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Info Seeker

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

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Message 11 of 102

Every time I come to their website ( https://www.medicare.uhc.com/aarp ) I waste hours only to end up calling on the phone and wasting more time! The new website is even worse! Two days ago I spent hours trying to find a new PCP since I received a letter stating that the current provider has left the practice. The search process simply does not work on this website. No matter what key words I input, I get incorrect information back if any at all. I put in "Lee Physicians Group" (current provider office) and get every doctor with the word "physician" in their profile! Yeah, that is all of them! I select various filters in the search fields but none work. For example: select 'female' but still have males mixed in. Select Fort Myers location but get them all! Put in a physician’s name but get no returns, even though I know they are in the network! UHC (United Health Care) actually selected/appointed a new physician for me automatically, way over in Cape Coral! They actually sent me my new ID card with my new PCP that I did not pick and do not want! I live in Fort Myers. So there are no physicians participating here anymore???

 

So as usual, yesterday I make the dreaded phone call. Yep, another day off wasted with UHC and still no results! After talking to a UHC rep yesterday for half an hour, and being put on and off of hold several time (they have to research EVERY question or escalate it to someone that may know the answer…), I finally realized she could not provide me with any information whatsoever! She said she could mail me a book with all the physicians listed in it! What!? I told her this is 2018, I am in your website now...just tell me how to access the available network physicians since the search function does not work! She said the website does not provide that. What!? So I cannot use the website to search for a new doctor nor can I access the information within the website. So what is the website for again??? So I asked to speak to a supervisor. After being on hold for a supervisor for 15 minutes, I hung up. This is not a one-time issue; this has become the new norm. Today I decided it was time to change insurance companies. So I have spent another morning on my day off to research other providers only to become so overwhelmed that I felt like giving up! I even sent emails from within the website a couple days ago asking for help and explaining what experience I had in a detailed message. They did not even respond! Fed Up! I suppose I will have to fill in one of those quote request online forms, only to be flooded with phone calls and emails from every agent in Florida! So I decided to put my review out there so others may make an informed decision on which Medicare supplemental insurance plan they place their healthcare needs with.

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

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Message 12 of 102

@emmafaithm1969

 

Something definitely does not sound right here with whatever the problem might be between the doctors orders and your Medicare Advantage plan.

 

But without all the details, you should file a complaint with Medicare about your Medicare Advantage insurer so that they can check into the details and determine the problem.

 

Medicare.gov - Complaints about you health or drug plan

 

A Medicare Advantage medical staff do have the right to question things which might go contrary to the diagnosis code a doctor may use.  

 

Sometimes it it might be just a simple code number being entered wrong but it would not take 4-weeks to come to a conclusion IF everybody is on the same page to get everything right.  Since your prescription drug coverage is embedded in the same plan, it could be a problem either on the provider end or the prescription end with the insurer.

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Info Seeker

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

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Message 13 of 102

I don't know about their supplemental insurance, but their complete plan has been a total nightmare for my health, especially my kidneys. Twice, within just a few short months, they refused to approve refills on my hypertension medication I've been taking for years, and forced me to go without it for about 4 weeks total while fighting with my healthcare provider who constantly tried to make it clear I needed my medication to protect my kidneys. (I had CKD Stage 3b at the time of the denial, which may be worse now.) The last lab results showed protein was spilling into my urine. Further damage to my kidneys! Anytime a doctor or his office has to argue and fight with an insurance company about your care, there is a serious problem and the patient is the one who suffers.

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Conversationalist

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

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Message 14 of 102

There was a misunderstanding posted in a comment here.  Doctors DO NOT have to take Medicare.  If they take it, they also have to take a Medicare Supplement.  They do NOT have to take a Medicare Advantage. 

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

5,951 Views
Message 15 of 102

Gail  thank you for your response.
I wish that I had know more about Medicare and Medigap  than I even know today, I would have fought with the Dr.s  for not actually providing me with a Pre Diabetis diet mainly because my Diabetis 2 is and has always been extremely contained and very mild. Instead they put me inmediately on pills, creating a pre condition that has  had implications in the future. 
I wish that I had know about the injections for my Macular Degeneration and what they ask you in any questionair plan which is  if you actually receive injections.  and I would have probably delayed the process or applied for a supplemental before the diagnosis was made.
There are lots of things that due to ignorance that I have done, have had consequences probably my fault.
I do fully understand what you are saying about the doctors, I still think that they are also gaming the system in their favor and not in favor of the patients. Because they do want those supplementals and they have to accept the original Medicare patients. 
I guess that is life and the system that we have in the US.  more than ever, I feel that we really need a National Health Care system. too many things are done these days that are not right or fair.

 

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

5,998 Views
Message 16 of 102

rker321 wrote:

Hey guys,  as a Medicare Advantage PPO recipient. I can choose to go out of network but before I do. I have to contact that doctor and ask if they are willing to bill my Medicare Advantage insurance. and of course  pay a lot more money for my co payment.
Having said that, when I just changed insurances, I made sure that I contacted the doctors that I knew were out of network to see if they would bill my Medicare Advantage plan, and they do. otherwise I would have had to choose another insurance carrier.

Having said that, I think it really sucks that If I choose a doctor out of network and they don't want to deal with my Medicare Advantage plan, and they already accept medicare patients, that they should be able to bill Medicare directly for the services that I incur. But apparently, it doesn't work that way, But, I have the intention to put a complain to Medicare  and see  what happens.

 

 


Medicare.gov - Your Medicare Coverage Choices

 

You pick either Original Medicare or Medicare Advantage - once picked that is your way of getting your Medicare benefits.  Between the two choices, everything is different - the amount they pay the provider, your copays, your coinsurance.  They do not co-mingle.

 

Medicare and You - video on Understanding Your Medicare Choices

 

In your previous post you said - I am just answering here for convenience. 

rker321 wrote:

If they are not health insurances those companies, what in the heck are they.? I am really not sure that I want to go to a simple medicare patient. I have always had the feeling that Medicare only patients are somewhat discriminated by the doctors themselves. is just a feeling, besides, Medicare only pays 80% of the bill and at least the other Insurances to cover more costs than the 80% and the drug prices are a lot better than if I just got a stand alone prescription drug  program. I don't have the advantage of negotiating like they do.

 

Supplemental Medicare Insurance is supplemental insurance, it is not health insurance; simply,  it only picks up what the main insurance does not pay.  It ONLY works with original Medicare NOT Medicare Advantage plans.  Compare it to perhaps gap insurance in the auto insurance industry.  Gap insurance, more accurately called gap protection, covers the difference between what you owe on your car and how much the car is worth.

Su

 

Medicare.gov - What is Medicare Supplemental Insurance (Medigap)

 

Look, rker321, I am sorry that your out of network doc has put you in this situation.  The dispute is actually between this doc and your Medicare Advantage PPO insurer - you are just collateral damage.  I can understand your problem but there is little you can do about it - However, you do have choices - Pick another Medicare Advantage plan, PPO, if that is your need, in your area where your docs are either in network or if it is a PPO, that they will work with you within the PPO as out of network.

 

You could change your choice of how you get your Medicare benefit from Medicare Advantage to Original Medicare but that will probably be either without supplemental coverage or a very expensive supplemental plan if an insurer decides to underwrite you.

 

I understand your fight here but honestly because a doc does have the right to pick his patients in this regards - limit in number or limit by insurer - I just don't know how this could be fixed.  Whatever excuse they give, it works out the same because original Medicare and Medicare Advantage plans are Medicare - just different ways of getting your benefits just in different ways.

 

Sounds like you have already made your decision - Hope this MA plan works better for you.

 

Good Luck -

 

 

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

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Message 17 of 102

Hey guys,  as a Medicare Advantage PPO recipient. I can choose to go out of network but before I do. I have to contact that doctor and ask if they are willing to bill my Medicare Advantage insurance. and of course  pay a lot more money for my co payment.
Having said that, when I just changed insurances, I made sure that I contacted the doctors that I knew were out of network to see if they would bill my Medicare Advantage plan, and they do. otherwise I would have had to choose another insurance carrier.

Having said that, I think it really sucks that If I choose a doctor out of network and they don't want to deal with my Medicare Advantage plan, and they already accept medicare patients, that they should be able to bill Medicare directly for the services that I incur. But apparently, it doesn't work that way, But, I have the intention to put a complain to Medicare  and see  what happens.

 

 

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

5,974 Views
Message 18 of 102

ykaplinsky wrote:

Gail, you are confused.  The doctor is not allowed to choose if he files with a supplement or an advantage plan no more than he is allowed to choose which insurance carrier he files with.  Advantage PPOs are a whole different world than supplements are.  YOU choose which you have and you and he are committed to using ONLY the one you choose. 

 

IF you choose a supplement, then by law, if a doctor takes Medicare, they have to take a supplement.  IF you choose an advantage plan, then the advantage plan has networks (supplements do NOT have networks) and a doctor can choose if he wants to be part of that network and accept their network reimbursement payments.  You choose, the doctor has to go by the rules of the plan you choose. 


You would have to keep up with all of rker321's post - but in my post I assume you are referencing, I said,

A doctor can decide which insurer they want to deal with and how much they want to deal with them.

A doctor even accepting Medicare assignment in original Medicare can still limit how many of this type of patient they accept into their practice.  The doc makes the call.

 

I understand what the subject of this thread is about (supplemental coverage) but sometimes threads just get off topic - it has very much so with the coversation between me and rker321.

Sorry.

 

You are right that once an original Medicare doctor (accepts assignment) elects to treat you, they will bill Medicare (CMS) for your sevices, Medicare (CMS) will pay 80% of their negotiated fee for the service and then send it on to your supplemental (Medicap) plan to pay their share since it is supplemental coverage.

 

You are right that if a doctor is within your Medicare Advantage plan's network, and he treats you, he will bill and be paid according to the fee schedule which the specific Medicare Advantage plan has with him.

 

However you are missing the point here and that is IF the doctor elects to treat you, IOW - he accepts you as a patient.

 

In a Medicare Advantage PPO plan, an out of network doctor can decide not to accept you as a patient - they have that choice.

 

In original Medicare, with or without a supplemental plan, even if a doctor accepts Medicare assignment, they still have the right to limit their practice scope to the number of Medicare patient which they treat.  That is why there is a selection, or use to be, on the Medicare Find a Doc site that says. "Accepting New Medicare Patients" - or if you call them for an appointment, they could tell you right then that they are not accepting any new Medicare Patients.

 

rker321 can tell you her specific circumstance but basically it involves a MA PPO of which an out of network doc has decided not to accept any patients that have coverage from a specific insurer - He was a long standing doc of rker321 which she had used in this MA PPO out of network capacity for a good while.  From my understanding it is really the result of the doc not liking the insurer for payment reasons, it seems -

 

The rest of this subject discussion is about possible a MA Medicare beneficiary going back to original Medicare and the circumstances underwhich they could get a supplemental ( Medigap) plan to "supplement" their original Medicare benefit - IF they can at all.

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Conversationalist

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

5,976 Views
Message 19 of 102

Gail, you are confused.  The doctor is not allowed to choose if he files with a supplement or an advantage plan no more than he is allowed to choose which insurance carrier he files with.  Advantage PPOs are a whole different world than supplements are.  YOU choose which you have and you and he are committed to using ONLY the one you choose. 

 

IF you choose a supplement, then by law, if a doctor takes Medicare, they have to take a supplement.  IF you choose an advantage plan, then the advantage plan has networks (supplements do NOT have networks) and a doctor can choose if he wants to be part of that network and accept their network reimbursement payments.  You choose, the doctor has to go by the rules of the plan you choose. 

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Valued Social Butterfly

Re: Is AARP United Healthcare Medicare supplimental insurance as bad as the customer reviews say??

5,970 Views
Message 20 of 102

Gail.

After reading your last post, I do realize that I know very little next to nothing about Medicare and how it works

If they are not health insurances those companies, what in the heck are they.? I am really not sure that I want to go to a simple medicare patient. I have always had the feeling that Medicare only patients are somewhat discriminated by the doctors themselves. is just a feeling, besides, Medicare only pays 80% of the bill and at least the other Insurances to cover more costs than the 80% and the drug prices are a lot better than if I just got a stand alone prescription drug  program. I don't have the advantage of negotiating like they do.
I realize what you are saying that the doctors have the last shot. in all of this, but, if they accept Medicare patients, and Medicare supplemental  why I as a PPO Medicare Advantage person they cannot bill my Medicare directly they do it for other patients. and bypass my PPO Insurance.

That seems somewhat a little lopsided.  and perhaps that is also not too fair to the consumer.
Perhaps, Medicare needs to be waken up of their dream land and start thinking about their rules a little. 

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