United Healthcare

[ThomasB614634]

 I recently learned that United Healthcare had the highest rate of denials for claims of the major players in the industry. Do you know this at AARP and if so, why would you endorse them? Price for healthcare should not be the only consideration which I would think you have checked but now I wonder if you check denial rates or other factors involved in purchasing this insurance.

 My membership is up for renewal and I'm very reluctant to renew considering this? Could you please respond?   Tom Bolonchuk

[js62231179]

With 30 million AARP members, AARP should have vetted and be supporting the most humane and equitable health care insurance platform, not one with almost 30% in service denials.  I will be leaving United Healthcare in the next round of Medicare signups. Disgusted!

[GailL1]

@ThomasB614634 

AARP does not endorse any of the branded products to which they get a royalty payment for the use of their name.  In fact quite the opposite based on the disclosures which they make on these products.  Read the small print.  I think people think this because it may be implied but the AARP is not giveing them the seal of their approval.

There is always a way to appeal a denial and most of those that are appealed are approved - well, 80% of them.

Medicare, the program, supports utilization management as a way to prevent unnecessary medical care.  Or care that is not in the best practices realm.  

Everybody should get the Medicare plan that suits their needs the best.  Be that providers in a network or a medication on the formulary - but then if something happens the doc and the beneficiary have to work within the system to present their appeal and get coverage if it represents best practices.

I haven been a member of AARP since about 2010 - but I am a frequent poster on this social media platform as well as others.  I try to teach people about Social Security, Supplemental Security Income and Medicare - since I am really, really old and do a ton of reading on all these subjects including what government has proposed for them.  (I said government, not party).

[BarbBee]

I selected United Health Care AARP insurance because of my view of AARP as an organization who worked to protect consumers. I am really disappointed. Trying to read and understand the 'small print' on the coverage documents is impossible and unreasonable for most people.

I am outraged at the tactics used to deny coverage. I has surgery scheduled and checked online to make sure I had been approved. It was NOT showing up in my online records. But the docter had a copy of the approval. I was totally panicked. In the age of computers how did he have the information and not the customer paying for the insurance.  

[michaela667402]

I believe "read the small print" is disingenuous".  AARP throws its weight, and seniors depend on that.  Perhaps small print is not appropriate

[gs4506]

There are more issues that AARP customers are facing related to their UHC prescription plan.  I have a tier 4 drug that I take daily and the medication can't be interrupted.  In 2024 I have been able to get a 3 month supply to avoid any interruptions.  Like many retirees I travel a great deal and the 3 month supply avoids interruption in taking my medication.  After the end of the enrollment period UHC notifies me that I can no longer get a 3 month supply and have to get the medication monthly. Please note that I'm notified of this after I have the option to select another insurance option.   Another example of change in UHC policy that inconveniences AARP customers.  It doesn't appear that these policies are being made by clinicians (doctors and pharmacists) but from individuals who are solely looking to cut costs for UHC to increase their already record profits.  UHC customer service was less than helpful when brought to their attention.  They are unable to tell you who makes these decisions or why the decision was made. 

Glenn Sheffield

[MichaelD420616]

Yup, The same thing happened to my wife. same MO. They sent the notice of no longer going to provide a prescription drug. the mail arrived on the day after open enrollment ended.. Go Figure.. Seems pretty underhanded to me.

[GailL1]

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@MichaelD420616 wrote:

Yup, The same thing happened to my wife. same MO. They sent the notice of no longer going to provide a prescription drug. the mail arrived on the day after open enrollment ended.. Go Figure.. Seems pretty underhanded to me.

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MAPD plans can do this at anytime based on the medication.  There is all kinds of reasons why it could be done - and all of those reasons can be sanctioned by Medicare - it could be that the medication has been pulled from the marketplace.  It could be that the manufacturer has a shortage.  it could be that a generic or bio similar has come into the marketplace.  It could be that the med has been reevaluated and it is no longer a drug of choice for her condition or other factors like her age or something else.

Depending on the elimination reason, an exception can be filed by her doctor for it to be covered.  

[michaela667402]

It could be that they are their own Benefit Manager...which is more than "could".

[AARPConsumerCare]

We're sorry to hear United Healthcare will no longer provide a prescription to your wife, @MichaelD420616. We are listening and would like to get more details about this. Please visit https://help.aarp.org/s/article/contact-aarp to chat, text, or speak with a representative who can get you in touch with our Member Relations team. - Diana G.

[MichaelD420616]

And this should be a AARP top priority. Given the membership of AARP. HELLO??

[wd3685]

I I have been the victim of these very same claims denials. I joined AARP United Health Care Medicare Advantage Plan as of 9/1/24 when I was no longer eligible to stay with my wife's plan when she retired. The claim denials are unfounded and the customer service advocates who supposedly are there to help you are a joke. I have been placed on hold for more than two hours while an "advocate" tells me they need to "escalate" my case to someone higher up. When they can't get a higher up on the line, I am told I will receive a call back which never happened after three attempts. Beyond frustrated and wondering what I'm paying for. AARP - are you listening here?!

[MichaelD420616]

wonder if others who have the UHC advantage plan had the dental taken out of the 2025 unless you pay an additional $59.00?  Sneeky.. first year included. 2cd year slide in an upcharge.

[GailL1]

@MichaelD420616 

Medicare Advantage plans ONLY have a shelf-life of one year.  That’s why you either have to re-UP to the same plan with whatever changes they have made or pick another plan during the combined open enrollment during the fall.  (10/15 - 12/07 - I think)

However, there is also a Medicare Advantage OpenEnrollment period going on right now (January 01 - March 31) and during this time you can switch to another Medicare Advantage Plan and the change should be effective the month after you make the change.

Medicare.gov - Understanding Medicare Advantage & Medicare Drug Plan Enrollment Periods 

Also in about Sept or October every year, your current Medicare Advantage (most all of them have a built in prescription drug program) OR your standalone Part D plan should send you what is called an Explanation of Change (EOC) and it will go over ALL the policy changes or any prescription drug plan changes - including the formulary changes.

Very important to review this document EVERY YEAR - sometimes insurers will only send you an email saying that it is available on line.  

So if you don’t like the MA plan you have now - check to see which other ones are available to you where you live and see if they better fit your needs.