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Health Net

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Kathy of Rancho Mirage CA (06/25/08)
Health net insured me for catastrophic health insurance. I had a double mastectomy for breast cancer. They refuse to pay the $70,000 due my hospital. They have been in many law suits over this.

Gender Descrimination... taking advantage of woman when they are sick with chemo and radiation and taking advantage of them. Woman have to fight Breast Cancer and Health Net

Kathleen of Tucson AZ (06/07/08)
I am still waiting a premium refund of $500 for policies cancelled in February. Repeated communications, in the form of email, have reassured me that the refund will occur in less than 3 weeks. My premiums were automatically drafted and the refund was to be drafted back into my checking account. The ironic part of this is that I STILL receive monthly premium notice reminds with a premium amount owed of -$500 - clearly part of their system recognizes that the policy has been cancelled.

I have requested my refund once again and this time asked for interest - probably won't see it.

Thad of La Quinta CA (06/07/08)
Purchased ppo supplement to Medicare on Feb. 1, 2008 (65 0n 2/7/2008). I sent application with credit card # to charge first month (119.00 + 80.00 farm bureau membership. I paid March, April & May @119.00 per month. The company continued to bill me 451.00 each month and never corrected their mistakes. Monthly calls did not get results.

All claims have been denied because of non payment by me even though the mistakes are theirs. So basically, I have paid for 4 months of supplement and are actually uninsured by them. All calls ended in dead ends with the company as they will not correct the accounting and their mistakes.

Sherri of Stratford CT (02/25/08)
I have been a subscriber to HealthNet insurance plan for 5 years. The insurance covers myself and my three year old and I am employed part time so my premiums are fully out of pocket at the rate of almost 13,000 per annum.

My son was diagnosed with speech and sensory problems (Aphasia and Spensory Porcessing Disorder)at age two. My state mandates that children receive early intervention from Birth to Three and that insurance also pay for those services. We paid on a sliding scale and Healthnet paid for the services my son received for speech and occupational therapy.

Healthnet paid this until the day my son turned three (when the state mandate expires) and refused all speech claims from the point he turned three. My son was seen by a Yale pediatric neurologist and diagnosed with Aphasia and was given a prescription for intensive speech therapy

Healthnet has refused to pay for any speech, using a fallout that my son would have had to acquire and then lose speech (for instance by having a stroke) in order to get speech therapy. My son never got the chance to acquire proper speech, hence the speech delay and the need for therapy.

I initiated an internal and an external appeal. I made numerous calls and was told everything from they only paid it when he was two because they had to by law, to just keep submitting claims and see what happens - a veritible dice roll with my son's claims.

My appeals were denied for the same clause that he had to have a stoke or accident in order to get the 30 promised speech therapy sessions in my handbook from Healthnet.

I started an appeal with the State Insurance Commissioner and was told that Healthnet was not consistent in their reasoning for the denial but that the Insurance commissioner was not optimistic about Healthnet coming through for my three year old.

Healthnet discriminates against children with disabilites - how else could we explain the fact they paid the claims for the year they had to as governed by the State and now refuses to honor their policy of paying for 30 speech sessions per year.

We are forced to pay 13k for insurance and 150 per hour for private speech. We are unable to do this. We are unable to help our child get the help he needs and we are completely let down by our insurance company who has no caring or concern what their loose interpretation of their policy does to the health and well being of a three year old child who needs speech therapy and occupational therapy as a medical necessity.

We are considering moving, refinancing or anything in order to get our child what the doctors say that he needs.

Terri of Richmond CA (02/13/08)
My husband and I have had double coverage through our respective jobs working for separate organizations for the past seven years. My husband had Blue Shield insurance for 5 years then Health Net for the past two years. I have been a Health Net Health insurance recipient for the past seven years. I found out last year from another Health net representative that because of our double coverage that we should not have had to pay any pharmacy co-payment even though we have been for at least the past six years. I was told that the benefits should be coordinated through the health plan and for the most part should not have any co-payment. My husband went to our local pharmacy (Lucky Pharmacy in Pinole, CA.) for me last week and came back with my medication and told me that he had to pay a $30 co-pay. I had to once again call Health Net and Miguel once again had to set up the account so that I would not be charged a co-payment. But I am concerned that for all of this time that (almost seven years) that I have had to pay hundreds of dollars in copays that I should not have had to pay.

Marjorie of Sacramento CA (01/31/08)
I was put on Cobra Health Net for a time when I was off work for medical reasons. When Sacramento City Unified School DIstrict Hired me back in November of 2007, they started to cover my Health Net through my pay check. I did not contact Health Net Cobra, because I Health Net is Health Net. Health Net is claiming double payment from me through November payment through Health Net Cobra and Health Net and will not refund me for November of 2007., claiming they have no record of me cancelling. Health Net is Health Net as far as I am concerned and why did I pay 880 dollars for insurance in November?

$445.00 in the hole

Florence of Peoria AZ (10/29/07)
I received a letter from above on August 16, 2007, stating that I would receive a refund for the batteries I had purchased for my electric wheel chair, when I followed the directions of Health Net and called Preferred Home Care for this service. Because I was told that they would take my chair for 4-6 weeks and no loaner, it was impossible for me to use their service, eventhough my policy covers replacement batteries.

I sent a complaint to Kay Smith stating my disappointment with Preferred Home Care to supply me with a loaner chair while they took my chair to replace these batteries. The response letter from Kay Smith apologized for the misinformation I received from Preferred Home Care and stated that a reimbursement check in the amount of $247.00 would be issued in 4-6 weeks. It is now over 10 weeks and I still haven't received this check after numerous phone calls to Kay Smith, I was told to expect it by the end of October, 2007. This is the end of October now and the check still isn't here.

Health Net, also does not have any specialists or primary care doctors in Peoria and I must depend on AAA to take me to my doctor's appointments. They have caused me to miss at least 3 of these appointments by showing up long after my appointment time, eventhough they schedule my pick up time at least 2 hours prior to when they arrive. I have asked for an out of network specialist, since the first one they sent me to was extremely offensive and I didnt want to see him again. I was denied. I, then, called the appeal board to get a 72 hour decision, since my illness is life threatening and I needed a specialist (endocrinologist) immediately for a mass (thyroid) that is grossly large and causing breathing and swallowing problems. Rosie told me that I had to write to the appeals board, even though I explained the urgency of having an over the phone appeal. I received a letter from this appeals board which stated that they would respond within 30 days. Health Net's endocrinologist specialists are all in the same group or clinic, therefore, when I called to see another specialist at that group I was told, their policy is that if I don't want to see the original specialist I had seen, they would not allow me to see another specialist in their group. I reported this to Health Net and was told, perhaps, you should find another health plan. I plan on doing this, but, unfortunately, I cannot change my plan until November 15th, which is the date anyone can change their plans. So, I am left with this life threatening illness until then.

The very real possibility of choking to death.

Kim of Orange CA (08/08/07)
My place of employment changed health insurance companies back in January of this year and due to my previous medical history I had to switch from HMO to PPO so I could keep my same doctor's that I was being treated by. I go in for PET Scans and CT Scans about every 6 months because I had stage 3 Melanoma and could not do chemotherapy. On July 25, 2007 I went for my 6 month visit to my Oncologist and they ordered me to have a PET Scan.

I was told that even though I have PPO insurance I still had to wait for an authorization. I received a letter in the mail on August 6th stating that they were denying the authorization because they feel that it is not necessary for me to have this scan done because my cancer has not come back in 4 years. I called Health Net on August 7th to file an appeal and I stated to this woman who didn't tell me her name that this was part of my treatments even though my cancer is currently gone. She stated to me that she would give the appeals department my information and it could take up to 30 days to get any response.

In the meantime I contacted my Oncologist and he called my insurance company to get it appealed also. My Oncologist was told Health Net will not cover this test because it is just for surveillance it is not for a reason which is absolutely untrue. Just because my cancer is currently gone does not mean these tests are unnecessary at this time.

If I have to pay for this PET Scan out of my pocket completely it will be at least $2,000.00 if not more and me being a single woman living on my own that is not financially possible.

This has caused me unneeded stress and grief and it is totally and completely wrong. How dare an insurance company that I am paying out the nose for tell me that my life or health does not matter just because cancer is not present at this time. I assumed that because I pay for PPO insurance that I woul dbe treated a little better, I guess not.

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