Health care in America is a
maze of poor information and inefficiency.
AARP United Health Care-
Medicare Solutions Adds to the Confusion
When you want medical help you
don’t want to spend hours looking for a doctor.
If you are enrolled in a Medicare “Advantage Plan" underwritten by
a major health care management corporation you might assume that a doctor is
easy to find. You just pick up the
provider directory (the telephone book sized reference sent you in the mail)
and call one of the physicians close to your home and make an appointment. Even if it isn’t an emergency, no one wants
to spend hours on the phone trying to locate a doctor who will see them. I am here to say that finding a doctor in the
provider network of the AARP United Health Care- Medicare Solutions Plan is a
torturous process that will have you sitting on the phone, pecking away at the
computer, and having painful and repetitive conversations with strangers for
hours on end.
Let me say that I do not go to
doctors frequently. In my experience in the labyrinth of the American medical
system I have always been lucky to have had a decent health plan attached to my
employment package. I saw the same
doctors for decades. I knew them and
they knew me. I thought Medicare would
be a continuation of that sort of care.
Not so! Medicare is a maze unto
itself. Layered upon the maze of
Medicare regulations, price structures, donut holes and a thousand and one
frustrating dates and deadlines is the “Advantage Plan”, a sort of Medicare
privatization that is supposed to reduce costs for participants and provide
good care within a network of providers.
I do not pretend to be an expert in the workings of either Medicare or
the “Advantage Plan” but I relate one experience for the reader to consider.
I have a pain. I live with it until I see it is not going
away by itself. I take out my United
Health Care plastic wallet card and call the primary care physician given me by
the “plan”. When I signed up for the
“plan” and saw that my own doctor was not a participant I should have known
that the “plan” was not for me. But I
signed up anyway. I assumed I could
easily get used to another doctor and the plan seemed to have dozens in my
area. There was no answer at the
office/doctor listed on my card so I took out the provider directory and began,
what turned out to be, a two and a half hour juggernaut of phone calls and
dead-ended conversations. I found many
of the listed providers put me through a vetting process, extracting mass quantities
of personal and contact info only to find out afterward that they didn’t accept
the UHC insurance. After the first few
calls I began each conversation telling the receptionist exactly what my
insurance was so there would not be a lot of wasted time. It did not matter. Though I’d warned them upfront and even
scheduled appointments a final reminder at the end of the process turned up
that the insurance was unacceptable and my time was wasted. Once I was sent on a “goose chase” calling
the accounting department of a large doctor’s group only to find that they did
not accept AARP United Health Care- Medicare Solutions Plan!
Remember-all of these doctors are listed in the 2014 list of providers
given me by the plan when I signed up!
Out of the twenty providers I
called, half refused to accept the insurance at all. Of the balance, many were not answering the
phone and there was no message machine or any way to know if they were even in
business. I left messages on a half
dozen machines but have received no return call in twenty-four hours. The only place that would give me an
appointment was a community clinic and the appointment was for a week in the
future. I was informed that they do
accept the “benefits” but the doctor who participates in the plan only comes to
the clinic for four hours, one day a week.
I was frustrated and shocked
with this experience. So I called the
provider. I spoke to a woman who gave me
the phone listings a half dozen more providers in my area and I kept her
waiting while I cross checked them. Half
of them I’d already called and didn’t accept the plan, and the rest of them
were either too far away to be of any use to me or were in the same clinic
where I’d gotten my appointment. I asked
to talk to a supervisor.
This is where I entered the
“Twilight Zone”. I told her about my
experiences in the pages of the provider directory. She apologized and, according to the
supervisor, the plan had recently been “cleaning up” and they were “updating” the
directory. In fact, she said, United
Health Care turned away many, many providers who wanted to participate in the
plan. Why, I asked, would you want to
limit the number of providers, and if so many wanted to participate why
couldn’t I find any in a metropolitan area like Westchester county, New York? Her answer was not intelligible. I asked her if I used the on-line directory
would I find more doctors who actually accepted the plan. She said “Yes!”
Today I went to the provider directory (PDF on-line) and it
was for 2013! Even more out of date than
the 2014 directory I’d been using. It
was 2393 pages of useless information! To wit- I quote from page 3:
This directory is current as
of
September 1, 2012. Some plan
providers may have been added or removed from
our network after this
directory was printed. We do not guarantee that each provider is still
accepting new
members.
To get the most up-to-date
information about the Plan’s network providers in your area, please call the
phone
number listed below or visit
our website at
www.UHCRetiree.com
.
Call Customer Service
toll-free at
1-800-457-8506
Now I know what it takes to be
a supervisor at United Health Care-You need to know how to get people like me
off the phone.
Health care in America is a
maze of poor information and inefficiency.
