Enter The Maze of American Health Care-bring a shovel!

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.