I specifically avoided UHC when choosing health insurance because I have heard so many awful things about denials of care from both those who have had UHC and those who are providers. It’s a good point about checking to see what my mutual funds hold, if any, health insurance companies.
No option! DH just had procedure under sedation recently, had some vomiting after. Nurse asked if he wished to remain longer for monitoring and anti-emetics. I said nope, I will bring him home and address problems myself. I have no desire for some claim denial based on remaining longer or receiving something off protocol.
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H has been working for the same company 35+ years, only Aetna.
Some would have the choice to forego employer insurance and buy insurance on the state exchange. Pricing can be relatively similar (but not always.)
Has anyone done this (United or not?)
Unitedhealth’s market cap is over $500B, and in the top 20 companies in the world by market cap…what that means is that thousands of mutual funds and ETFs hold it.
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My employer began offering the same insurance plans administered by either UH or another insurer. Coverage is supposed to be identical. Guess which one we picked and are sticking with…
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Unfortunately, no control over that. Same as other companies I might not invest in if I were buying individual stocks. So I do only what I can reasonably do.
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It’s hard to avoid the inherent conflict that we have in the US…publicly traded companies’ fiduciary duty is to the shareholders (not customers/patients/consumers.) And that fiduciary duty is a legal obligation.
Obviously that can cause quite the conflict.
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My daughter is currently dealing with her insurance. The policy says prenatal care is covered without needing to meet the deductible. Sounds good, except so far all the lab work and ultrasounds the doctor ordered are not being covered because they are not “prenatal care”.
I had the issue with an “out-of-network” anesthesiologist at an in-network facility with all other providers being in-network. I got it straightened out after several phone calls referencing both the federal surprise billing act and the fact that our state had a similar law before that went into effect. One of the people I talked to said “Oh, our computer hasn’t updated to reflect the surprise billing act.” This was 6 months after it went into effect. Someone less aware of current laws would just have paid it, and that’s what they count on. This one is on the anesthesiologist group practices too, since they were getting more from their out-of-network billing than the insurance ended up paying them.
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I’ve had a United HealthCare Medicare Supplement (not Advantage) for two years and have been very happy. I was shocked to hear the number of claims denied, when compared to other companies. I’m glad to know we can change companies at the start of each, so will continue on until I encounter problems.
This brings back memories of an insurance denial when my daughter was young, 1993 or 94. She was born with a condition that insurance claimed was “cosmetic”. I saw a news story on another child with the same “cosmetic” problem. Long story, short, we teamed up, took our kids to the Minnesota Legislature, found doctors to testify, and got a law passed so that now, all people with that particular “cosmetic” problem are covered.
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I have had a couple of issues with Anthem. First was when son had a pre-authorized surgery. They did a couple of different procedures for two different diagnoses at the same time. That messed up billing and caused Anthem to deny. It took several months to get hospital and Anthem to use the right codes to get it approved. What would have been a $17k bill to me was eventually $3k paid by Anthem.
My other issues with Anthem have been due to routine blood tests. These should be covered, but for the last two years were denied. I was able to get one recoded and paid by Anthem but gave up this year and just paid it myself. I see the doctor tomorrow and will probably ask her to order fewer tests in the future.
My husband has UHC and has fewer problems with them than I have with Anthem despite him having way more health issues. His only problem has been getting his Ozempic covered. There was a delay but they eventually agreed to cover. It is to lower his A1C, not for weight loss. He still has to use a manufacturer’s coupon to make the cost reasonable though. If he ever loses access to those coupons he will probably stop taking it.
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From what I have seen, employer provided insurance is highly subsidized, and employers do not pay out anything close to the entire subsidy amount of you forego it (and the amount paid becomes taxable income). So foregoing employer provided insurance to buy a similar coverage policy on the ACA will likely cost substantially more.
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I have been dealing with cancer for a while (not quite ten years). I fortunately have or had a slow form of cancer for which there is a simple and relatively inexpensive blood test that shows how much exists right now. After a treatment for a while the blood test showed some cancer, but not enough that it was likely to be possible to find it. After a while the blood test eventually got to the point that there was likely to be enough cancer so that they could find it on a PET scan. Finding it is of course very useful to allow treatment.
My insurance at first denied the PET scan. Then they approved the PET scan, but did not approve the injection that you need to have a PET scan. The whole point of a PET scan is that they inject you with a radioactive sugar that goes quickly to whatever is growing, which includes wherever the cancer is, then they scan you and see where the radioactivity has gathered. You can’t do a PET scan without the injection.
On appeal they eventually allowed the injection, but at that point there was only one week left on the approval for the PET scan. Fortunately the health care facility was able to find a slot available for the test during that week. They found one small spot of cancer and “took it out”. Since then (2 1/2 years now) blood tests have been showing no sign of anything wrong. The word “undetectable” has become my friend.
I do not understand how they can approve a PET scan but not approve the normal process that is needed to do a PET scan.
Fortunately the cancer I have (or had) is so slow that a two month delay did not matter. This would not be true in many other cases.
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I can share lots of stories. As both a patient and a provider. Will see if I can summarize later (heading to the airport at the moment)
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We had retiree healthcare provided by my husband’s company. We had an HSA, my husband’s coverage was paid for mine was $165 a month. Our OOP max was $7500 and that included both of us. Plus the company gave us $1500 for our HSA. Edited to say that we had a high deductible plan.
They are discontinuing retiree healthcare and gave us $11,400 each to pick a plan on the marketplace. You think, ok that’s generous, we should be able to pick a plan for that
I just picked a plan, it’s a PPO BCBS. It’s $2200 a month. Not a high deductible plan, our deductible is $7500 a person not per couple with a $9000 OOP Max. It doesn’t cover the immuno suppressant medication that my husband has been on, but it does cover another. It only covers some of our physicians, the other covered all of them. It doesn’t even cover the few generic drugs we are on. So the family deductible is $18,000 and it barely covers our needs. That was the best plan.
So no, I don’t think you can find a plan that would be comparable to an employer one. My husband worked for 40 years and this was one of the benefits that kept him at this company. The good news is that we don’t have to be on these marketplace plans for that long.
And the other good news is that somehow my husband is ahead of his medication so we will have time to apply for this new medication that he will need to switch to. Just in time for him to switch to Medicare where his rheumatologist will probably get to fill out all this paperwork again. To tell a company that he needs a medication that he’s been on for that last 20 years.
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Something similar happened with me. While I was pregnant, OB referred me to a different OB for an opinion due to complications during birth #1-- should I have a planned C-section? OB #2 did various tests, recommended CS for sure. Insurance denied all claims despite OB#2 also being in network, because evaluation was “not prenatal care.” I mean I was pregnant, seeking care specifically regarding said pregnancy, but it wasn’t prenatal care? I did appeal, but eventually gave up.
I am a doctor. If I can’t navigate insurance, who can?
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Kind of like buying that car with the option to add an engine.
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Original Medicare w/ Supplement G covererd everything my RA doc / Internal Med doc / GYN doc, Podiatrist doc, Gastro doc have submitted - I simply get a statement of what’s what. All covered, every time. I have Aetna but I understood that if Medicare covers it and the provider takes Medicare it doesn’t matter who the insurance company is, it’s all paid.
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We have had a few. Nothing that was going to send us to bankruptcy, but more than one occasion of needing to do extended payment plans to pay for things that insurance wouldn’t cover. My premiums are heavily subsidized by my employer - looking for a different plan on the marketplace is not financially feasible for me.
@Mjkacmom here’s a story: my kid graduated from college and was headed to grad school but did not have health insurance provided by either school for that summer. So the kid signed up for insurance . A month later the kid was hit by a car with a life-threatening injury, a month in ICU, a month inpatient rehab, many months outpatient rehab with a total bill over $400k. Things can happen to anyone. I worry about my kids’ friends who say they cannot afford insurance.
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