consideration.

You said, "There is no crisis at all. The reason costs have increased is because of 'insurance'. Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the 'insurance' was paying."

REBUTTAL: First off, "there is no healthcare crisis?" Absolutely 100% false. Turn on the news, read a newpaper, or Google it, there IS a healthcare crisis in America. I can't even imagine why you'd say that there isn't. That's like claiming that the sun isn't hot.

Second, the real reason health care expenses continue to rise is because, simply, providers are greedy. You need their services and they're going to try to get as much money as they can. I've never seen a poor doctor, have you? I ought to know considering my current position. If you eliminated the insurance carrier's ability to control prices for services, you'd be stuck with a monster bill, which I could almost guarantee you couldn't pay, especially if it was for something major like a surgery or extended inpatient stay. Read up on how many bankruptcies there are in America due to medical bills.


Third, the only reason you've been paying 1/3 of the billable amount for your out of pocket expenses is because that is simply a courtesy some providers have. It's a settlement, basically. It's not a standard. Even if a provider extended this courtesy to you for major services, 33% of an inpatient stay or surgery charge is still a heck of a lot of money. If you want to gamble with your financial future like that, whatever, it's a free country.

Here's a scenario for you. Let's say you need a kidney transplant. The average cost for this is roughly $250,000. Mind you, that's not including ancillary services and providers. So, let's say you get your one-third settlement going again. (Yeah, right.) One-third of that is $82,500. So, by all means, pay out of pocket. I hope you have a large bank account.

Personally, a surgery I underwent was billed at over $75,000. My final cost (exlcuding my premiums) was $400. (This is my deductible) So, how is this a rip-off?

Finally, you said, "If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen."

REBUTTAL: Is this a serious comment? People from other countries come to America for healthcare because most countries don't have the same facilities, technology and medical standards that we have. As for people going outside of America to get care, this happens constantly. Many people do this to avoid FDA restrictions, to undergo an experimental procedure, or to obtain non-FDA approved drugs.

Robert, seriously. Were you drinking when you typed your last blog?

Why not reinstate the OP? Humana covered before "auto withdrawal" failed. Why not now?

I agree wholeheartedly that costs would plummet if managed care were cut out of the loop.

I pay out of pocket as well. Can't afford health insurance. When I turn 50, I may have to change my strategy. What if I get cancer? (like leukemia). What if I fall off a ladder? Accidents and health problems do happen unexpectedly, and I believe I am skating on thin ice.

If the goal of doctors and hospitals were to care for the healthy, surely there would be no healthcare crisis. The fact that we don't leave the USA to live elsewhere does not prove there is no crisis.

The fact remains that we are collectively paying $640 billion a year (plus $25 billion bailout this year) to insure the healthy. The ones with "pre-existing" conditions get none. 50% of the money goes to giant corporations like Humana to increase market share on Wall Street. It is a huge budgetary concern in the USA, second only to national defense.

The legislature is now poised to cut the defense budget in a desperate attempt to decrease the deficit. This is why I (and many other Americans) believe there is a "crisis". I'm sick of throwing my tax dollars down the drain. Give us choices. The OP needs another choice to STAY ALIVE. Right now, it is unlikely we can pay for cancer treatments out of pocket, especially because we cannot work full time while receiving chemotherapy.

Right now, it seems reasonable to assume that the condition the OP suffers from should not be based on whether a payment went through successfully or not. Humana should reinstate due to the fact that the OP had "pre-existing" insurance. Why can't it work both ways?

Because managed care has the upper hand. It is an oligopoly which gobbles up tax dollars and spits them into shareholder's pockets. Citizens like the OP are left holding the bag, and they feel ripped off. I see no valid, logical reason (unless corporate greed is considered as such) why the OP needs to be "dropped".

Yep, 100% of my healthcare costs were paid out of MY pocket. How about that?!

I did that for 17 years between getting out of the USMC, and reenlisting in the US Army. Get it? I did 9.25 years active in the Marines...was out entirely for 17 years...and have since been in the Army.

I know exactly how the system works, both as an active duty member, and as a civilian. I even spent a couple years dealing with the VA system. I am the true expert on this country's healthcare systems.

There is no crisis at all. The reason costs have increased is because of "insurance". Take those companies out of the picture, and costs will plummet. This is due to the providers having to compete for the dollars available. Every doctor I dealt with lowered their prices as soon as I told them I was paying cash. I'd be taken care of for 1/3 of the billable amount the "insurance" was paying.

If it's so bad here, why do people worldwide come here for healthcare, instead of other places? I don't see anyone running to Canada to get treated. It does not happen.

The OP let his/her policy lapse. This was a bad mistake on their part, since there is a pre-existing condition involved. If YOU were paying the OP's medical bills, wouldn't YOU place requirements on coverage? Of course you would. And if the person you were going to cover was overweight, smoked, had heart problems, or any of a number of other issues that would cost YOU more, YOU would put limits on coverage including NOT covering them.

The OP still has none, to the best of my knowledge.

Managed care is helping a select few, those declared "insurable" by managed care.

If you think everything is OK, you are entitled to your opinion. It is no help to the 40 or 50 million uninsured US citizens.

We need choices.

I guess your advice is to sit back and enjoy the health care crisis and the recession.

Some of us are not enjoying it as much as you are.

If you follow the money, 50% of our healthcare dollars do not go to patient care.

Now sit back and enjoy it.

Franzg, you're a determined dude, I'll give you that. So you said....

"Advisors in the US Army believe managed care is a threat to our national security."

Ok, I read that article you mentioned in one of your previous posts. It basically said that an insurance carrier couldn't handle massive amounts of claims if some huge catastrophe hit America. (let's say for example, a nuclear assault or hurricane.)

Again, the term "military intelligence" proves oxymoronic. Let's start off with a possible attack on America by foreign powers. Should some incident like that occur (God forbid), a common insurance policy wouldn't even come into play. Crisis management of that magnitude is the responsibility of the government. (including applicable health concerns for citizens). This is why basic insurance policies don't cover "acts of war, declared or not". That's also why our military members have Tricare (military health insurance.)

Ok, now that that's settled, let's move on to a natural disaster such as Hurricane Katrina. Even if the titanic amount of claims presented to an insurance carrier somehow managed to bankrupt it, by law, those remaining unaddressed claims would be covered by another assigned party.

"Advisors in the US Army believe managed care is a threat to our national security."

That's kind of a harsh comment. I suppose they think a rogue insurance agent is going to suicide bomb a national landmark or something. Oh, the comedic mayhem caused by our own high ranking officials.

The op does not, as far as I know.

I'm glad you are entertained by my posts.

You still think Frist is a liberal with constituents?

I think managed care has had its chance, and has failed. It needs to be eliminated. It has failed this victim, and many other cancer survivors.

Advisors in the US Army believe managed care is a threat to our national security

http://www.kepplerspeakers.com/content.aspx?id=2162

Nobody wants these silly managed care corporations anymore. Their stocks are tanking, and in order to stay afloat, they now receive $25 billion from our current taxpayer funded bailout package. For $640 billion a year, we should not have so many uninsured individuals. We should not have people denied insurance because "auto-withdrawal" did not work.

Managed care stinks, unless you are a lobbyist or managed care CEO. Or one of the "healthy wealthy" who can afford all the out of pocket expenses.

Humana will always win this argument, unless the legislation changes. Flushing taxpayer salaries down the Wall Street sewerage drain is part of the fiscal irresponsibility that helped cause the current healthcare crisis and also put the US into so much debt. I think we should be doing a little better for this client than flaming those trying to help.

We have tried voting "conservative" in the past (even voted for "liberals" like Frist), and it has been a gigantic disaster. We are now attempting to resuscitate this failing system by pumping $25 billion into it. Time to stop flaming, and start doing something about it.

"This client needs help. Please give advice. Leave frickin' Frist and Moore out of it. Otherwise, you are not being helpful."

I already did that. Try reading what I wrote. My very first response told her what she needs to do. When are YOU going to try following your own advice?

"By the way, Bill Frist no longer has 'constituents', you moron."

I love how you fail to ignore WHY that is. Tennessee doesn't really like Liberals.

As for being a moron...try to remember that YOU are the idiot who turned this thread political. Dolt!

"He does own huge chunks of our healthcare dollars though."

Yes, by EARNING them by treating patients who willingly PAY him.

"Now go back to to your sterile cubicle, and post how Bill Frist is a liberal."

Considering YOU are the only one who thinks otherwise, I'll ignore your request. As for a sterile cubicle, right now mine is a hangar, housing Apache aircraft. In October, it will be one with sand all around me.

This client needs help. Please give advice. Leave frickin' Frist and Moore out of it. Otherwise, you are not being helpful.

By the way, Bill Frist no longer has "constituents", you moron. He does own huge chunks of our healthcare dollars though.

Now go back to to your sterile cubicle, and post how Bill Frist is a liberal.

When did Bill Frist become a Conservative? That'll be big news to his constituents.

Since we have gotten so political, I thought I might answer this question:

"Show me where I or any Conservative ever agreed to any Federal money going to any private enterprise."

Answer: Bill Frist

"Frist has a fortune in the millions of dollars, most of it the result of his ownership of stock in Hospital Corporation of America, the for-profit hospital chain founded by his brother and father. HCA paid over $1.7-billion in criminal penalties for Medicare fraud. Frist's 2005 financial disclosure form lists blind trusts valued between $15 million and $45 million."
Source: New York Times December 15, 2000

Not only did Frist support Medicare taxpayer dollars going to managed care, he also supported fraudulent use of the money.

Now were even. Let's leave Michael Moore and Bill Frist out of this. This ex- Humana client needs advice on how to get reinstated.

Geesh. Regardless of whose belief system is more "popular", I still think managed care has failed, especially in this case.

Let's face it- There is a HUGE gap now between those who are "insurable", and those who are not.

That's why we have so many uninsured Americans. The system fails whether you are "conservative" or "liberal". Manage care is bad for just about everyone. (except lobbyists and managed care CEOs).

Comparing this $640 billion joke to the VA hospital and Medicare is an insult to our intelligence. Are you suggesting we join the military if managed care companies refuse to reinstate us? Or perhaps we should wait until we are declared "disabled" from our illnesses before we are "insurable". Or maybe we should wait until we are 65 years old (if we last that long).

Or follow your advice and "move out of the country"? Are you all insane?

C'mon Humana, show some sense, and plug this gaping hole. To suggest that the government has nothing to do with managed care is either ignorance or denial. Either way, seems like the government believes managed care needs help to the tune of $25 billion (2009 taxpayer funded economic stimulus package).

Show me where I or any Conservative ever agreed to any Federal money going to any private enterprise.

Go ahead...post it. Have fun looking. You will never find it.

This country is now over $11Trillion in debt, not counting the dozens of TRILLIONS of dollars worth of debt from SS/Medicare/Medicaid.

And none of it was spent Constitutionally. The US Constitution allows for national defense, and not much more.

Regardless (or should I use the right winger's favorite "irregardless") of whether you are right wing or left wing, we are ALL being reamed by managed care.

The constitution is supposed to uphold the rights of citizens. That was the intention of our founding freakin' forefathers.

Yeah, Michael Moore is a fat blowhard, and his documentaries are alarmist and over the top, but he is in the movie business. We can't take him too seriously. Just because you are not entertained by him doesn't mean he needs to be ripped on this forum. You have a choice not to pay the $10 to see his films. Big whoop.

The big issue here is reinstatement. Health care is obviously more important to this ex-Humana client than her cellphone plan.

I'm quite sure this client is being honest, and made attempts to pay Humana. She probably also has tried calling them to be reinstated, and probably received a response (or no response) which made her quite uneasy.

Perhaps healthcare coverage does not need to be "dictated" by our federal government. I guess you think it is OK if the banks are, however. That is a little hypocritical, if you ask me.

Now the 2009 taxpayer funded stimulus package (we call it the "bailout") is providing funds to keep recently unemployed workers insured by Humana. I guess you should write your congressperson and complain that it is "unconstitutional".

"Instead of attacking Micheal Moore, why not give advise on what this poor woman needs to do?"

She needs to stay in contact with both the Insurance Company, and her employers HR office.

"Right Wingers never want to discuss the facts on issues like health care....the facts are against them."

Really? The fact is, the US Constitution does NOT allow the Federal Government to spend one penny of the Treasury on it. If you believe it does, post the EXACT wording that authorizes such a waste of tax dollars. We evil Right-Wing CONSTITUTIONALISTS are more than prepared to discuss such issues. We are the ONLY ones who have the facts on our side.

"We've followed your 'get the government off our backs' ideology since 1980 and looked at where it has brought us....corporations like Humana running amok....making money by denying coverage to sick cancer patients."

That's a hoot! Here's a thought, if you hate the US Constitution so much in favor of an authoritarian Government telling you what to do, how to do it, and dictating to you everything you have and do, move to that country. The reason people come here is to escape those places.

And if you think the Feds can run a healthcare system, why is Medicare/Medicaid the disasters they are? Get sick in another country. Go to a VA Hospital. You'll get a valuable lesson.

It is entirely possible that Humana will refuse to cover due to the client's health. Regardless of how much money the client mails them. After all, this is kind of the issue here, not whether AT & T needs a ripoff report.

AT & T would not deny service after payment was made.

Its a real problem for us consumers. This client admitted to missing a payment. The problem is the issue of "reinstatement". Its a very scary prospect in this case.

It's kind of the wrong approach. Its like a restaurant refusing to serve someone because they are "too hungry".

Perhaps those with health conditions that Humana feels uncomfortable with (Such as pregnancy), would be better served by other means other than managed care plans.

We need choices. If one hates AT & T, a client can use Sprint instead. Neither corporation would deny service to this individual because of their health.

I sympathize that the author has cancer. I'm sorry that that's the case. (In fact, both of my parents died from cancers).

AT&T is the real problem here. They overdrew the author's account so Humana didn't get their money. That being said, I don't understand why everyone is making Humana out to be the bad guy here. Bottom line: they didn't get paid, so they dropped you. That's pretty much a standard for any business. If you don't pay your auto insurance, they drop you. If you don't pay your cable bill, they turn the cable off. If you don't pay your phone bill, your phone gets shut off. Why should health insurance be any different than those other services? Granted, it wasn't the patient's fault that AT&T screwed up, but I don't think it should be a surprise that Humana would drop you if they don't get paid. How are they supposed to know that AT&T made a mistake?

As for Humana not calling you to tell you that your payment didn't post, sure, that would've been a nice courtesy, I'll agree. However, it's your responsibility to make sure your bills are paid. I'm sorry to be that way, but that's the way it is. When my mother got cancer, she gave me legal rights to pay her bills for her from her bank account. If your treatments are effecting you to an extent where you can't manage your bills and your finances, I would advise doing something similar. I'm not trying to sound like a jerk, but something this important shouldn't be left to chance.

You should be filing a ROR on AT&T instead of Humana.

We obviously need other choices than managed care. This victim has contracted a disease, and to add insult to injury, now has been "dropped" by Humana.

If the consumer had some other means to obtain coverage (other than these managed care companies), perhaps the problem could be solved.

We need to urge legislators to offer coverage for people who need healthcare.

Maybe managed care would be OK for the healthy and wealthy. Not all of us are so lucky. They seem to be grossly inadequate for those who need medical treatment.

BTW, Humana will not insure any pregnant female. That's kind of sexist. Of course, we will be told it is the client and employers who are denying coverage in the next post.

Instead of attacking Micheal Moore, why not give advise on what this poor woman needs to do? Right Wingers never want to discuss the facts on issues like health care....the facts are against them. We've followed your "get the government off our backs" ideology since 1980 and looked at where it has brought us....corporations like Humana running amok....making money by denying coverage to sick cancer patients.

Michael Moore is not telling the truth, John.

I beg you to quit watching Michael Moore movies. I imagine that you've bought, rented, read, or heard about the Michael Moore movie 'Sicko'. This grand opportunist and liar has obviously brainwashed you as well. About the lawsuit mentioned in the movie, please research it on the internet. You'll find the following facts:(this is pasted DIRECTLY FROM WIKIPEDIA)

'Video of Linda Peeno's testimony appeared in Michael Moore's 2007 documentary Sicko. On June 28, 2007, in a statement about the movie, Humana declared that Peeno was never a Humana associate (permanent, full-time employee), but rather a 'part-time contractor'. Humana also disputed the portions of Congressional testimony that were shown by saying that because the patient's specific healthcare plan didn't cover heart transplants, the denial of coverage was valid.'

Valid, John. That means that the employer of that patient didn't want to cover transplants in their policy. It's unfortunate, I agree. Again, what's covered or not in a policy is a decision made by Humana's client, not Humana. How about this example? Catholic hospitals and healthcare systems don't approve of abortions, elective or medically necessary. (I ought to know; I've run the billing and coding department in one for the past twelve years.) So if a pregnant woman who works for a Catholic Hospital can't pay out of pocket for her medically necessary abortion, I'm sorry, it's not Humana's fault. Blame the employer who wrote the policy.

While you're online, do some research on Mr. Moore as well. He has stock in all of those companies he criticizes and much of his data is flat out false. You are falling prey to a guy who just starts controversy so he can get more tickets sold to his one-sided documentaries. In short, he's lying to you so he can make money. Granted, managed care isn't perfect, but it's not the devil you guys are making it out to be.

One of my good friends recently contracted leukemia. His life has changed dramatically, of course.

He has been advised by his cancer doctor not to quit his very stressful job. If he changes jobs now (in order to live closer to his children) he may be declared "uninsurable".

Managed care insures its clients based on the monetary risk it must take to do so. Insuring a person who needs healthcare is just "too risky" for these giant corporations.

Unfortunately, most of us have no other option than to enroll with these crooks. We are treated like some kind of Wall Street commodity, like tobacco and ammunition. It is another example of how twisted managed care really is.

What is even more startling to me, is that corporations like Humana are just doing what the government allows it to do. We should not expect these giant corporations to look a gift horse in the mouth. The managed care corporations like Humana are the proud spawn of our lawmakers and lobbyists.

I think John is right- The problem needs to be addressed in a way where the public is educated. The legislation must change. Please write to every applicable government person you can. You can't really complain to the folks at Humana- they are too busy watching the Wall Street ticker at the moment.

And please update us about the status of your insurance woes. They are very important to us.

This is HORRIBLE and it's classic sleazy behavior by health insurance companies. They are ALL about profit and denying medical coverage...They will exploit any opportunity to deny coverage to sick people. This is exactly why we need universal health care in the USA.

Your best bet is to contact Michael Moore...the famous film producer and consumer advocate....He is the one person who can make insurance companies shake in their boots as he has taken them on. I think your story should particularly interest him.

http://www.michaelmoore.com/

mike@michaelmoore.com (RipOffReport man: PLEASE don't censor this email address...this poor woman needs help)