Business Profile

Health Insurance

UnitedHealth Group

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Complaints

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

Customer Complaints Summary

2,822 total complaints in the last 3 years.
1,074 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.

Initial Complaint
Date:10/24/2024
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 receive regular, ongoing monthly care from a healthcare provider. In the initial submissions for reimbursement of these services, *** repeatedly asked for me to give them the provider's *** and W-9. I provided that information -- multiple times. They nonetheless denied reimbursement, repeatedly asking for this information and saying that the lack of that information is why they couldn't reimburse me. Eventually, they started reimbursing for these services. But, I still have 9 of the original bills that they denied while we were going through this repeated request for the *** information. I have appealed these denials, and they have lost the appeal information in their systems -- the claims department and the appeals department do not have information systems that can share information, and so the claims department can see that I appealed but the appeals department has nothing. They would like me to resubmit the appeal -- by fax machine, or regular mail. The expenses at issue were from *********, so the amount of time this has taken me is unacceptable.This is a process that is obviously and intentionally designed to make it difficult to be reimbursed for eligible medical expenses.
Business Response
Date: 11/15/2024
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 Answer
Date: 11/18/2024
I am rejecting this response because they have not done anything. I received a generic, automated email from UHC 3 days ago (so a month after I complained to BBB) asking for more information, but that is it.

Business Response
Date: 11/19/2024
Hello,
Optum Consumer Affairs contacted ****** ********* via email on November 15th, and again on November 18th, requesting additional information. We are unable to proceed with further research until we receive the following information:
Member Name (for the claims in question)
Provider Name
Individual dates of service
By providing us with this information, we will be able to investigate the specifics of your claims and address your concerns more effectively.
Thank you kindly,
Optum Consumer Affairs
Initial Complaint
Date:10/24/2024
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 filing a complaint against Optum Rx, Surest, and UnitedHealthcare for their gross negligence in handling my urgent appeal (Plan Member ID: ************, Case Number: PA-D7927745). Despite submitting my urgent appeal on October 11, 2024, along with multiple follow-ups via fax to the designated urgent line (with confirmations of receipt), my appeal has been completely ignored. California law mandates that health insurance providers process urgent care appeals within ***** hours ***** Code Regs. t** 28, *******). Despite this requirement, I have not received any response or update. Furthermore, I have spent countless hours on the phone being transferred between departments, with no one taking responsibility for the status of my appeal. This has not only been frustrating but has also jeopardized my urgent medical needs. I am legally entitled to a timely response to my urgent appeal, and your continued failure to comply with the law constitutes a breach of contract and failure to act in good faith. If this issue is not resolved immediately, I will have no choice but to escalate this matter further, including but not limited to filing formal complaints with the **********************************, seeking legal action for damages, and pursuing all other remedies available under state and federal law.I expect an immediate resolution and request a response within the next 24 hours, acknowledging this complaint and providing an update on the status of my appeal. I trust that you will treat this matter with the urgency and seriousness it deserves. I am not comfortable attaching my appeal packet to this complaint as it is public but am happy to email a copy of the appeal packet that I have faxed numerous times. Plan Member ID: ************
Business Response
Date: 10/28/2024
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,

****** *.
Customer Answer
Date: 10/29/2024
I am rejecting this response because:

It is absolutely unacceptable to state that I have exhausted all internal appeals when I have submitted only one. The handling of my case was not only inadequate but also reflects a failure to properly review the documentation provided. If the review team had taken the time to consider the facts, they would have recognized that my doctor prescribed the medication for prediabetic treatment, not for weight loss, which is the reason for the denial.

Moreover, I must address the serious concern of discrimination based on my weight. It is deeply troubling that the review team appears to be making assumptions about my medical needs based solely on my physical appearance and weight that is recorded in medical documents. This practice is not only discriminatory but also violates several laws, including:

******* Civil Rights Act (Civil Code 51)**: Prohibits discrimination based on physical characteristics.
**California Health and Safety Code (Health & Saf. Code 1257)**: Emphasizes the right to receive appropriate medical care without discrimination based on physical characteristics.
**Health Insurance Portability and Accountability Act (HIPAA)**: While primarily focused on privacy, improper assumptions made by healthcare providers or insurers about a patient's medical needs can lead to violations of confidentiality and the obligation to provide care based on accurate medical information.

I want to make it clear that I am currently in the process of contacting the ******************************** regarding this matter. Additionally, I will be filing complaints with the **********************************, as well as the U.S. Department of Health and Human Services (HHS), and also *********************************************** (NAIC).
Business Response
Date: 10/31/2024
UnitedHealthcare has responded directly to the member regarding the specific concerns detailed in this complaint on October 28, 2024. We thank you for providing us with the opportunity to address this concern.

Should the complainant have additional questions or comments after receiving our response, please kindly request the complainant contact me during normal business hours at ******************************.

Sincerely,
****** *.
Customer Answer
Date: 10/31/2024
I am rejecting this response because:

This has been beyond poorly handled, and I will be communicating my feedback via every outlet and resource available to me regarding what a terrible experience this has been with Surest, Optum, and United Healthcare. I will be exploring all avenues to seek justice in this.
Initial Complaint
Date:10/24/2024
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 have dealt with *** for several years through United Healthcare and have had issues but usually got paid. Since switching over to Anthem Healthy Blue, they have not paid me anything even when their end shows I've been paid and there are checks issued. They know my address because it's always on the trip logs yet they always omit part of the address so the check gets lost in the mail and they have to get a check retrieval. Another issue I have is them making some of my trips disappear in their system so Healthy Blue keeps sending me letters to say certain days are not approved. When I make an appeal, it always comes back as an adverse decision. If you accidentally make even the slightest mistake on the trip logs and try to correct it, they immediately reject it. Some of them are so ***** I just know they're doing it so they won't have to pay me. When you already have a page of signatures, some of the providers are very far and it's unreasonable to ask them to sign again on another trip log. When I talked to *** over the phone they said the provider should fax a letter stating the dates that were rejected so they can process the payment. I have done this 3 times now and have yet to be paid. I always submit the trip mileage reimbursements by scanning and emailing so I have a record. I have had to submit every single 2 months worth of trip logs at least twice, some of them 4-5 times and STILL haven't been paid. When I inquired about how much the check was, it was like pennies on the dollar. They are supposed to pay $.50 a mile and the checks (which I have not received) did not reflect that. I am asking for an audit for all the trip logs to be paid correctly in a lump sum so we don't have to track down 3-4 checks that seem to get lost in the mail.
Business Response
Date: 10/23/2024
We appreciate the complainant reaching out with their concerns. Unfortunately, this individuals health plan does not allow *** to accept complaints on behalf of its transportation program. The complainant will need to submit a complaint directly with their health plan. Their health plan will then work with *** to investigate and resolve the concern. We look forward to working with the complainant to improve their transportation experience.
Business Response
Date: 10/25/2024
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
Date:10/23/2024
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.
United Healthcare denied a sinus revision after a previous sinus surgery and major jaw surgery. I have daily headaches. I have to miss work frequently. They made me jump through hoops and wait 6 months, just to be denied. They denied my doctors appeal and peer-to-peer. Im filled a complaint with the ***************************** and I plan to file individual complaints to the medical boards of the MDs and nurses that denied my claim. I also plan to consult an attorney to be compensated for any missed work, surgical fees, and other out of pocket expenses incurred from this.
Business Response
Date: 10/25/2024
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
Date:10/22/2024
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.
Got temporary coverage from USHealthGroup ************************ and had to go to the ** soon after. After the date of care, I was able to secure new insurance and asked them to cancel my plan GOING FORWARD. They retroactively canceled my plan back to the date of coverage and told me they wouldn't cover my claim. When I explained their mistake, they essentially told me they couldn't do anything about it and after a lengthy hold on the phone, they changed their story to say that they actually received the bill after my cancellation date so they didn't have to pay it. They said I was welcome to file an appeal. The appeal had to be a physical letter sent to *****. This is an elaborate scam and they will find anyway they can to not pay claims. In order to avoid collection activity, I have had to pay the hospital.
Business Response
Date: 10/23/2024
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
Customer Answer
Date: 10/23/2024
I am rejecting this response because: The issue is not resolved. The they indicated they could not locate my policy. I am providing the information they have requested.
Policy/Certificate: 52z352584f
Plan: 52figip/
Claim #: 242680276p

Business Response
Date: 10/29/2024
UnitedHealthcare has responded directly to the [member/provider/group] regarding the specific concerns detailed in this complaint on October 28, 2024. We thank you for providing us with the opportunity to address this concern.

Should the complainant have additional questions or comments after receiving our response, please kindly request the complainant contact me during normal business hours at ************

Sincerely,
**** *******
VP-Consumer Affairs
Initial Complaint
Date:10/22/2024
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 5/13/24, my son had dental services of $1400 done. The dentist sent in a claim to the primary insurance which is a MEDICAL plan through my ex-husband ********** Blue Shield. In return, ********** sent a pre-determination letter saying they are paying $0 for the claim. Per my dentist, if the MEDICAL plan is paying $0 then there will not be an explanation of benefits because they have already said they are paying $0 through the pre-determination letter. Therefore, the claim was sent in to my DENTAL insurance (GEHA) to pay the claim. Since we were having problems with the claim being paid, I paid $577.50 out of pocket and the dentist put in the claim to GEHA to pay me vs the dentist. Since June 2024, I have been calling GEHA to get reimbursement. I keep telling them the same information all over again. At one point my claim was closed even though I had not been paid. EVERY TIME I call, someone tells me something different. When I spoke to ********** Blue Shield, they verified if the pre-determination says $0 then they are not covering the extensive DENTAL services under their MEDICAL Plan. I think it is safe to say that no medical plan will cover the services performed on my son. I would like my reimbursement payment of $577.50 sent to me. The last reference number I have is ************.
Initial Complaint
Date:10/21/2024
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.
Our minor daughter, **** **** had a referral for OT from her ************ Physician, ******************** We were told by *** that the reason the bill wasn't paid by an IN NETWORK provider was because that ****** had a coding error. 7/2/24 (Insurance covered $595.57 out of $680.00 for **** **** for Therapy at Aurora Sports Health - **********, ***************, 6/25/24 (insurance covered $444.68 out of a $****** bill for the same provider, 6/11/24 Acct # ********* (Insurance covered $397.63 out of a $460.00 bill and the only bill that wasn't resolved that they should have paid was for 6/19/24 for ****** (then for whatever reason ONE business day) before my wife's surgery on the following Monday the company decides to reverse the payments for 7/2/24, 6/25/24, 6/11/24 for the above aforementioned amounts. This is log of whom I spoke to about these charges ****** coverage6/19/24 ****** visit - paid patient portition ($65.32) on 9/24/24 Claim control number *********** 7/9/24 - spoke to ***, she will send ******** visits to the "coding team" for review, this will take 7-14 business days 7/30/24 - **** with UMR confirmed that ****** should be in network and covered per plan; we should see some processing in a week or two 8/21/24 - "****" indicated that this service date (6/19/24) will be re-processed like the other service dates with ****** 9/9/24 - 9:40 - 10:13 am; spoke with ********, she saw the same issue she indicated that we should expect to see changes in a few days, I will be calling back on 9/12/24; document handle number for reference is 240909-00021687 9/12/2024 - 11:36 - 11:47 am - spoke with *********, she is going to get this reprocessed right away (similar to what **** did on 7/30/24); she was able to see a patient responsibility of $65.32 for the 6/19/24 service 9/16/24 - UMR now includes an EOB with a patient responsibility of $65.32, ITS VERY SUSPICIOUS YOUR COMPANY REVERSES THIS ONE BUSINESS DAY BEFORE A MAJOR SURGERY. LAWYER UP!
Business Response
Date: 10/29/2024
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
Date:10/21/2024
Type:Customer Service 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.
***, of all payers- has within the last three months began determining on their self-funded plans that none of our documentation is sufficient any longer. CPT codes that have been reimbursed quite a few times are now denied without explanantion. in this case, CPT ***********, and ***** are denied, with no explanation as to why these diagnostics are no longer supported. Optum, the claim review team, will not speak with providers- they won't tell our practice why they are in contrast to the rest of their peers- suddenly considering our records to not support these diagnostics. I do also have the **** which does not have instructions for these CPTs either.
Business Response
Date: 10/22/2024
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 Answer
Date: 10/22/2024
I am rejecting this response because:

We have been assigned as the Authorized representative by the patient. This form is on file as the *** in question is in response to a member appeal with that form included.
Business Response
Date: 10/24/2024
Hello,

We are writing to confirm receipt of your Better Business Bureau complaint received within Optum Consumer Affairs on October 22, 2024. Thank you for bringing this issue to our attention.

According to the BBB correspondence, we have 7 calendar days from the date on the correspondence to issue a response. This matter is still under review.

We will contact Mr. ********* ****** directly upon completion of our review.

Thank you kindly,

Optum Consumer Affairs
Business Response
Date: 11/12/2024
Hello,
Optum Consumer Affairs contacted ********* ****** on October 28, 2024, and advised Mr. ****** the claims in question were re-reviewed and reprocessed accordingly. The provider should have already received an updated Provider Remittance.
Thank you kindly,
Optum Consumer Affairs
Customer Answer
Date: 11/12/2024
Better Business Bureau:

UHC initially upheld their determination and sent us a letter explaining such, they never provided us an explanation as to specifically what they were denying in our medical records, nor what we could provide in order to obtain recognition on these CPTs

Directly after receiving the denial lettter on the second level appeal- which I am happy to provide- UHC overturned their own decision, and paid the claim.

No determination was given as to why it was denied and then upheld TWICE under appeal- or why it was overturned only after scrutiny by the BBB.

Our only impression we can take from this is that the denial was arbitrary in the first place, as this particular denial reason is never given by any other payer- it is only UHC, and only within their self-funded products where this happens.
Initial Complaint
Date:10/20/2024
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.
Made appt last may,2024 to get a cataract removed (30 min procedure) by opthamologist.eye ********* can"t be done til Jan 30, 2025. My driver license has expired and i cant get it renewed. I essentialy have no ins with this 5 Star rated ** My wife is 87 and needs help.
Business Response
Date: 10/21/2024
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
Date:10/19/2024
Type:Delivery 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.
Weeks ago, I received a bill for a procedure I had on 5/2/24. I then received a second bill for the exact same procedure on 5/2/24 only the amount increased for what i owed. I've submitted this information twice to GEHA by email, then by fax to the medical claims, I've never gotten a response from GEHA. I need to know what **** is correct.GEHA won't respond to my requests.

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UnitedHealth Group is NOT a BBB Accredited Business.