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Message 21 of 73

@SharonB897005 what the heck is a "state" plan?


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Message 22 of 73

I am sure these health assessments by MA insurers could be very helpful, @SharonB897005 

 

However, let's not forget that MA providers get a bonus pay from Medicare if the beneficiary is rated at a higher risk.  The reasoning behind this (goal of risk payments) is that they want these insurers to keep these (perhaps sicker) folks under their care - Traditional Medicare doesn't want the "more" sick in their fold - and it actually penalizes the beneficiary because they probably can't get a reasinably priced supplemental plan by then either, if at all.  So Medicare pays a bonus to the insurer for treating these potentially "sicker" folks.

 

It all goes back to how the info is justifiably used and interpreted.  It should be a combination, not one or the other. (an "and" not an "or")

- to benefit the beneficiary

- to benefit the insurer's pocket

 

I am sure that that final decision is above your pay grade.  It happens with all the data combined - from doc, from health assessers, from test, from Dx codes -

 

But if the system of payment to insurers from Medicare were not so complicated and there were not so many special calls - perhaps it would be a little more forthcoming.  It is all for meeting the goal (as described above).

 

 

 

 

 

 

 

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Message 23 of 73

As a licensed agent for Medicare Advantage Insurance carriers, I work with clients that have chosen United Healthcare as their coverage.  If you have also done that you will periodically receive calls from a nurse to check with you about your health, to see how your chronic illnesses are such as diabetes or high blood pressure.  Also, once a year a housecalls provider will schedule an in home appointment to come out and do another annual assessment.  These have proven very helpful and, in some cases, have detected early colon cancer.    

So, when you get that annoying phone call asking about housecalls or for personal information make sure it's your insurance plan first. Then, if you are comfortable giving the information proceed. You do not have to participate in these programs. They are optional.

I always tell my clients that if they are happy with their current coverage,  just tell the person on the phone that or give them my number to contact. It doesn't always stop the calls. 

But, I have heard if you tell them you have "the state" plan, they will leave you alone.

 

Your NC Medicare Agent 

God bless!

 

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Message 24 of 73

As a licensed agent for Medicare Advantage Insurance carriers, I work with clients that have chosen United Healthcare as their coverage.  If you have also done that you will period receive calls from a nurse to check with you about your health, to see how your chronic illnesses are such as diabetes or high blood pressure.  Also, once a year a housecalls provider will schedule an in home appointment to come out and do another annual assessment.  These have proven very helpful and have detected in some cases early colon cancer and allowed treatment 

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Message 25 of 73

Removed reply to avoid possible retaliation.

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Message 26 of 73

@mc4039 UHC keeps calling me about these home visits. 

 

You probably have a managed care plan, HMO or PPO, but not original Medicare and a Medigap plan. In other words, an Advantage plan.

 

The home visit is to make sure you are doing what you need to maintain your health . . . and protect THEIR wallet.

 

It is only when you get sick(er) that THEY have to pony up serious money to  pay your claims.

 

Original Medicare allows you and your doctor to make decisions about your health care. No house calls. No follow up phone calls. They assume you are an adult and can take care of yourself.

 


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Message 27 of 73

The calls are coming from UNited Health Care

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Message 28 of 73

What's up with these "House Calls" program? I have a great relationship with my primary doctor, I make all of my visits, have all of my tests run on time, yet UHC keeps calling me about these home visits. I find it to be a gross invasion of privacy. I believe there is an ulterior motive and someone needs to start looking into this from a legal standpoint. I don't appreciate UHC trying to wedge itself between me and my Doctor. I already canceled my car insurance and house insurance that I had through AARP/Hartford and went back to State Farm. Perhaps I need to do the same with UHC. Also, I am tired of getting all of these renewal letters from AARP when I have over two years left on my membership. What’s up with that?

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Message 29 of 73

@BarbMHill  since your situation is "definitely" calls originating from UHC your complaint needs to be direct to them and do it in writing. It may not solve your problem but it can't hurt.

 

Try directing your complaint to the UHC customer service department.

https://www.uhc.com/contact-us/for-members

 

Complaining to the FTC may not work since businesses are permitted to contact customers where a relationship exists. That being said, I can't imagine a business continuing to call once the customer told them they wanted to opt out of ANY solicitation. 

 

Charities and political organizations are also exempt from the FTC Do Not Call rules.

 

Here are some guidelines on how to deal with unwanted calls. This applies to "cold" calls absent a business relationship.

 

https://www.ftc.gov/tips-advice/business-center/guidance/complying-telemarketing-sales-rule

 

https://www.ftc.gov/tips-advice/business-center/guidance/complying-telemarketing-sales-rule

 

 


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Message 30 of 73

Thank you for your reply. It is DEFINITELY  UHC.  They do leave a message to call them back. 

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