United Health Care denials and failed reimbursements

[arander]

 My wife and I switched to UHC this year on a recommendation from a broker who was "helping" us.

Over the last few years my coverage with Florida Blue was in jeopardy due to mid-year contracts with our providers and hospital group in our county. My wife had Aetna for several years with no difficulties but was told her existing policy was no longer available in Florida(?).

Shortly after agreeing to policies with UHC starting in January this year, we receive letters from our PCP, the hospital group and UHC stating they also are in mid-year contract negotiations and may drop coverage June 1 if not resolved.

My first question is "why these companies can negotiate and drop services mid-year while we are locked in Jan through Dec?" I have sent letters to a local congressman on Medical and Health committees requesting a correction to this practice but no replies. 

Of course, during this period of uncertainty, all reimbursements and customer service were completely stopped and absolutely worthless to attempt. It seemed that everyone couldn't give proper directions in English or connect you to the correct department. I actually had two department reps arguing with each other on a 3-way call trying to assign blame (until I told one to "get off his back and help me!". 

  Moving ahead to June 1 after contracts were signed, we were inundated with printed forms of claim denials and reimbursement failures. A $10.00 vision check was received for a $100.00 dental checkup, eye exams were paid but glasses were denied and partial payment of covered services were paid.

It became very apparent that company policy was to slow down or even halt processing during these months of "negotiations".

My wife and I are praying that nothing other than routine visits occur this year so we can get as far away from these crooks as possible at years end. We don't intend to request reimbursements for routine visits as it's not worth the frustration.  

AARP has never really offered any services or discounts for us that we use and we will reconsider that membership also. They should be ASHAMED of the pretense they project regarding help for our generation. 

[GailL1]

@arander 

Contracts expire when they expire - it is also a ploy since having a large group of beneficiaries using a plan or a provider could help in the negotiations. Leverage, so to speak but it does not work all the time depending on what the side wanting something wants (more money most likely).

I have never heard of any pretense from AARP - they are who they are - take it for what it is worth to you or not worth to you, whichever is the case.  They have no clout with any insurance company.  They make money from selling their branded name sake to companies that use it in their promotion of their product.  I think that is smart of each of them - AARP and the insurance company - but a benefit to our generation - probably not.  

Glad the contract negotiations were at least settled and your have your coverage until the annual open enrollment for Medicare Advantage when you can pick a new plan that will hopefully meet your needs and expectations.