Reply
Highlighted
Contributor
0
Kudos
14882
Views

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

14,882 Views
Message 11 of 67

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.

Report Inappropriate Content
0
Kudos
14882
Views
Highlighted
Honored Social Butterfly
0
Kudos
16499
Views

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

16,499 Views
Message 12 of 67

@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
Report Inappropriate Content
0
Kudos
16499
Views
Highlighted
Periodic Contributor
0
Kudos
16503
Views

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

16,503 Views
Message 13 of 67

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.

Report Inappropriate Content
0
Kudos
16503
Views
Highlighted
Conversationalist
1
Kudos
16510
Views

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

16,510 Views
Message 14 of 67

@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.
Report Inappropriate Content
1
Kudos
16510
Views
Highlighted
Conversationalist
1
Kudos
16506
Views

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

16,506 Views
Message 15 of 67

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


Bark less. Wag more.
Report Inappropriate Content
1
Kudos
16506
Views
Highlighted
Honored Social Butterfly
0
Kudos
13611
Views

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

13,611 Views
Message 16 of 67

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
Report Inappropriate Content
0
Kudos
13611
Views
Highlighted
Contributor
1
Kudos
13470
Views

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

13,470 Views
Message 17 of 67

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!

 

Report Inappropriate Content
1
Kudos
13470
Views
Highlighted
Contributor
0
Kudos
7132
Views

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

7,132 Views
Message 18 of 67

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 

Report Inappropriate Content
0
Kudos
7132
Views
Highlighted
Contributor
0
Kudos
5836
Views

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

5,836 Views
Message 19 of 67

Removed reply to avoid possible retaliation.

Report Inappropriate Content
0
Kudos
5836
Views
Highlighted
Conversationalist
1
Kudos
6539
Views

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

6,539 Views
Message 20 of 67

@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.

 


Bark less. Wag more.
Report Inappropriate Content
1
Kudos
6539
Views
cancel
Showing results for 
Search instead for 
Did you mean: 
Users
Announcements

Introducing jen43, one of our featured ACEs! Check out their profile and fill yours out, today!

Meet an ACE

Top Authors