lois t Tcn

This review is from a real person who provided valid contact information and hasn't been caught misusing, spamming or abusing our website. Check our FAQ

Verified Reviewer
| map-marker Minneapolis, Minnesota

Failure to provide coverage multiple denials of covered claims

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full

Member of Ucare for many years. All premiums are auto-pay through my checking account.

Hospitalized on March 28, and repeated hospitalizations and TCU care until 5/18. UCare has sent multiple denials of coverage for various reasons. Out of Network, Coverage not in force, now, they have sent a denial for lapse in coverage, even though premiums have been deducted automatically every month, with no returned premium. I moved to northern Minnesota from Minneapolis to be closer to family and help due to my recent extended illness and the necessity for rehab.

I informed UCare of my new address in late May and was told that my Classic plan would not cover me in Northern Minnesota. I applied for a new plan, the Complete, which was cheaper by $73 per month, but had similar coverage and co-pays. The new plan was effective 6/1/2023. Both plans have the same policy number.

UCare deducted the June Premium but used the old plan premium amount, resulting in my overpaying $73.00. Okay, they can't refund that money but hopefully will remember to apply the overage to my July premium. Not holding my breath. My main problem is that because of the change in plans, UCare has denied numerous (35 pages) claims that were covered under Classic, for various and erroneous excuses, (Out of Network, Coverage not in force --prior to 6-1) and now they have informed one of the providers that my coverage lapsed from 4/30 to 6/1.

That means that the provider is billing me over $9000 as private pay, and I have 30 days to pay or it will be turned over to collections. ,,, I have spent hours on the phone with Ucare and providers trying to clarify and rectify these problems, UCaew has informed me that they will send the claims back for reprocessing (research), however, this process is now taking up to 90 days. BTW that 90 days is up from the 10-14 days they told me on May 28th, and that one claim is still not reprocessed.

Reason for problem..."Well, you did move". or System Glitch.

View full review
Loss:
$15000
Cons:
  • Really bad customer service
  • Really poor claims handling

Preferred solution: all claims paid before my credit is affected. "System Glitch" fixed. Apology.

User's recommendation: There probably are companies out there that can provide better customer service and claims handling.

1 comment
Guest

I agree. They are rude incompetent and left me without medication although I had a grant a pre authorization prescription.

Talked to two supervisors antonette and Tenisha.

They have no manners and should be banned from cs. Speaking to their supervisors was denied

Insurance Expert Talks

Exposed: Types of Insurance Scams and Fails

Mar 7, 2021

In this video interview, Charles R. Gallagher, an attorney, explains what sort of insurance fraud happens with consumers. Find out more about insurance fraud, the worst cases discovered, and how to protect yourself from insurance scam.

Read full article
Charles
Charles

Charles R. Gallagher, an attorney and managing partner with Gallagher & Associates. His practice focuses on insurance litigation, foreclosure defense and consumer law.

Why Trust Reviews on PissedConsumer?

  • Professional auto and live moderation
  • 100% user-generated content
  • Equal opportunity and protection
  • Zero tolerance for fake reviews
  • Verified content
  • PissedConsumer is on the Inc. 5000 list

For more information read Blog article