Long before have my second child I called the 800 line and reviewed my benefits online. Well to my surprise, after have an emergency c-section 3 plus stay at the hospital, I started to receive bills. These bills were not only for my, but my new born. You see the costumer services reps at United and my online benefits stated the mother and child were both covered under the mother as long as they discharged together, if baby stated, it would then assume its own identity, ocpays, and deductiable...HAHAHA!!! I had to pay my whole $4500.00 out off pocket for me and almost $4000.00 for the baby.
***Here is the kicker. Our work heard of this and changed the insurance plan. We were all assured by the salesman that this plan would cover mother and child completely under the new $2500.00 deductable. (I even asked if the back of the paper, in one of corners had invisible ink with disclaimers?) We were assured nothing would make the payment go over $2, 500.00 as all as mom and baby state and were discharged together...Guess what... This information was a big fact lie. I just called about maternity benenfits and was told by the benefits department that a normal healthy birth for mom and baby would be $2, 500.00. With complications you could reach a $4000.00 out of pocket for each. WOW!!! ONCE AGAIN HAVING A BABY WENT FROM ONE AMOUNT TO POSSIBLE MORE THAN DOUBLE.
Peopele be aware there are benefits exclusion, diclaimers and riders, that also play a part. When you look at you benefits package, you are only viewing what they want you to see. My own HR Dept. was shocked when the sale gentleman told me I should have consulted her for the exclusion/disclaimers and riders manual, She had no idea that there was such, nor did she know who to access it. I am glad to have insurance, but it would be nice the facts and not all the smoke and mirrors!!!

My Father is in a skilled nursing home with a terminal disease. He has coverage under UHC through his pension plan which is suppose to cover this. He also has extended coverage with them. They have refused to pay! Each month it is a different excuse of additional paperwork they require. We have been paying out of pocket for the past 6 months. What can we do about this?

UHC's customer Service is non-existent. I received a bill from my former physician for services performed July 2007 through November 2007-yes THREE years ago. I spent 3+ hrs on the phone. I am sure UHC's main customer service site is in India. I was transferred back and forth at least 10 times. I was transferred to an automated survey twice, and once when I asked to speak with a manager, the customer service rep hung up on me. I finally spoke with somebody who seemed to be able to help me but they mentioned by records had been 'PURGED". I somehow doubt that. 'Archived' perhaps, but surely they are 'somewhere' in their system. My former physician has re-submitted the claims twice and each time UHC denies coverage: "Insurance Terminated". Well, DUH! No kidding I am not covered by UHC now, but for the entire year of 2007 I was covered. I have copies of the second submittal by the physician's billing department. Even the form states, "Per the website, this patient was covered 1/1/07 - 12/31/07. Please reprocess for additional payment." I wrote UHC a letter with supporting documentation. I did hear back but they state they have "No record of this claim." Then the form letter tells me to visit www.myuhc.com to view my claims and EOB's. Well I cannot access anything because I am now with Aetna .The stupid letter even tells me to "call customer care on the back of my member ID card..." and to mail a bunch of required info to, "The address on your member ID card."

They infuriate me so much. I am not paying another dime...other than postage to keep sending documentation that I was covered. How can they get away with this crap?!
I'm not to happy with the physician either. Why wait THREE damn years to refile a claim?? I do have one of the EOB's with a claim number stating that the physician was paid. At the very least I hope to be off the hook for $140 of the $345 they are demanding.

I called the office of the Georgia Insurance Commissioner to find out why United Health Care was sued for $750, 000 by the state of Georgia. The investigator told me it was because they would not pay for claims in the time period specified by law. He also told me this is the second time Georgia has had to sue the company. United Health Care was sued for the same thing about a year ago for $2.8 million. This is the company AARP is advertising on TV as the company senior citizens should get for their supplementary to Medicare. I am glad I called my office of Insurance Commissioner, maybe you should also before you buy insurance.

My wife has been suffering from bone loss for many years, last April fell and broke both legs. As the only drug offered to enhance bone growth her physician prescribed Forteo, which she has been injecting herself daily for almost a year now. With their drug approval service they will not fill a prescription a few days early so these devices have 28 doses per vial. Called last Thursday to get refilled, pharmacy had to call doctor to get a renewed prescription which they did. Her drugs ran out yesterday, now after a year United Health Care needs the doctor to approve this medication, THE DOCTOR WROTE THE PRESCRIPTION!!! What does that tell you... Now this process will take who knows how long to process and all the advantages that this drug has provided my wife is mute...
What can be done???? This stalling process by the insurance company can be dangerous to a patients health...

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