Contributor ⭐

United Healthcare- Should not be sponsored by AARP

Forum|Forum|5 years ago
December 5, 2020
30 replies
34170 views

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I asked the sales representative why the lists are so incorrect and outdated.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!!!

GailL1

Community Champion ⭐⭐⭐

United Healthcare isn't sponsored by AARP -

For use of their (branded) name, AARP receives royalties from UHC - thus UHC AARP Medicare plans are a revenue source for AARP.

Read the Disclosure:

AARP® Medicare Advantage from UnitedHealthcare

Disclosures

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.

State Availability

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.gov - Medicare Advantage Plans

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.

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

S

s939942g

Contributor ⭐

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.

GailL1

Community Champion ⭐⭐⭐

@s939942g

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.

Here is a list of the types.

https://www.aarpmedicareplans.com/shop/compare/compare-ma.html

Screenshot_2021-02-07 Compare Medicare Advantage Plans AARP Medicare Plans.png

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

E

ElliotS204698Author

Contributor ⭐

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! ?

P

PoeticPlum

Contributor ⭐

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!

PoeticPlum

R

RodyS297776

Contributor ⭐

This is Sad, these things should have a system or atleast they should update these lists.

F

FreddieF283055

Contributor ⭐

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.

GailL1

Community Champion ⭐⭐⭐

@FreddieF283055

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.

Medicare.gov - What's Medigap

Medicare.gov - When can I buy Medigap?

Medicare.gov - Cost & Pricing of Medigap Plans

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

L

lizcooksey

Contributor ⭐

I completely agree. I'm appalled that AARP has associated itself with United Healthcare and my experience with the latter has left a bad taste in my mouth for several reasons. One is that their list of 8 opticians in my zip code turns out to have only 2 that are actually taking the United Healthcare insurance, and their prices AFTER insurance are more than an out-of-network optician nearby. WAY more -- by a couple hundred dollars. One on the list is not only closed, but the woman who ran it died in 2010!

W

wacoed

Contributor ⭐

My current provider notified me that my plan of 4 years would not be offered in 2025. THE SEARCH BEGAN. Was considering an AARP UHC plan but could never get over The Conflict of Interest. Why is AARP not being transparent with seniors? HOW CAN THEY BE WHEN THEY ARE “hawking” their partners wares. THEN I BEGAN READING SOME OF YOUR COMMENTS. Thank you. I will not be pursuing UHC and, I cannot support AARP anymore and will be canceling my membership.

N

nswan

Contributor ⭐

I agree that AARP should not be endorsing United Healthcare, from which they receive royalty fees. One of the reasons I dropped United Healthcare Medicare coverage after one year was because United Healthcare was in constant dispute with various healthcare providers. Also of concern was frequently receiving misinformation from United Healthcare customer service.

L

l264203s

Contributor ⭐

United Healthcare AARP Advantage PPO should not be promoted or endorsed by AARP if they care AT ALL! It has been a nightmare dealing with them, they continue to provide incorrect information and it is nearly impossible to get any legitimate assistance from customer service.
Again today I spent an hour on the "chat option" trying to confirm in-network info. I was misinformed about in-network facilities and when I pointed out the mistake they back-peddled and changed the info. It is unbelievable.
In fact, on the website of several hospitals that were claimed to be "in-network" I am seeing a notification that they are no longer affiliated.
Here is the info from one:
"Unfortunately, UnitedHealthcare has forced St. Peter’s Health Partners out of its network, effective July 1, 2024. This impacts patients who are covered by UnitedHealthcare employer sponsored commercial (excluding the New York State Empire Plan), Medicare Advantage, Medicaid and Essential Plan health plans. UnitedHealthcare has disrupted your access to St. Peter’s Health Partners hospitals, facilities, and physicians."

Meanwhile, during the chat, the rep was telling me they were in-network. When I shared this I was told to hold, then told they "had negotiated coverage until November 1.
I could go on but the point is they cannot be trusted to give true info and it is costing me hundreds, likely thousands in co-pays that are now rolling in.
I have a chat printed telling me something was covered and it was not. That one test will now cost $700 co-insurance.

There are multiple comments here about this and AARP doesn't seem to care?!?

GailL1

Community Champion ⭐⭐⭐

@l264203s

Network changes happen all the time in Medicare Advantage plans because they are contractual with a start and end date which happen throughout the year. The BEST place to find out if a provider is still in-network is to call the provider.

You are right, an insurer’s CS reps might not know about the changes - they are looking at the same info you have. It takes time to work its way thru their systems. The same is True of Traditional Medicare, providers can change their status with Medicare from taking assignment to participating where they can bill you +15% or to “non-participating”, where nothing is covered by Medicare. - again these happen throughout the year and it takes time to change things in their system(s).

You can also usually change plans via a SEP (Social Enrollment Period) if this is a real inconvenience or importance to you.

Per Medicare:

There are other situations where you might qualify for a special enrollment period (SEP), like if you joined a plan based on misleading or incorrect information from a plan representative or State Health Insurance Assistance Program, or you’re notified that there’s a significant change in your plan’s provider network. These special enrollment periods are evaluated on a case-by-case basis.

Now they may not give a SEP if the provider is a single doc or small provider but with something like a hospital chain or healthcare system, that’s big enough to warrant a SEP evaluation.

Medicare.gov - Special Enrollment Periods

UHC posted this on their website on 07/26/2024

St. Peter's Health Partners leaves UnitedHealthcare's network

I saw in this notice that they did extend Medicaid coverage until the end of August. That’s the 60 day “cooling off period” so I believe it also affects Medicare Advantage plans too. According to St. Peter - the actual stoppage was on 09/01/2024 - That’s 60-days from the date the actual contract expired

on 07/01/2024.

WNYT 08/15/2024: Sept. 1 Deadline Nears for When St. Peter’s Won’t Accept UnitedHealthcare Coverage

It also was covered in several NY newspapers.

Open enrollment begins in a few weeks (starts 10/15) for 2025 plans - if you cannot wait that long, cannot find another provider and need to change police’s NOW, a Special Enrollment Period sanctioned by CMS is the only way to go.

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

P

PaulE709499

Contributor ⭐⭐

Making the right choice with a healthcare plan is so difficult these days. My mom, a retired state worker, has an HMO plan. The newest plan book typically outdated so we call the referred office to confirm covrage and also get the physician EIN number to double check that they are covered in that location.

V

VickiM376855

Contributor ⭐

My current medicare advantage plan has raised the rates and started to deny coverage. AARP should not sponsor these plans any longer, United Health Care is now in the business of making money instead of providing necessary care to the people who pay for their coverage. I agree whole heartedly with the above post. AARP needs a new plan. We now pay more to get less. Very dissapointed. Seems nothing has changed since you posted this. 😞

GailL1

Community Champion ⭐⭐⭐

@VickiM376855

It is rare that a Medicare Advantage plan has high premiums or even premiums at all - You do have the right to change plans every year during Medicare plan open enrollment to pick a plan that best fits your needs.

You can File an appeal or a complaint with Medicare, the program - it is all a part of the same program - original Medicare and Medicare Advantage -

Medicare.gov -Filing A Complaint or an Appeal

Medicare Advantage plans are paid by Medicare to service your healthcare needs based on the benchmark of the current year. If you have other extra coverage, which the OG program does not have, you may have an added premium.

IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna

Disclosures

Sign up

Login with SSO

Login to the community

Login with SSO