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My Complaint About Humana Health Insurance

Author:

Jack is a volunteer at the CCNY Archives. Before retiring, he worked at IBM for over 28 years. As of 2/2020, Jack has over 100,000 views.

my-complaint-about-humana-health-insurance

Introduction

I am a customer of Humana Health Insurance company. I have been since 2016 when I first qualified for Medicare and needed to sign up for Part D, prescription drug coverage. This article is to provide some important information for all customers. I have gone through the experience and found out the details of what is going on. It will save you money in the long haul.

- Jan. 2020

My History...

I turned 65 years old in 2016. I signed up for Medicare for the first time in my life. I sought the help of my local library which has a service to help with seniors with their medical insurance needs. They informed me besides the mandatory Part A and B of medicare, I should sign up Part D prescription drug supplemental insurance as well. Even though I was healthy and did not need any prescription drugs at the time, it is a good idea to join. In the eventuality that I will need it at a later time, I would not have to pay a penalty. The cost at the time was a minimal $12 a month for the basic plan. I decided on their advice to take it and the company chosen was Humana.

The way it works is a State by State basis. Healthcare insurance is difference for each State. In my home state of New York, this was presented as the best option for me being healthy and not requiring regular prescription medication.

In the next few years, with each October, a renewed plan was sent to me and I continued with Humana as the insurance provider.

The cost went up each year and I just assumed it was due to inflation or cost escalation. After all, the company is there to make money and they cannot continue operating at a loss.

What Happened in 2019.

Then in 2019, something odd happened. My new premium for the 2020 year was going to be $70, doubling from the $35 per month I was paying. That is what peaked my interest. All these years, I have not had any prescription drugs. Why is my premium rising much higher than inflation?

I called the help line at Humana just to get some answers. After a 10 minute hold, I was able to speak to a live person. After explaining my circumstance, he informed me that there is a cheaper plan and it would only cost $13.20. He then transferred me to another agent who started to enroll me in the new plan. I spent the next 30 minutes providing the same exact information such as address, social security number, DOB, Medicare number...and answering a bunch of legal questions basically protecting their liability. At the end, I asked the agent why was this necessary and she informed me that their system does not allow them to access the personal data of my account. Essentially they must treat me like a brand new customer and gather all the same information. It also gives her credit for signing up a new customer...

I asked to speak to a supervisor or to a customer service agent where I can submit a suggestion and she informed me that is not possible and that I should just go their website and there is a live chat feature which is designed for such feedback.

Feedback To Humana

I did as she suggested and sure enough there is a live chat link. I answered a few questions and picked the corresponding items on the drop down menu to inform them my intentions...and the message that came back was live chat is not available for your option. My option was relating to Prescription Drug Plan.

That seems odd to me. Why would they have a feature and not complete the process?

I decided to try another path. I search all over for a contact email for Humana. In the modern high tech. era, surely they must have a customer service email or general information email contact. To my surprise, there is none.

Finally, I was able to find the corporate address of Humana. Apparently, this is the only mechanism to contact Humana other than the 800 number. The 800 number is strictly used for signing up customers and very busy. It took me over 10 minutes to get through the first time.

I decided to write Humana a formal complaint.

Filing A Complaint

My complaint was a one page type written letter. I have three parts in this complaint. It outlined my frustration dealing with this company over the past week.

A. The cost of my plan was increased too high and that they should have signed me up to the cheaper plan available. In fact, this has happened to me the previous year 2018 and I was over charged for a more expensive plan that I did not need. I requested a refund for the over charges.

B. Their system is not up to par since in order for me to switch to the cheaper plan, I had to spend 40 minutes on the phone providing the exact same information as already in their system to begin with. This was a waste of my time and the time of their agent.

C. There customer service needs improvement since the live chat was not available and my only option was to write the letter. They should provide at minimum a contact email.

The Response From Humana

About a month and a half later, I received a response letter in the mail. It basically state that they disagree with my complaint and that they would not pay me the amount I requested. Their claim is that the information of the changed plan was sent to me each year in a letter and that it was my duty to follow up and call if I wanted to keep my old plan. They have the right to switch my plan each year based on some criteria...

They provided an 800 number for me to call if I still have questions.

It was clear to me that this is their standard canned response to any complaint. It sounded reasonable and protected them legally. However, it did not address the other two parts of my complaint.

Follow-Up Call

I made the follow up call and at first spoke to a customer service representative. It was clear after a minutes that she was not understanding my complaint. I requested to speak to her supervisor. After a short delay, a man came on the phone and he was much more receptive in dealing with a difficult customer like me. I asked if he read my complaint letter. After a few seconds, he said he did and he understand my frustration. He tried to make some excuses about their system and agree with me it needs improvement. I ask that he escalate this to higher management and he agreed to do so. As for the third point, he also said he will notify his management of this suggestion.

The main point of my complaint, was revealing. He said they change plans every year. It is not a matter of continuing a plan but a total revamp of plans each year. Every plan is assigned a code. Come each October, the old plans terminates. A set of new plans are created. The company then proceeds to place all customers in the new plans. In my case, they put me into a high cost plan. The way he explained it, it is simple economics.The cost of a plan is tied to the level of drugs that you are taking. There are different tiers of drugs with various costs associated with them. Depending which drugs you take, it may make sense to pay for a more expensive plan and receive the savings on the cost of the drug. It makes total sense to me.

The only problem in my case is I did not take any drugs. They should have kept me in the lower cost plan.

My Advice to All Customers

Here is the bottom line. This will save you money. Regardless of which plan you are assigned, make sure you call in each October during enrollment period. Ask for the various plans available and pick the right plan for your circumstance. Don't assume they will do that for you. They will always put you in a higher cost plan and want you to call to switch back to a lower cost plan.

That is by design. They will make more money this way. Their simple ingenious strategy is to switch you to a higher cost plan, make it difficult for you to call in, hope you give up. And if you persist, make you spend more time re-enrolling and hope you give up. If 90% of the people does that, think of all the extra premiums they will get.

Summary

This has been an eye opening experience for me. I had no idea this is what goes on in one of the largest Health insurance company. When it comes to health insurance.

Caveat Emptor. Buyer Beware! They are out to steal your money. Simple as that.

I am waiting to hear back from Humana...Not holding my breath.

Humana Stock Has Done Very Well Last Five Years

The Stock symbol for Humana is HUM. Here is a plot of their stock prices for the last five years.

my-complaint-about-humana-health-insurance

Postscript

A lesson in greed. This issue only came into my attention because Humana's greed. If they had only increased my premium by a small amount each year, I would have paid it and never given it a second thought. The fact it doubled in one year is what caught my attention. They are exposed for the crooks they are. Thanks Humana for giving capitalism a bad name.

My hope in writing this article is that you will change your ways or else, some other insurance company will come along and take your customers away. Survival of the fittest, or in this case the best.

Some Related Info

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2020 Jack Lee

Comments

Eric Dierker from Spring Valley, CA. U.S.A. on January 21, 2020:

Great job of an all too frequent happening among our insurers. You persisted took the time to make it right.

Marie Flint from Jacksonville, FL USA on January 20, 2020:

Sigh. This is our age of automation and computer logarithms! Some people, believe it or not, thrive on confusion and complications (not necessarily you, Jack).

Coming from a "lower-class" family of farmers living below the "poverty level," I never understood the concept of money growing, economic growth, etc. Money is only a medium of exchange. As the little Shepherd's Purse Fairy, (Cecily M. Barker) says in its song, "You cannot grow a pound from a farthing in the ground/Money may become a curse/Give me, then, my Shepherd's Purse." (The plant, by the way, has tiny heart-shaped pods for leaves. It would do everyone good to use the heart when dealing with money issues.)

Insurance companies are based on odds and statistics. What is the estimated change of an accident (or disease) occurring? That's how the companies base their charges--so, it's not just the cost of living; it's the rate of accidents or illnesses as they are occuring.

Big pharmaceutical companies are also playing a role in this. Medical doctors are practically seduced to prescribing the latest "breakthrough." When I had explained to a primary caregiver that I did not use prescription drugs, the health care team honestly did not know what to do with me.

In the end, to each his own. Faith in a pill works too.

Kudos to you, Jack, for tending your finances. It's amazing how many people do not, only to find themselves in tens of thousands of dollars in credit card debt.

Blessings!

The Logician from now on on January 19, 2020:

I know about mail. I’ll tell you this about email. I have asked questions about problems through email when available and I can tell you honestly Zi have never gotten a reply email that answered more than one of my questions in the email, often doesn’t answer any of my questions but just sends me canned messages that avoid totally the specifics of the questions I ask!

And when I reply reading the same questions wanting specific answers I get the same bs! It’s unbelievable.

Jack Lee (author) from Yorktown NY on January 19, 2020:

T, thanks for your feedback. I hope you are wrong. Most companies I dealt with genuinely wants to help. This company seems to be the exception. It is by design they are doing the way they are. The whole contact by mail is an example how they try to hide rather than interact with their customers. How many companies do you know that do not have an email contact?

The Logician from now on on January 19, 2020:

Thanks Jack for your account of the incompetence and deceit of customer service as well as the company’s policy.

But for me this is deja vu. An uncannily familiar replay of just about every customer service encounter I’ve had with all kinds of companies for all kinds of services over the past 15 years!

The only company I’ve had good, actually exceptional customer service from is Apple!

I have had almost identical experiences to yours with the phone company, my internet provider, satellite and cable companies, Anthem, bank acts, credit card companies, free trial offers from the internet, you name it. A couple I actually won monetary reimbursement years later through class action suits that were filed for the same complaint as mine.

I’ve asked for a supervisor and the CS agent just gave me to another CS agent who pretended to be a supervisor.

It’s a sign of the times Jack. No respect for customers, they are just numbers and if the customer gets in their face With a complaint delay, divert, lie, and hope they get discouraged and go away because there are millions of other dupes to take his place. Fake news everywhere, no representative government, just power hungry money grubbing career politicians.

A sign of the times.

Jack Lee (author) from Yorktown NY on January 19, 2020:

liz, Thanks for checking in. The squeaky wheel gets the grease always works.

Liz Westwood from UK on January 19, 2020:

This is an enlightening account. It never ceases to amaze me at how a simple query over a regular payment can suddenly bring about a reduction. In similar circumstances, when I feel I am getting nowhere with a complaint I usually ask to speak to a manager. If all else fails, I google the CEO's email, drop them a detailed email and you would be amazed at how quickly I get a response