ComplaintsforUnitedHealth Group

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Initial Complaint
11/07/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have been trying to obtain coverage for a GLP-1 medication for around a year. I work for the state of **** and received notification this year that ******* would begin covering Zepbound. I have been paying out-of-pocket for the medication for the past year totaling $4950 to date. As a consumer, I am stuck in the middle of a never-ending process between my doctor and OptumRx trying to get the medication covered. The process is not consumer friendly and I am constantly calling OptumRx to try to get additional information. This medication is being requested for continuation of therapy with positive results for control of high cholesterol and high blood pressure. The continue use this medication reduce the risk of major cardiovascular events. I can provide information showing my out-of-pocket expenses from ******* pharmacy in ******, **** if needed. I can also submit labs as needed. The last time I called ***** was the most frustrating because now they are saying, I need to have paid claims on file for Wegovy or ******* in order to get Zepbound paid for. However, if I try to request these medications through my doctor, OptumRx tells me Ive exhausted all of my appeals options and Im out of luck for six months. My doctor has tried to have a peer to peer review with OptumRx, who did not call on the date. They were supposed to call for the peer peer review.
Business response
11/07/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Customer response
11/07/2024
I am rejecting this response because:

I signed a consent form when I filed this complaint that BBB could advocate of my behalf.
Business response
11/12/2024
Hello,
We are writing to confirm receipt of the Better Business Bureau complaint received within Optum Consumer Affairs on November 7, 2024. Thank you for bringing this issue to our attention. We want to assure you we are researching the details of your inquiry and will respond to you as quickly as possible regarding your concerns.
Optum Consumer Affairs attempted outreach to ***** ***** on November 7th and again on November 8th, leaving a voice message with our direct contact information.
Thank you kindly,
Optum Consumer Affairs

Customer response
11/13/2024
I am rejecting this response because:
Still in open communication with optum. Have spoken with them yesterday and today and have a call scheduled for tomorrow to discuss further.

Business response
11/15/2024
Hello,
We are writing to confirm receipt of the additional comments by ***** *****. Optum Consumer Affairs is working closely with ***** ***** and will provide updated information as available. ***** ***** has been provided Optum Consumer Affair's direct contact information and is welcome to reach out as needed.
Thank you,
Optum Consumer Affairs
Customer response
11/15/2024
I am rejecting this response because:

Still working towards resolution. Would like this to remain open until resolution has been met. ***** is still reviewing documentation.
Business response
11/18/2024
To whom it may concern,
Optum Consumer Affairs spoke with ***** ***** advising all appeal levels have been exhausted. Pharmacy benefits are to be administered per the plan design, the latest denial explains that all appeals have now been exhausted. Ryver ***** has been provided Optum Consumer Affairs direct contact information should there be any further questions or concerns.
Sincerely,
Optum Consumer Affairs
Customer response
11/19/2024
I am rejecting this response because:

This is not the same information I received last week. Was told optum was reviewing to see if there was another level of appeal for Wegovy since it skipped to EMR. Also, if all appeals levels have been exhausted, it is due, in part, to lack of communication between optum and my physician. Optum never exercised the peer to peer process that was requested by my physician leading to a forced appeals process. this is a main reason for my BbB complaint. Optum claims they are here to help get medications for members yet, do everything possible to blame the physician and member without taking the rightful step of having a peer to peer conducted to clear up and confusion between the plan and physician. Leaving the member stuck without medication. This is also not the only medication that has happened with for Optum. They update clinical coverage criteria with the goal of non coverage. At the end of the day, my plan sent a letter in July stating these medications would be covered. Optum should assist myself and the physician to get what is needed to get it covered. Saying level are exhausted it not acceptable. There is clearly a disconnect here that needs remedied.
Initial Complaint
11/07/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was unfortunately scammed by a *** from *************** several years ago. For whatever reason, *************** would not let me use my *************** card to pay for medical expenses. At the same time, they started charging a monthly maintenance fee for the account. So basically I cannot use the money in the account, and their fees are slowly draining the account. I attempted to get my money out of the account by calling them. Unfortunately, I have to sign up for an account and other services in order to close my account. This is an unnecessary burden aimed solely at preventing me from getting my money. All the while, they are draining my account. I don't want another account or other ********************. I want to close my existing account. I don't understand why it has to be so difficult.
Business response
11/08/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Initial Complaint
11/06/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
One of thr main purpose of getting UHC was because of the rewards. On October 8th I stop getting rewards because thr app would not sync with ****** fit. I spoke to three customer service representative since then. One help me with trouble shooting and another today tried to do the samething. The first ****** told me everything is connected and my rewards would be updated. Then the one from today told me that they would reimburse me the rewards. In addition that she could see my activities on their end. For example the walking. However when I asked how.many steps I did they went around my question. I ****** this problem and it seems like a UHC problem. I saw several people experiencing the same thing. Thus its a problem they are not trying to fix. I want my rewards from October 8th or whenever I stop getting them.
Business response
11/07/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Initial Complaint
11/06/2024
Complaint Type:
Customer Service Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Today, 11/06/2024, I attempted to set up an online account with United ************************** for my new ******** prescription drug plan. I was unable to set it up after numerous attempts as it kept giving me an error message. I contacted customer service via chat and worked with ****,. She said that I had an incomplete account associated with my email address and the web tech team would help me with deleting of the incomplete account. After the deletion of the account I could use my email to register. She said to contact ************ Monday - Friday 6 a.m. to 10 p.m.CST Saturday 8 a.m. - 4 p.m CST and they would solve my problem. I called the number and before they would help me with my technical issue, they tried to sell me a savings plan of some sort and would not move on when I refused to approve a fee the savings plan. I told them in no uncertain terms that I did not want this program and I want to technical support. The person I spoke to said to call him *****, just kept trying to get my information to sell this program to me. I finally hung up on him without my problem solved. What kind of technical support is it when you call and they want to charge you and send sell you some sort of savings program in order to have technical support. I find this very misleading and very unethical to be referred to this number that she had to know was going to be a sales pitch. They need to be reported for such behavior.
Business response
11/07/2024
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollees correspondence and/or a description of the issue, we will be responding directly to the enrollee
Customer response
11/07/2024
Better Business Bureau:

I want to cancel the complaint as I dialed the wrong number. It was all my fault not United HealthCare's. I apologize for causing any problems. ***** *******
Initial Complaint
11/05/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
This business is responsible for billing for the ambulance ride I had to take on September 4, 2024. I have been calling for weeks trying to get a copy of my invoice to submit to the insurance, and every time I call and ask for a supervisor to return my call, they never do. I have no other way of getting in contact with them or another way to file a complaint.
Business response
11/06/2024
This will acknowledge receipt of your complaint to the BBB, complaint number ********. Thank you for bringing this issue to our attention. Unfortunately, we are unable to find a policy for you in our system. Please provide us with your member information. After we receive this information, we will investigate your issue.

Sincerely,
Consumer Affairs
Initial Complaint
11/04/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was IN the hospital. When I got out, as I knew my premium was due while I was admitted in the hospital, I called on a conference call with a member of the healthcare marketplace. We were told as long as I paid on the 1st of November, nothing would be suspended. I paid on the 1st as promised for both October AND November. When I went to pick up my medications, my coverage was suspended and I had to take out a payday loan just to cover my husband's insulin AFTER i paid my premium. I have a recording of a supervisor last Friday, telling me that she was going to call the pharmacy and let them know how to bill it to make it go through. She never called and I had to pay cash. This is fraud and theft! Now today, I have been on the phone for over 4 and a half hours trying to speak with a supervisor. I have been disconnected and called right back, called other numbers I was given an told to call etc. this is ridiculous!
Business response
11/06/2024
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA),I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollees correspondence and/or a description of the issue, we will be responding directly to the enrollee.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ******************************.
Sincerely,

****** *.
Initial Complaint
11/04/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
*** has a program called One Pass Select which gives members who pay monthly to access multiple gyms in the area. I first signed up for the digital version that would give me home workout videos, but after speaking to One Pass, I was convinced that the perks of becoming a premium member would be worth it. One of the perks of becoming a member is a free ******* plus account while I was on the phone with them. We came up with a plan to cancel my previous ******* plus account to put it under my One Pass account when the renewal was up. According to their rules, the premium account doesnt activate until the start the next month so there was a waiting period but they said that after the premium account kicked in, I would be able to cancel my ******* plus account on the renewal date And sign up again but under my One Pass account, which would cover it. They never said this was time sensitive. In fact, they said the opposite. Now they are saying, after I already canceled my previous ******** account (which I would have gotten at a discounted rate upon renewal if I stay with that W+ account) that the offer wasnt valid for W+ coverage. So basically, they lied to me and told me that there would be perks available if I sign up and then they took those perks away; they did this in order to get me to sign up. All I want is for them to keep their word on what would be available.
Business response
11/04/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Customer response
11/04/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Since they cant correspond because of HIPAA, I will place my complaint with HHS and the state insurance department.
Initial Complaint
11/02/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I am filing a complaint against Optum for poor communication and lack of follow-up concerning an urgent request for information. On August 27, 2024, I received a "Second Notice for Information" from Optum regarding a treatment I received at Tysons Emergency on June 4, 2024 (Event Number: PMR 12809061-12810813). This notice explicitly requested that I contact Optum immediately, which I did. However, despite this notice and an earlier one, Optum has not followed up or provided any additional information to address my case.I made every effort to comply with Optum's request by calling the provided toll-free number *************) as instructed. Unfortunately, my calls and attempts to reach a resolution have been ignored, leaving me with no clear understanding of the information they are requesting or how to proceed.This lack of follow-through has caused unnecessary stress and confusion, as I am left uncertain about any potential billing or administrative implications related to my treatment. I request that Optum take prompt action to provide the necessary follow-up, including clarifying the information required and assisting me with any steps needed to resolve this matter.
Business response
11/04/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Initial Complaint
11/01/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was diagnosed with chronic hepatitis C infection by my primary care physician in 10/2024.We decided on treatment with the medication *******. He sent the prescription to my retail pharmacy (a local CVA) who transferred the prescription to their specialty pharmacy in ************. The specialty pharmacy informed me that they needed prior authorization from my physician which he processed and was approved. Once that happened, the specialty pharmacy stated that they couldn't fill the prescription because they were not my insurance preferred pharmacy. I had to contacted my insurance and advised to ask my primary care physician to redirect the prescription to OptumRx (aka BriovaRx). My physician had already checked my hepatitis C viral load (~200K copies), checked for fibrosis (FIB-4 score of 1.0) and the genotype of hepatitis (genotype 6) as per guidelines. Optum Rx refused to fill the prescription unless they were provided with copies of the laboratory tests directly from my physician's office. My doctor's fax was not working and I offered to fax them the results myself but they declined. At this point, I've been trying to get this medication for almost a month and Optum Rx policies and protocols are doing nothing other than delaying my care and putting my health at risk. Since I also have HIV infection, I have a higher risk of rapid progression to fibrosis and as a primary care physician myself, this kind of unnecessary barriers only put patient's health at risk.
Business response
11/04/2024
To Whom It May Concern:

Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to the Better Business Bureau regarding these concerns. Since your letter provided a copy of the consumers correspondence and/or a description of the issue, we will be responding directly to the consumer.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at ************.

Sincerely,

Consumer Advocate
Initial Complaint
10/31/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
They deny all ***** Dental procedures. I need a crown and they keep saying - 50 Percent of the tooth must be missing. The tooth has a large filling and it's cracked.When I called them they said - the narrative wasn't sent in with the request....I know that's not true because I saw what the dentist sent in. My husband went through the same troubles.I'm in pain and I need this work done... when I called them they said it would be another 30 days for them to make a decision. Ref I-450115356 talked to *****
Business response
11/06/2024
Due to the protections of the Health Insurance Portability and Accountability Act (HIPAA), I am unable to respond directly to you regarding these concerns. Since your letter provided a copy of the enrollees correspondence and/or a description of the issue, we will be responding directly to the enrollee.

Should you have any questions or comments, please feel free to call me. I can be reached during normal business hours at *****************************.

Sincerely,
*******

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