UHC vs Humana?

[Corporate ORphan]

I am looking at replacing my COBRA with private health insurance and have narrowed it down to UHC and Humana. I have had come experience with UHC and they were ok. My husband's physician said they would take the PPO but not he HMO because of all the authorizations Humana required.

I did notice they require pre-authorization to go out of network.

Anyone have any experience with them?

THanks!

[fisherman]

My family and I have had an individual policy for four years with them. We have been fortunate and have not met our deductible in any year yet but we know that day will happen. We have an HSA policy with a $7K deductible for about $500 per month for four people so not out of line for the market. We all were in good health when we got the policy though the process was very long and hard. I do not think we could have gotten the policy with any problems in our record from the level of questioning we went through. They were friendly through out just the process was the harder than even getting an FHA loan. They have not had any problem giving us credit toward our deductible each year for the few expenses we have had but they have never had to pay a claim so I do not know how that would go from first hand experience and I am not looking to test that anytime soon.

Their rates have gone up an average of 12% each year. They offered the policy on the terms we wanted as far as coverage was concerned. $7k deductible and then they pay 100% which makes planning easier. We have not had much trouble finding doctors that take it either.

[Dimsumkid]

Quote:

Originally Posted by Corporate ORphan I am looking at replacing my COBRA with private health insurance and have narrowed it down to UHC and Humana. I have had come experience with UHC and they were ok. My husband's physician said they would take the PPO but not he HMO because of all the authorizations Humana required. I did notice they require pre-authorization to go out of network. Anyone have any experience with them? THanks!

We just did what you're doing now in January. Applied to UHC, Humana and Aetna. I have some slight wear on my cartilage on my left hip. Dgoldenz helped immensely with info and tips. I ended applying to UHC and Humana. Humana's underwriting slapped me w/lifetime rider to exclude any arthritis of any type for my lifetime. UHC put a rider only on my left hip. Then I sent in a specialist's letter documenting how minimal my hip situation was and UHC removed the rider completely and sent me a letter to add to my policy. Humana wouldn't budge on removing the rider at all, even with documentation sent to them. Our coverage was with UHC group insurance via COBRA before this switch. We got the $7k max out of pocket family plan for 3 (wife and son got preferred status). rate was $427/mo health and $57/mo for dental. My rate was a little higher since my BMI was considered higher than ideal, was told I wasn't off much, but they wouldn't tell me exactly so that got me a standard rate.

[East Texas]

We live in a rural county and have our company sponsored retiree health insurance with Humana PPO. The local doctors and the only hospital in the county are not in the Humana network. We drive about 70 miles to get to our in-network doctor and other in-network medical facilities. The problem with my plan is if we use an out-of-network facility, there is a separate deductible and no stop-loss on costs.

Check out all of your potential medical service providers (doctors, hospitals, labs, etc) to see if they're in-network. Otherwise you may get an ugly surprise.

[Corporate ORphan]

Thanks for the feedback. I didn't realize that the "hard" part of applying isn't the long insurance forms. What a nightmare! I guess I'm going to end up applying to both. It never occurred to me to do that.

Anyone actually go out of network with Humana? We're wondering if the "pre-authorization" means they can say "no" so that we couldn't go to a particular doctor out of network? Even if it was only going to go towards the deductible.

We would like to relocate to another state someday (probably within the next three years before the Health Reform Bill really kicks in.) The only thing better with Humana is the transportability so we would be allowed to get sick, etc. before we move. I like UHC better for everything else. Plus the "quote" on line was about $200 more than UHC. Though who knows if we would get the quoted price. For a $10,000 deductible HSA account Humana's quote was $500/month!

UHC will only cover us if we move somewhere they sell policies, PNW isn't one of them and Oregon is currently near the top of our list.

[Dimsumkid]

Just thought I'd mention that UHC wanted payment when you apply, Humana doesn't. I applied to both since the premiums were within $25/mo of each other and knowing I had a potential issue (had applied Aetna a few weeks earlier, they increased my premium in lieu of a rider), I wanted to know if I could get coverage elsewhere with less exclusions/better rate. $200 is a big difference, good luck.

[Mulligan]

Quote:

Originally Posted by Corporate ORphan Thanks for the feedback. I didn't realize that the "hard" part of applying isn't the long insurance forms. What a nightmare! I guess I'm going to end up applying to both. It never occurred to me to do that. Anyone actually go out of network with Humana? We're wondering if the "pre-authorization" means they can say "no" so that we couldn't go to a particular doctor out of network? Even if it was only going to go towards the deductible. We would like to relocate to another state someday (probably within the next three years before the Health Reform Bill really kicks in.) The only thing better with Humana is the transportability so we would be allowed to get sick, etc. before we move. I like UHC better for everything else. Plus the "quote" on line was about $200 more than UHC. Though who knows if we would get the quoted price. For a $10,000 deductible HSA account Humana's quote was $500/month! UHC will only cover us if we move somewhere they sell policies, PNW isn't one of them and Oregon is currently near the top of our list.

This is what burns me about todays health premium costs for some people. You get the "privelage" of paying $6,000 a year in premiums, just to remind you that you still have to pay the first $10000 in medical costs! If you get a major health problem, just make sure it happens early in the year, so the $10,000 deductible doesnt roll over and you wind up paying a double deductible!

[dgoldenz]

Quote:

Originally Posted by Mulligan This is what burns me about todays health premium costs for some people. You get the "privelage" of paying $6,000 a year in premiums, just to remind you that you still have to pay the first $10000 in medical costs! If you get a major health problem, just make sure it happens early in the year, so the $10,000 deductible doesnt roll over and you wind up paying a double deductible!

Some companies used to have a rollover provision where any claims in the last 3 months applied to the following year's deductible...Humana still does this on their Portrait Share plan, but I don't know of any HSA plans that have the feature.

[East Texas]

Quote:

Originally Posted by Corporate ORphan Anyone actually go out of network with Humana? We're wondering if the "pre-authorization" means they can say "no" so that we couldn't go to a particular doctor out of network? Even if it was only going to go towards the deductible.

My Humana PPO plan only cares about in-network versus out-of-network. I can go to anyone out-of-network knowing it's going to cost me out the wazoo (Texas term for... you know...). Most of the out-of-network providers in this area will accept the amount Humana pays for the procedure (regardless of the deductible being met); however, out-of-network has a separate deductible under my plan and no stop-loss.

[Corporate ORphan]

Just got off the phone with the third agent at Humana. SHe said the other two agents were mistaken. Only the group plans are transportable in all 50 states. Humana's is only transportable in the 26-27 states they sell insurance. As long as we don't upgrade the policy we would not be subject to underwriting in those states.

I looked back at Humana's web site and in the fine print it mentions that the transportability is only available in certain regions


Anyone have experience with moving and UHC? Will they really not require underwriting again if we move to a state where they are licensed to sell policies?

I understand why people go without insurance. Not only is it very expensive. It is stacked in favor of the insurance companies and very frustrating to obtain. This has got to be the worst experience I have ever had buying a product. No matter what happens, I think I will feel ripped off and wondering if I am really "covered".

[Corporate ORphan]

Just got an e-mail from Humana's customer support (took them a week to answer.) THey say it's portable! Now I feel like I am back to sguare one.

[Corporate ORphan]

Does anyone know how difficult insurance is to get in Oregon? It is in our top 3 places we are considering re-locating and UHC doesn't sell there. We are "healthy" now... no prescriptions, etc. I am concerned that in the time it takes us to decide where we want to move, one of us gets into an accident or gets sick and we won't be able to move to Oregon because we won't be able to get/afford insurance if we go with any other company but Humana.

[dgoldenz]

Just looking at ehealth, it looks like there's only Regence BCBS and then a few regional companies in Oregon.

[Dimsumkid]

I just got a follow up call from Humana, they stated I last contacted them for 2/1 coverage on 1/14 and wanted to know why I didn't follow up/get a policy from them. I explained I had to send them information about my "early arthritis" condition and a specialist's statment stating my non issue with this diagnosis. Sent the same info to UHC and Aetna and both removed any riders on me, Humana decided to keep the rider intact, refusing for lifetime, any and all coverage for any arthritis in any part of my body (this was in my left hip). I think the underwriters (in my case) were more strict from Humana than the other two companies. Just wished this call would've come in the week I had faxed them the letter instead of waiting 5 weeks to call me to follow up.

[nvestysly]

DW and I are considering individual health insurance. I'm planning to leave MegaCorp in July so we need an individual policy effective August 1st.

Thinking it may take a while to fill out the application, have it reviewed/processed, etc. I think we should get started now. The insurance agent says he cannot submit the application more than 45 days from the start of the policy. So a couple questions came to mind:

1) Assuming there are no significant delays can I really expect to get everything submitted and approved in 45 days? I'm considering HumanaOne and UnitedHealthOne.

2) Any updates on Humana or UHC? I'm leaning toward UHC because that's what we have now. However, the Humana quote is $100 per month less! Both of these are for $10k deductibles.

3) Anything I'm overlooking?

[dgoldenz]

Humana's phone application is usually approved the same day you apply, UHC usually takes 1-2 weeks. Both could take longer if they require any medical records or a paramed.

UHC requires the effective date to be at least 15 days from the time you apply and will go a max of 60 days out, Humana 45 days out.

Other than provider networks, their benefits are similar on HSA plans, exactly the same from what I can tell other than maybe some fine print inside the policy. Be aware that UHC doesn't cover mental health unless your state mandates it. UHC also has the deductible credit for each year you don't meet your deductible, but since your policy won't be in effect until August 1, it wouldn't be reflected in your policy until January 2013. Your policy has to be in effect by June 30th to get credit for the current year.

[Buckeye]

Our Humana policy was approved almost immediately. They must only check some database. They couldn't have contacted any of our doctors for additional info of which there was virtually none.

[JOHNNIE36]

We've had United Health Care now for three years; however, it's a Medicare Advantage Plan and I like it. You have to Medicare eligible to have this plan so maybe my comments wouldn't mean much so I will pass. Now, if you're 65 or older I can offer some advice.

[Corporate ORphan]

STAY AWAY FROM UHC. They are incompetent. We applied to them and it took about a month. It was a nightmare. We both felt like we had been raped. We ended up going with BCBS who approved us for the quoted rate in less than a week and have been very easy to work with. They also ask for a lot less history. Among other things UHC did:

- They called repeatedly asking the same questions.
- THey put a rider on the policy that they wouldn't cover anything to do with our GI/intestines because we each had one polyp removed during a colonoscopy. With this rider they still upped the rate by $125 a month and we don't take any medications, are healthy (correct weights, BP, etc.) with no chronic conditions. The UHC rep (not the my broker) told me almost NOBODY gets the quoted rate.
- They sent letters to the WRONG address, including a copy of our insurance form, which included 10 years of health history. Luckily, we did not have our SS# on the application (you do not need to give it to file for private health insurance even though they asked for it) and the address they sent it to doesn't exist. THe post office said they would have just sent it back to the sender. We never got any confirmation from UHC that they had it back. Just a letter of apology for their incompetence.
-THey charged our credit card before approving us and then when we declined their offer they wouldn't just give us a credit. We had to pay the cc bill and they issued us a check (which we did get in a timely fashion).
-You have to give them access to deduct the premiums from your banking account or you pay a large fee to be billed. There are no other ways of payment.
- When they bought GOlden Rule they dropped all the individual policy holders and said "good luck". My hairdresser had 60 days to find new insurance.

We see this as a blessing that we found out BEFORE we actually had the insurance. If it's this hard to give them our money, how hard would it have been to get a claim paid?

I am seriously thinking of filing a complaint with our state insurance commission.

[dgoldenz]

Quote:

Originally Posted by Corporate ORphan STAY AWAY FROM UHC. They are incompetent. We applied to them and it took about a month. It was a nightmare. We both felt like we had been raped. We ended up going with BCBS who approved us for the quoted rate in less than a week and have been very easy to work with. They also ask for a lot less history. Among other things UHC did: - They called repeatedly asking the same questions. - THey put a rider on the policy that they wouldn't cover anything to do with our GI/intestines because we each had one polyp removed during a colonoscopy. With this rider they still upped the rate by $125 a month and we don't take any medications, are healthy (correct weights, BP, etc.) with no chronic conditions. The UHC rep (not the my broker) told me almost NOBODY gets the quoted rate. - They sent letters to the WRONG address, including a copy of our insurance form, which included 10 years of health history. Luckily, we did not have our SS# on the application (you do not need to give it to file for private health insurance even though they asked for it) and the address they sent it to doesn't exist. THe post office said they would have just sent it back to the sender. We never got any confirmation from UHC that they had it back. Just a letter of apology for their incompetence. -THey charged our credit card before approving us and then when we declined their offer they wouldn't just give us a credit. We had to pay the cc bill and they issued us a check (which we did get in a timely fashion). -You have to give them access to deduct the premiums from your banking account or you pay a large fee to be billed. There are no other ways of payment. - When they bought GOlden Rule they dropped all the individual policy holders and said "good luck". My hairdresser had 60 days to find new insurance. We see this as a blessing that we found out BEFORE we actually had the insurance. If it's this hard to give them our money, how hard would it have been to get a claim paid? I am seriously thinking of filing a complaint with our state insurance commission.

It's a good thing you've never had to talk to CareFirst. I think they've taken 5 years off my life already.