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Medicare REQUIRES a Yearly Update to Health History?

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Regular Contributor

Medicare REQUIRES a Yearly Update to Health History?

I received a call (that I let go to voicemail) supposedly from United Healthcare. They keep calling to "help me complete my annual health assessment" to help me "get the most out of my health plan".  The message goes on to say that "Medicare requires us to update your health history every year". The call is from the 612 area code  ... no idea. And says I should call back to a 833 area code number. 

First of all: Does Medicare REQUIRE UHC to update my health history every year? 

Second: I am not calling back UHC at any phone number other than the one on the back of my membership card. 

 

Is this legitimate or is it bogus?

 

Thanks!

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Regular Contributor

Back in March, I posted information that said I chatted with a Medicare person and that person said that Medicare DOES require the MAP provider to update health information every year, but UHC said that completing the survey was optional.

 

***HOWEVER***, I just now finished a chat with a Medicare person. I asked if Medicare requires the MAP provider to update health information every year. The Medicare person said (and I quote), "No, that is not a requirement from us. We don't even do that here".

 

So, according to this Medicare person, what @LoisG776336 said is true. Medicare DOES NOT require the MAP provider to update our health insurance every year.

 

The problem I am having is that I asked two different Medicare people the same question and got two different answers. If I ask a third person, I'll probably get a third, different answer. (Our government dollars at work.)

Periodic Contributor

Shall we take bets on a third call? 😂 Too often this happens with government programs. During the pandemic it happened over and over again with unemployment agents giving out differing answers. People became extremely frustrated, especially when they relied on information from agents which proved to be incorrect.

Thanks for the follow-up!

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Contributor

UHC called and addressed me by name. I responded with "speaking." The caller then sought to verify my identity by asking for my birthday. I noted that they initiated the call, and since I had no means to confirm their identity, I was not comfortable sharing any personal information. The person mentioned something about standard practice and I ended the call.

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Regular Contributor

Very smart move @dayanandaa818861  to not give out any personal information. NONE. I might have gone even one step further and, instead of verifying that they were speaking to the person they named, instead of replying, "Speaking", I might have replied, "How can I help you?" (which is a more polite way of saying, "What do you want?")..

Regular Contributor

(Replying to my own post ...) Here's some additional information that adds only a little clarity.

(1) I chatted with someone at Medicare and was told, "Medicare does require your plan to update your health history every year". 

(2) I emailed UHC and received a reply that said, "Medicare does require United Healthcare to reach out about the assessment, but this is an optional survey and you are not required to complete the survey if you do not want to. It wont affect your plan benefits in any way". Other information I received (via email from UHC) said I could complete the survey online. (I did find a Health Assessment page on the UHC web site.)

 

So, Medicare requires UHC to update my health information, but UHC says my providing the supporting information is optional. So, does this mean UHC submits "old" information if I choose to not complete the health assessment?

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Periodic Contributor

I am being bugged by them this month (October 2023) with voice messages about this, saying the exact same thing. It should be illegal for them to state that Medicare requires them to update our health history every year when they absolutely do not.

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Honored Social Butterfly


@LoisG776336 wrote:

It should be illegal for them to state that Medicare requires them to update our health history every year when they absolutely do not.


Medicare Advantage plans ARE a legal part of the Medicare program - They are Part C.

So if it is your choice to get your Medicare benefits via a Medicare Advantage plan - then in this respect - THEY ARE MEDICARE - but I don’t think they will drop you for not complying - they just want to know your state of health and the risk that your health may impose and thus they get paid more.

It's Always Something . . . . Roseanna Roseannadanna
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Periodic Contributor

Being an advantage plan isn't even an issue in what they are doing.

My gripe is their stating that Medicare requires them to update our health history every year when that is not at all true, thus trying to force people to complete the questionnaire. To regularly bug you with calls about this, each time stating this lie, is wrong. I won't be completing it and I know I won't be dropped as it is not a requirement.

BTW, love the Roseanna Roseannadanna reference. She left this life much too soon.

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Honored Social Butterfly

I think this is up in the air at the present time - OIG is now conducting an investigation into this matter - results will be in sometimes in 2024.

The jest of the investigation is the purpose they are doing it - 

  • To improve the health experience of the beneficiary OR
  • To improve their bottom line

Risk adjustments are a part of the payment method for them and so are bonuses in those who are ranked either 4- or 5- star.  

Also some of the assessment could be linked to supplying added benefits - for whatever, maybe like transport to medical appointments - they have branched out so much in these added benefits, I can’t keep up.

 

ASPE Office of Health Policy HHS.gov 05/25/2023 - Issue brief - Enrollment & Spending

 

The rationale folllows the thought that MA plans are a part of Medicare and risk adjustments as well as managed care are how they are paid, so does it lend reason that they would want to know your health assessment annually, at least, to plan accordingly.  So since it is part of their pay methodology, and they are part of Medicare - they induce that it is required - 

OIG.gov - Medicare Advantage Payments Generated by Health Risk Assessments for 2022

 

Hey, I didn’t invent how government does things - I am just the message bearer - they write and interpret the message.

 

Perhaps it would help those who are getting these solicitations for health assessments to be informed of the reason behind them - could be more than one.

 

Maybe you should asked for a few bucks to complete it.  😎

 

It's Always Something . . . . Roseanna Roseannadanna
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Periodic Contributor

Whether or not Medicare requires them to yearly update people's health records is not up in the air and never has been. Medicare does NOT require them to do this. They kept trying to push the same assessments on a different plan before I was ever on Medicare, only they didn't say Medicare required it because it wasn't one of their Medicare plans. One doesn't get added benefits if they complete it.

Anyway, I just commented because I, too, have suddenly been receiving these calls, not that I wanted additional information about it. Since Medicare doesn't require what they state, they should not be permitted to claim they do.

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