United Healthcare- Should not be sponsored by AARP
I went to the Medicare site and looked for a company that might have a plan to replace my pathetic plan by Emblem. My wife and I looked at which doctors were part of the United Healthcare AARP plan. When we started, my primary care provider was listed so I went ahead and applied. I got a confirmation letter. Since my wife is being treated for lymphoma and has more doctors than I do, we looked up all of the doctors treating her and NOT one was listed as participating. We looked up five and none were listed.
What really upsets me is the wait for a representative but more importantly that they transferred me three times and I wound up in sales because the other representatives would not help me as they probably wanted to transfer me to sales.The sales person told me that she would look on the list to see if there was a mistake and I had "misread" the doctors list. I am a retired teacher - an English teacher- and to imply that I could not follow the list was insulting. The representative insisted on looking it up and she claimed that one of my wife's doctors was listed. I questioned this and she looked again and saw that the doctor took certain United plans but NOT plans involving Medicare Advantage. What bothered me the most is that like the lists at my "beloved" Emblem, the lists were very wrong about things. I even saw on a list that was for pharmacies that are participating, a listing of a pharmacy in my neighborhood that had been closed for THREE years.
I asked the sales representative why the lists are so incorrect and outdated. She told me that entries are changed or taken out if the doctors or pharmacies update them and notify United. REALLY? And you have the customers make his decision about a plan based on a list that is inaccurate. . Wow! If I owned that pharmacy, the very first thing I would do if I were closing was to call United. It would be my ultimate responsibility. Seriously? Shouldn't they revise their lists (United and Emblem) by hiring help to check the lists, to update them. BAD BUSINESS!!!! So sad, so inept, so dumb!!!
I sincerely agree with you about AARP UNITEDHEALTH. MY MEDICARE SUPPLEMENTAL HEALTH INSURANCE POLICY PREMIUM INCREASED BY 200% PERCENT?? WHY BECAUSE THEY STARTED USING A ORGANIZATION THAT SCORES A INDIVIDUALS BASED ON YOUR MEDICAL HISTORY, PERSONAL DEMOGRAPHICALLY INFORMATION , DIAGNOSIS, MEDICATION prescribed, medical tests taken, any special medical equipment used and the number and frequency of Doctor office visits. They can't deny you because of a preexisting medical conditions, but you pay an ridiculous premium amount for coverage that only pays 20% of medical bill costs.
Were you covered by a UHC Medigap plan and wanted to change to a different letter plan with the same carrier? If so, underwriting may be required. The UHC underwriting guide may call for a Level 2 rate for high risk if you no longer qualify for a standard rate.
You are not REQUIRED to accept the higher rate. You can keep your existing plan.
Did you relocate to a different address? If keeping the same plan your rate may be adjusted to reflect the new cost area, but underwriting is usually not required.
If this is an underwritten plan you can be denied coverage in most states.
It seems obvious your agent was neglectful in explaining the process.
That is NOT normally the way a Medicare Supplemental (MEDIGAP) plan works or determines the amount of your premium. IF you changed plans, especially to another insurer, after your initial enrollment period and your state does not specifically have rules that cover your ability to change plans after your initial enrollment period, then YES, the new insurer CAN use underwriting for the new policy which can result in higher premiums OR EVEN A DENIAL OF COVERAGE.
However, if you have been with this Medigap plan for a long time, then something else is going on - (see the Medicare link below on the Cost & Pricing of Medigap plans.
We eventually went with Blue Cross/Blue Shield. They are rated poorly but since we have been with Emblem/Hip for forty years, we have given them a pessimistic try. We just could not bear to give Emblem another dime because in the last three or four years customer service has been bad to vile.
These lists I am complaining about are not up to date on the Medicare site...So you can use the company's list or the Medicare site and you will not see a list that is very faulty - very incorrect. If you call customer service - guess what the customer service person will look up the list you saw and use it, insisting it is up-to-date. Even if you look up a doctor and he/she is on the list, you had better call the doctor to verify current status. on the other hand, if your doctor is not on the list, it is possible he should not be on the list since everything is questionable. If you have a primary care doctor and five specialists, you have got some important phone calls to make before buying a different plan with a different company. Good luck and be persistent!
As for Aarp, I admire this organization a lot and I understand that they get royalties from United but with the organization's power, wouldn't you think that they might "request" that United get its act together! ?
This is not unique to UHC in any way. What you experienced is the issue with ALL Medicare Advantage plans. Unlike Medigap, Medicare Advantage plans can change at any time of the year. Your provider can leave the plan whenever they want, leaving you with a plan that your primary care physicians no longer accept and you cannot change plans until the next Open Enrollment Period. It's very possible the provider recently left the plan and that's why they are no longer on the carrier provider list. Again, not specific to AARP or UHC. This is with all managed care plans. Unfortunately, you could very well have the same issue with BCBS. If you want to avoid this, try enrolling in a Medigap plan instead. However, if your health is poor, you may be denied coverage if you're outside your Medigap Open Enrollment Period. But it does not hurt to try.
Thank you so much @ElliotS204698 for having the guts to step up and report all of the rocks you are encountering along this road. I can't imagine what it must be like for your wife & you; to have to deal with the disease itself. But, to have to go up against the company you thought was your protection, is too much. I pray that things get better for you and your wife especially. I hope that the organization can use this as a learning tool, for advance repairs in different areas of AARP. While much of America is shut down sort of, corporate America needs to take this opportunity to fine tune all of their systems that interact with the public; from the outside... in! We the people and our needs are real! I was reading your article and saw people were scared or something to respond & I thought of the old Bobby Womack hit, Nobody Wants You When You're Down & Out. Hang in there, I'm proud of you. No matter what God will see you through!
@kb2064 the situation you describe is not unique to UHC. ALL managed care plans have lags in listing par providers. At least now the directory is electronic. In the "old" days the directories were printed once a year.
You will encounter issues like this with ANY managed care plan . . . which is why I rail against them.
If you want to let an insurance carrier pick your providers there is a price that goes beyond dollars and sense. You have limited access to care and the players can change at any time, not just from one calendar year to the next.
Folks love their Advantage plans until they use them.
Original Medicare has no networks, pre-authorizations, referrals and no surprise billings. You have unfettered access to care.
Don't blame the carrier, it is the system that is the problem. You will find this same issue with any managed care plan, regardless of the carrier.
AARP commercial member benefits are provided by third parties, not by AARP or its affiliates. Providers pay a royalty fee to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. Some provider offers are subject to change and may have restrictions.
Not available in Alaska, Delaware, Maryland, Michigan, Mississippi, Montana, Wyoming, or the U.S. territories.
Since most MA plans work with (constantly changing) networks of doctors and other health professionals and those networks are based on contractual agreements, either party can change them.
Your best source of MA health insurance coverage with a specific doctor is to check with their own insurance representative in the doc's office - also find out how they could be listed on the specific plan - group or individual. They might also be able to tell you other MA groups for which the medical provider or other health provider is affiliated.
If specific providers were the end goal, perhaps traditional Medicare would have been a better choice if the providers take Medicare at all - course, switching now may leave you financially vulnerable if there are high healthcare cost or pre-existing conditions because a Medigap policy might be denied, or very expensive and contain some exclusions for a period due to health.
You have until Monday (December 7) to switch MA plans during open enrollment.
As far as their ability to keep their list of providers updated - Medicare.gov says this and describes some of the different types of coverage available under MA plans - HMO, PPO, PFFS, SNP - familiarize yourself for your benefit:
Medicare Advantage Plans are another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). In many cases, you’ll need to use health care providers who participate in the plan’s network and service area for the lowest costs. These plans set a limit on what you’ll have to pay out-of-pocket each year for covered services, to help protect you from unexpected costs. Some plans offer out-of-network coverage, but sometimes at a higher cost.
Just like any other insurance - the more options, the more inclusive, the higher the (premium) cost.
I am not having some of the problems with Unite Healthcare that others are - they are simply not paying my providers - after six months and multiple phone calls by me and my provider. They told me when I signed up that my providers were covered and confirm that when I call them, but they are not paying and I've had to pay in full the charges from my providers because they can't afford to wait any longer for payment. AARP should not be advertising, promoting, endorsing, etc, this company. It was on te strength of their recommendation that we went with them, and we now have no fait in AARP's recommendations, suggestions, etc.
Something sounds wrong here but where the problem might be is anybody's guess. Providers do come and go in specific networks - it is up to them.
So here is one more place to check -
Get out your AARP - UHC MA plan insurance card and note the exact name of the plan - then call your provider's office and talk to the person that submits the claims cause it sure sounds like the provider is NOT in the SPECIFIC plan that you currently have.
Are you even getting a notice from your insurance plan that they are paying or not paying for the services that you have used? They should be giving you this notice when the claim is processed and if not paid, giving you a reason as to why not.
AARP UHC Medicare Advantage have several plan types and it is up to the provider to be enrolled in specific type plans. I assume that you know what type of coverage you have - The name of the plan should be plainly stated on your insurance card and the provider has to be in THAT specific plan.