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My doctor confirmed that I'm pregnant a few days ago, 7-8 weeks along, high-risk. I immediately started to look for obgyn's that participate with my insurance. Initially I saw a long list of obgyn's and started calling them according to ratings I had found. It turns out that the majority of the doctors (more than ten) on the list of obgyn's weren't obgyn's, or had since stopped practicing the ob part. I found this to be a common issue. Then I called two more that hung up in mid sentence. The two I was left with were ones that had plenty of horror stories from previous patients online...really bad in every way. Five hours waits in hot waiting rooms, rude staff and arrogant doctor, one was supoenaed (spelling?) while the patient was in the waiting room, some didn't run tests enough, took forever to get results, rushed visits, unanswered questions, etc., not submitting the claims to insurances and making patients pay instead etc. One felt that the lack of quality of care actually caused her child's death. There's no way I would go to those places with so many overwhelmingly bad reviews.

I called my insurance rep for help a couple of times, and they kept rattling names off to me from the same list on their site of the list of doctors. I knew more about the status of their doctors than they did. Why doesn't anyone there take the time to call or visit the doctors on their plan each year and ask them if they still perform the services and intend to continue to do so for the next year in order to keep the list of doctors updated and accurate? Every time they mentioned a name to me, I was able to say "Doesn't practice that specialty anymore", "That doctor went on her own and doesn't practice with the other two any longer, and she no longer practices the ob", "That doctor doesn't deal with pregnancy, they deal with cancer and hysterectomies", etc. It going on like that. The rep asked me if I expanded my search, and by that time I had expanded my search to 25 miles away from home. She said I may qualify to switch to their ppo plan, but this company and their deceit lost my trust.

My husband looked up new insurance and said it wouldn't be effective until September...entirely too long to wait for my first visit to an obgyn with a high-risk pregnancy. We're stuck with this one. Thankfully one doctor's office that I liked and had called and left a message for, but took days to get a callback, contacted me and I have an appointment. But for that doctor, I had to call his other locations to get them to call the ONLY location they practiced obgyn services at to get them to contact me. Otherwise they didn't return calls. I will be switching insurances after the baby is born. DO NOT use Humana. Most of the doctors on the list don't actually practice the specialty, others are too hard to contact, and otherwise you're left with the really bad doctors that have a one-star rating with many people leaving essays worth of bad reviews for. I'm actually wondering if I could report Humana for fraud because of all of the doctors they list, knowing the list is outdated, and they're aware their list in inaccurate. After reading other comments on here, apparently people have the same problem with finding doctors in all specialties, etc. with Humana.

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Anonymous
#856649

This will be my last update to my original post above.I've continued to have problems with Humana and the welfare clinics that I have to go to (no other doctors).

I'm now 11 weeks pregnant and still no ultrasound, etc. I've seen a nurse practitioner at a welfare clinic once, but the administration at this place also didn't get my referral for my ultrasound until over a week later. They told me that they sent it to the place I'm supposed to get my ultrasound at, but we shall see. I just wanted to write this last update to let people know that there's a way out of having to be stuck with Humana until the open enrollment period starts.

Call healthcare.gov (Marketplace) and present your case to them. You must have a life qualifying event in order to be granted special enrollment, and it isn't as easy as you may think. Write every detail of every problem down, including that you need a certain specialist and that the list of doctors on the site weren't actually real (i.e., my problem with not being able to find a real obgyn on the list of doctors that Humana provided. Sure, there was a long list, but most weren't obgyns anymore).

This is misrepresentation, and to be blunt, fraud. But normally, what is considered to be a life qualifying event is if you lose your insurance at no fault to yourself, birth/pregnancy, divorce, relocation, and things along those lines. The full list of what a life qualifying event is, is listed on healthcare.gov. If you have...

If you aren't able to reach your doctor's office when you continuously call, or they never call back, etc., mention that. I actually told the representative that I felt that Humana committed fraud by listing doctors that aren't real on their site. . .basically ones that don't practice in that particular field of specialty any longer.

The first lady my husband and I spoke to only helped us fill out an application for the Marketplace over the phone and she said we didn't qualify. My husband asked to speak to her supervisor, and after explaining our situation to that person, that I'm pregnant (which qualified me), high-risk, and then mentioned all of the problems with Humana, and the only obgyn I could go to was 20 miles away, etc., we were granted a special enrollment period. Even if you aren't successful with your first call, try again. You'll get someone different who may know more and be able to help you.

My husband and I had a long conversation about it with a very knowledgeable representative from Blue Cross Blue Shield, the insurance we've switched to, and this is everything he told us to do.

My husband called to cancel Humana today, and because I've seen comments from people who have had problems with canceling their policy with them, my husband took a few more steps. He demanded that they delete his credit card information, sent Humana a certified letter stating the termination of our insurance, and he went to the bank to cancel any future bills that will come for Humana, which will make the bank manager personally responsible for them. Our new insurance is effective on September 1st, and while the premiums may be more, we will get to see real doctors and have a large selection, we won't have to worry about Humana denying claims or not paying the doctors (common complaint I've read), and the coverage is better overall.

The number to the representatives at healthcare.gov is: 1-800-318-2596. I hope this helps anyone who reads this!

Another good insurance company my husband and I were looking into was Cigna (depending on the plan), otherwise, I don't know anything about the others.Good luck!

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Anonymous
#851161

I'd like to add to the post that I wrote above.I'm noticing that the ONLY doctors that seem to participate with Humana are welfare clinics.

I have nothing against them, but at the same time, they don't have the equipment needed to monitor my pregnancy. Also, I'm sitting in a room full of people with various health issues rather than just my obgyn. I'd like to avoid the worst of the illnesses when flu season rolls around, or when there's a higher volume of people with other contagious illnesses (step, etc.) during certain times of the year.

I also feel my doctors don't take me seriously because of my insurance.

My PCP kept telling my husband and I that our referrals took 14 days, but when my husband called Humana, they said three days, tops. We also found out that our doctors didn't submit requests for referrals for things my husband and I needed checked out. I was able to find an obgyn, but my obgyn is also at a welfare clinic and isn't equipped with equipment such as ultrasound machines, etc. to monitor pregnancies.

Because of this, I have to wait for a referral to an outside place that can do the ultrasounds...only to find out today when my husband called Humana that no referral request had ever been submitted for me to get an ultrasound. I feel that if my husband and I don't change insurance companies now that I'll be stuck going through this entire pregnancy with no monitoring. The only doctors that participate with this insurance...

Please don't get this insurance because doctors are dropping like flies, and you'll be left paying over $600 per month in premiums only to see bad doctors in welfare clinics whose staff will not submit referral requests.You'd be treated better if you were on Medicaid instead.

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