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Business Profile

Health Insurance

Humana, Inc.

Complaints

This profile includes complaints for Humana, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see

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Humana, Inc. has 57 locations, listed below.

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    Customer Complaints Summary

    • 294 total complaints in the last 3 years.
    • 119 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:08/28/2023

      Type:Billing Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      On March 28,2023 I was visiting with family and friends in Ontario, Canada when I experienced a spontaneous spleenic rupture. I was transported on an emergency basis from Welland Hospital to the Niagara Falls Hospital and then to the St. Catharine’s Hospital where a medical team was available to do the critical surgical procedures ! On April 14 I was flown from Toronto to our hospital in Naples , Florida. I remained in hospital for additional procedures and care . After a week I was released to home and doctors’ office care which continues now. Till this point our health insurance provider Humana has payed none of the expenses related to the emergency I experienced in Canada . We have paid two of the bills ($1100 approx Can funds to avoid Credit Bureau Reporting . Humana has assured us that the emergency related expenses are covered under our policy. They indicated that they haven’t received the information regarding the charges in Canada even though we sent them twice, the second time they picked them up at the Post Office and signed for them because we sent them registered! When we call Humana by phone we receive conflicting opinions and directions. They did finally admit that they did receive the requested documents.. but still no payments . The Canadian Hospitals and Doctors ( doctors bill separately in Canada) are calling us directly now . Humana seems to have gone silent. Today we are sending another package of documents related to the doctors expenses in Canada since Humana claims they don’t have them . Our communication with Humana seems to involve conflicting information, denial in the face of fact, and a failure of communication from them to us. We call them ! HELP Humana must pay their portion of the emergency hospital and doctors expenses. I

      Business Response

      Date: 10/27/2023

      Due to not having an AOR to send the letter thru the BBB we sent the letter directly to Mr. ****. 

      Customer Answer

      Date: 11/21/2023



      Complaint: ********

      Humana associates previously told me to go ahead and pay the invoices I received from the Doctors in Canada and then Humana would reimburse me when I provided the receipts.  I have provided those receipts and still expect to be reimbursed the $7355.15 that I paid to satisfy those invoices.



      Sincerely,



      ******* ****

      Business Response

      Date: 11/22/2023

      The response is being sent directly to Mr. ****. 
    • Initial Complaint

      Date:08/18/2023

      Type:Service or Repair Issues
      Status:
      AnsweredMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I am low income , on Social Security Disability, and I receive full Government help paying my prescriptions. I have been disabled for 20 years, with Humana for at least 10 of it, and Have never had to pay for than couple dollars for my one prescription a year. Humana sent me a letter last september, stating that i would have to start paying 13.65 a month. I called the immediately and asked them why I had to pay. They looked at my records and agreed it was mistake to send letter, the Government covers me fully. Today, August 17th, I got a letter from Humana stating that I owed 107.20 cents and that if I dont pay it, My prescription coverage will end in October. They never sent any bills before , for 13.65 or any other amounts. I contacted them again, and although the reps could see that I called about this before, that my cost was determined by my social security amount. I talked to a supervisor who thought it was very strange that there been no bills sent out before, but still insisted that I owed the money. He did say they would investigate. I called Medicare and Social Security, both verified that I receive full prescription coverage and nothing should have changed , I should not be charged anything. Seems to me to be some sort of extreme mistake or really bad scam. Either way, they pissed me off and are wasting three hours of my life showing them they are wrong.

      Business Response

      Date: 08/25/2023

      Upon receipt of this
      inquiry, a thorough review of the issue was completed. Outreach was made to the
      Humana Medicare Billing Team, and it was determined that you currently have a
      balance of $120.60 for your PDP plan. In the beginning of 2023, four states
      began having a premium greater than zero for 100% LIS (Limited Income Subsidy)
      eligible members. That included California, Indiana, Kentucky, and New York.
      Your 2023 premium for your Humana Basic RX plan is now $13.40 per month.

      Customer Answer

      Date: 08/28/2023



      Complaint: ********



      I am rejecting this response because:
          I have already talked with The Board of Directors and they agreed to waive the 120 dollars. Although The fee will be charged for Oct - Dec.  they also said.   If the business has any questions,  I urged them to reach out to the

      board of directors and ask them.   As Of right now, I have no balance due to Humana,  If the business doesnt  agree , I will contact the Board of Directors, once again.  I have all of their emails.  So, look and make sure the balance is 

      still what you say and then contact board of directors. If they say they dont know what  I am talking about , I will take the time to contact them, again, Since i just talked to them two days ago, maybe you dont know?  Anyways, Let 

      me know soon before I switch to Silver Script. As far as I am concerned , the case is closed.  If you think other wise call me.


      Sincerely,



      ***** *****

    • Initial Complaint

      Date:08/16/2023

      Type:Billing Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      Had knee replacement on 6/22/23 which was pre approved by Humana Medicare Advantage. **** was filed and received by Humana by Resurgens Fayette Surgery Center on 6/27/23. I have spoken with Humana more times than I can count about completing this claim as I can recover my co pay of $325.00 from a medical spending account but not without an EOB which I cannot get until the claim is paid. They have lied to me, told me innumerable different stories of how the claim is being paid tomorrow, it is in review, it is pending, one after the other. On 8/15/23 I checked the claim status and it was marked "completed" on 8/14/23 and an amount shown they paid. I asked when the EOB would be ready and was told 24-48 hours. I checked this morning, 8/16/23, and it was put back "in review" status. I called and spoke with a supposed supervisor who told me that there was a wrong code (*****) so they were waiting on the surgery center to correct same. I spoke with the surgery center insurance person, ****, and she told me today that they did not submit that code at all and that Humana had requested my records on 8/8/23 which they sent that day. I am so angry and frustrated that no one can tell me the truth about this with Humana. I called their Corporate office and asked to speak with someone whom I could file a complaint with and was put to the claim customer service department again.

      Business Response

      Date: 08/25/2023

      Humana has 60 days to
      process participating provider claims and claim number **************** was
      processed on day 50; therefore, there was no delay in processing the claim. I
      was able to obtain a copy of the EOB for claim number ***************** Attachment
      A is a copy of the EOB.

      Customer Answer

      Date: 08/28/2023



      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.




      Sincerely,



      ****** ******

      ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 
    • Initial Complaint

      Date:08/08/2023

      Type:Order Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I'm the POA of my sister who's has been in a nursing home for the last 4-5yrs due to two **************** ********** **** **** ***** ********** Humana and other companies calls into the nursing home to solicit patients to sign up for their programs and this is what the issue is about. Most of the companies are taking advantage of these patients by getting them to sign up for these Medicare Advantage programs and most of the patients have no idea what they're signing up for, nor what they are signing, period. My sister has been signed up with Molina Health Care for the last 2-3yrs, maybe 4, and I'm the one who signs her up, as well as all of her other papers/info, because not only am I had POA, I'm her sister and I'm the one who placed her in the facility due to her illnesses.

      ****** is not only with many illnesses, including ****************** ************ ***** ******* ********** *** ** *** *******. .I continue the plan for my sister ****** ******* with Molina Healthcare plan for this year, but finds out a few months later (April/May 2023), that she was signed with Humana without my consent. Some way, they either came into the facility and/or called her in her room to solicit the plan without my knowledge, and she never told me, because she thinks what she's doing is OK. She has no idea or forgot she was already signed with Molina Healthcare. When I found written documents in her room upon a visit, I asked her if she remembers when she signed up with Humana. She couldn't remember and even stated that she didn't.

      I wrote Humana on June 29, 2023 (copy attached) and to this date, I haven't heard from them. No one has gotten in touch with me when they should. They should not be contacting my sister who has no idea what day it is, so she have no idea what she's signing up for, and everything should go through/by myself and/or her younger daughter, who is also one of her POA. Humana didn't go through either one of us. I wanted her to stay with Molina healthcare.

      Business Response

      Date: 08/28/2023

      It was determined that the member was enrolled into the Humana plan, effective May 1, 2023, per the application signed on April 24, 2023. Humana received a
      disenrollment request from the member's sister on June 30, 2023. The request was reviewed, however, there was no member signature on the request, nor do we have a valid Power of Attorney (POA) on file. The member is eligible for a cancellation of enrollment case effective date May 1, 2023, for the Humana
      plan. However, we need to have a copy of the POA on file since the member did not sign the original request. Once we receive the POA documents we can process the cancellation request, and the member would be reinstated back into her previous plan upon CMS approval.

      Customer Answer

      Date: 08/29/2023



      Complaint: ********



      I am rejecting this response because, not only did I forward a letter, as well as a copy of the POA papers signed back in 2012 for ****** ******* over to Humana, along with other forms of documents showing that I'm over and handles ******** legal/life issues when it comes, all the way to this day/date. Not only that, those same POA papers are (attached now) was also forwarded to BBB as well on August 21, 2023 @6:55pm. I keep my records of any/everything I do.


      Humana is trying to hold on to a plan that they obtained illegally and I will challenge it in legally in court if I have to. I know for a fact my sister did not forward a copy of the enrollment to Humana in the mail. Someone had to call her over the phone or go in person to her nursing home to her bed and make her sign those forms and she had no idea what she was doing/signing. She already had insurance at that time and is in no reasonable state to change it or know what/why to change it. She just does what she's told without thinking due to her illnesses ********************* I dare someone/or a company think that they can comes in and I help themselves to someone I help care for and take advantage of them, all for greed and to obtain a sale. Not on my watch!

      Sincerely,

      ***** *********

       

      PS:  For some reason this won't allow me to attach some of the forms. It's stating that it's too large to fit within this message. So I need another way to forward another copy of the POA, it's in about 5-6 pages.

       

       

       

       

       

      Business Response

      Date: 09/01/2023

      It was determined that the member was enrolled into the Humana Gold Plus ********* plan, effective May 1, 2023, per the application signed on April 24, 2023.
      Humana received the member's POA documents and a valid written disenrollment request on August 24, 2023. The disenrollment request was processed, and the
      member was disenrolled from her Humana Gold Plus *** ********* plan effective August 31, 2023. A retroactive cancellation request has been sent to Medicare to have the member’s Humana Gold Plus *** ********* plan cancelled effective May 1, 2023, so that she can return to her previous carrier. The enrollment will still show active, from May 1, 2023, through August 31, 2023, until a case decision is received from CMS. This can take 60-90 days to be received. This is to prevent Access to Care (ATC) issues and Claims processing issues, while waiting for the member to be reinstated into her prior carrier. A letter is being mailed to the member dated September 1, 2023, informing her of the retroactive cancellation request.

      Customer Answer

      Date: 09/05/2023



      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 thus far, as long as no other Rep doesn't sign my sister up again behind my (family) back, because someone visited her today.

      I received a call and was informed by my sister @11:45am, as well as the nursing home staff that someone supposedly from Humana **** ******* came by to visit my sister again and had her do some form of signature with her thumb print; why? Now I'm not sure what that was about, because I wasn't there and my sister doesn't know why she thumb print some computer/some form of ipad. Was this because she couldn't sign otherwise or were she half-asleep from medications taken? No one should have been there yet again in her room, getting her to sign anything, nor review her chart, which the staff alerted me it had been done, because they didn't know any better. The nurses are not aware of my fight with Humana, but a couple staff members in the financial/social services offices are, due to my sister (****** *******) signing with multiple advantage programs, because she knew no better. So, I'm hoping I won't have to start this fight all over again. 




      Sincerely,



      ***** *********


      ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 
    • Initial Complaint

      Date:08/07/2023

      Type:Product Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      In July 2023, I specifically ordered the following blood pressure model:
      A&D Deluxe Pressure Monitor, Model UA-651 which is an approved model by the American Heart Association and uses Bluetooth.

      But instead, it was switched to Medline Elite Automatic Blood Pressure Monitor Model MDS3001U.

      I was told these blood pressure monitors were comparable but they are not. The blood pressure monitor I ordered is Bluetooth with a 5 year warranty. This means all my readings will automatically pair to my iPad app. The one switched cannot be used with any app and has a 2 year warranty.

      No where did it say on the online store purchases can be switched for a different model. Even my purchase confirmation had the image of the A&D model. I specifically researched the A&D Deluxe Pressure Monitor, Model UA-651 which is the one I ordered. I really would like that model or a refund. Trust me, not all blood pressure monitors are equal. I did reach out several times to Centerwell Pharmacy Customer Service but have had no response. They took my info and said someone would be in touch but as of today, I have not heard back.

      Business Response

      Date: 08/21/2023

      Attached you will find the company's response.

      Customer Answer

      Date: 08/21/2023

       

      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.




      Sincerely,



      ***** **********

      ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 
    • Initial Complaint

      Date:08/02/2023

      Type:Delivery Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      Humana/careneeds plus false mislead me on two occasions that my essentials money card was mail out and I never received it in months recently they told me the same thing and I never received it on the second occasion I was misled so Humana can take over my insurance while falseing me to believe you will get more in return I never received my food card essentials card from Humana while they sent others there card in 10 days but I’m not getting mines 10 days or nothing. Most importantly I’m hungry and needs to buy my food so I need my card that I was promised

      Business Response

      Date: 08/11/2023

      Please see the attached response

      Customer Answer

      Date: 08/12/2023

       

      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.




      Sincerely,



      ********* *******

      ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 

       

      I accept the business response thank you

      ********* ******* 

    • Initial Complaint

      Date:08/01/2023

      Type:Sales and Advertising Issues
      Status:
      ResolvedMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I continue to receive phone calls on my phone numbers at ************ and ************ claiming to be from "Humana". They generally call my home phone when I am either working or sleeping. I have continually told "Humana" to not call me at either of these numbers, and I have also reported them numerous times to the National Do Not Call Registry. I need Humana to permanently put it down in their systems not to call me at either of these two numbers, as I have not given them any form of authorization to call me at these numbers.

      Business Response

      Date: 08/08/2023

      Please see attached response.

      Customer Answer

      Date: 08/08/2023



      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.




      Sincerely,



      ********* ******

      ***If you are happy with BBB's free services, please consider giving to BBB's Consumer Education Fund, which provides other free services to the community, like Charity Review, Identity Theft Seminars, Free Shred/Recycle Events, Senior Citizen programs, High School and College Programs, and providing information at local community events. Donations can be sent to: BBB Consumer Education Fund, 13104 Eastpoint Park Blvd., Louisville, KY 40223. For more information on these programs, call 800-388-2222. Thank you for your consideration. 
    • Initial Complaint

      Date:07/28/2023

      Type:Billing Issues
      Status:
      AnsweredMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      see attached

      Business Response

      Date: 08/04/2023

      Please see the attached response
    • Initial Complaint

      Date:07/27/2023

      Type:Service or Repair Issues
      Status:
      AnsweredMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      On January 17, 2023 I had a dental procedure done at Tri-State Dental . The dental office faxed
      the statement to Humana Dental insurance for payment. Humana did not allow a payment. The dentist is out of network so the payment should have been 70% of actual. Since then I have contacted Humana customer service about 7 times trying to get reimbursement for the dental bill which I paid. Humana refuses to do anything about my requests. The amount i want for reimbursement is $188.30.

      Business Response

      Date: 08/09/2023

      The company indicated that it responded directly to the customer.
    • Initial Complaint

      Date:07/24/2023

      Type:Product Issues
      Status:
      AnsweredMore info

      Complaint statuses

      Resolved:
      The complainant verified the issue was resolved to their satisfaction.
      Unresolved:
      The business responded to the dispute but failed to make a good faith effort to resolve it.
      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.
      Unanswered:
      The business failed to respond to the dispute.
      Unpursuable:
      BBB is unable to locate the business.
      I successfully appealed, with Humana, their wrongful denial of coverage for a dental claim. They agreed, and it remains undisputed that they owed me $1,401 but have only delayed payment and even after promising to pay me directly they only later made fraudulent claims of eventually having paid my dentist. I had originally made payment for all service in full to my dentist who properly submitted claims to Humana in the manner that would prompt any reimbursement to go directly to me from Humana. After months of delay after my successful appeal, a Humana representative first lied by claiming the Dentist had wrongly submitted the claim in a manner to direct reimbursement to the Dentist. After investigating with the Dentist, I contronted the Humana representative who then admitted the Dentist had indeed correctly submitted the claim and payment should and would be sent to me directly. It was not sent. After more delay and no receipt of funds, Humana falsely claimed it had records showing it sent the payment to the Dentist. I confirmed the Dentist received no such payment. Humana then provided alleged payment details, method of payment, and info as to how the Dentist must contact their payment processor to sort things out. But the Dentist confirmed it was impossible for them to have received the payment in the manner alleged by the Humana representative and confirmed that with their payment processor as instructed and again reminded Humana payment should be sent directly to me. Moreover, the Dentist's bank records confirmed no receipt of the alleged payment. Nonetheless, months later, Humana has never paid me, notwithstanding their admissions that the money was owed and should have been sent directly to me.
      {I should note the original care, claim and appeal were over a year ago, but the most recent exchanges between Humana and my Dentist and myself, and thus Humana's continued fraud, were within the past year}
      Humana Case Number = *************

      Business Response

      Date: 08/04/2023

      Please see attached response.

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