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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 1 of 59

From what I've read UHC gets money for every "risk" they report to Medicare but they are not required to use that money for the Med Advantage program.   Before retirement, I had regular group insurance thru UHC and they claimed the annual health risk assessments and wellness checks they were pushing, would help hold premiums down.  In the over 10 years of doing these, premiums skyrocketed and many employees who honestly answered HRA questions got dinged on their "score" which translated into less money being deposited in their Health Savings Account by the company. 

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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 2 of 59
House Calls is a service not a requirement. They are notorious for bothering people. I agree with you about there being Medicare, UHC and their contractors between you and your doctor. No wonder Medicare costs are high. Too many people making money off something you already paid for.
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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 3 of 59

When working I had UHC and they pushed these annual wellness exams and risk assessments.  They tell you its to help lower premiums.  Not once in 10 years did our premiums go down.   What I dont like is all the third party contactors UHC hires for these services.  It is no wonder medicare costs are so high.  They put 2 to 3 groups inbetween you and your doctor and each get paid.

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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 4 of 59

@somarco wrote:

@GailL1 for those who want more "inside baseball" about the Medicare payment system, this KFF article is written in mostly plain English.

https://www.kff.org/medicare/fact-sheet/medicare-advantage/

 

Probably more information than most people want or need  . . .

 

But the phone calls are about saving money.

 

Their (insurance carrier) money, not yours.


Yep, it is about the insurer's money - but if this program worked as designed for it's target purpose, it is suppose to save Medicare money too.  Shenanigans shouldn't play a part - not saying that there are shenanigans but it is hard to trust but verify the way it seems to be set up - seems the verification of the risk could be and should be more cut and dried.  

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 5 of 59

I think the calls are a good idea for people who don't maintain a good, regular relationship with a primary care physician.  For those of us who do, however, it's really annoying, and there should be a way we can opt out.

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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 6 of 59

@GailL1 for those who want more "inside baseball" about the Medicare payment system, this KFF article is written in mostly plain English.

https://www.kff.org/medicare/fact-sheet/medicare-advantage/

 

Probably more information than most people want or need  . . .

 

But the phone calls are about saving money.

 

Their (insurance carrier) money, not yours.


Bark less. Wag more.
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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 7 of 59

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


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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 8 of 59

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).

 

 

 

 

 

 

 

* * * * It's Always Something . . . Roseanne Roseannadanna
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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 9 of 59

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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Re: I am sick of all these phone calls, UNITED HEALTHCARE

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Message 10 of 59

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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