Health Care Costs - United Healthcare

[disneywithfive]

My company is thinking of changing plans and going with a PPO with United Healthcare. Looks like it's going to cost us more money but can someone who has them, please give a review of their experiences with the company.

 

[ceecee]

We've had UHC for years. All of my doctors accept it so we've never had to go out of network, a few Rx were not covered (Nexium and Claritan) but they offered alternatives and my Dr approved those instead. They also have some kind of rating on the Drs because when I called to see if a specialist was covered he told me yes and that he was a 3 star Dr...3 out of 3!

 

[NotUrsula]

Which plan? Makes a big difference.

 

[ckmommy]

We have a PPO with UHC. I have been very pleased with them so far.

 

[meliss8599]

LOOOOOOVE UHC. We minimally pay OOP with them--their coveragea and customer service is excellent. Any time we've had to switch in the past (due to employer changing providers chosen) we were never as happy as we were w/UHC.

 

[sunshine1178]

My company is thinking of changing plans and going with a PPO with United Healthcare. Looks like it's going to cost us more money but can someone who has them, please give a review of their experiences with the company.

I have a UHC ppo through work. No major complaints. Good communication, quick processing, no trouble finding in network providers.

 

[solotraveler]

Which plan? Makes a big difference.

This. UHC has millions of subscribers and there are thousands of different plan variations.

What type of plan/coverage is being offered?

 

[Melynny]

I am not sure where you are, or if other plans are offered, But, I had United Health care for several years thru my employer. They were great, paid everything, the copays were reasonable.. then they ( or my employer) added a larger deductable before anything would be paid, And raised my portion paid per pay check , and then the next year they changed the portion of many, many tests and services to 80/20 pay, insurance paid 80 % and I paid the 20 %, even after the deductable and the larger co pay. Now I don't know if this was UHC pushing this or if it was my employer, but since I have several on going health problems, it beacame very expensive, even with insurance.

I have since switched to Mercy Health Plans, not sure if it's in your area, but I have been so pleased with them, they have really reduced my medical expenses. The only difference between UHC and Mercy, is that Mercy will not cover anything that is considered out of network. I made sure that all of our dr.s that we had longer term relationships with accepted the plan and we were set. We have had to use the emergency room while in Florida several times, as well as out of town and have not had any problems.

My only advice is to make sure that you read the paperwork that details what is covered and what is not and at what percentage. Our Dr.'s still try to get a copay for visits to a dr's office for tests only, even though they are fully covered under our plan, and the minute we question, they say oh yeah.. that's right. I can imagine how many just pay because they have not read the fine print.

 

[rvchat]

at all. They keep billing us so they don't have to pay the doctors. Then when we call (long waits) to rectify, they say oh, ok and this 'may' happen again.

I've had to file several complaints already. YOu can check those, see how many others have had issues. BBB.

GL, pm me if you like

 

[mrspaha]

We have been with United Healthcare for several years; our insurance is through my husband's employer (union, actually).

What is or isn't covered is not decided by United Healthcare. It is up to the employer to specify in the policy what's to be covered. So our coverage might be different from my neighbor's coverage who is insured through United Healthcare with a different employer. Likewise, such things as copays and deductibles are going to be different dependent on the plan that your employer has negotiated with UHC.

Overall, their customer service is pretty good. Occasionally, I have had to call when a claim has not been paid. An example when this usually happens is when I have had to have lab tests or xrays at a hospital. The hospital sends a bill, which UHC usually pays right away. But when they get the related bill from the radiologist or pathologist for the same xray/blood work, they usually deny it at first, but then pay it after I call.

They have a large number of physicians and specialists in their network (at least in Chicago), so we are generally able to stay in network.

 

[a1tinkfans]

UHC has many many policies, variations depending on what your employer is requesting. The only real way to get peoples opinions for your exact type of coverage is to know what you are getting.
I have been with UHC for 20+ years, thru an employer, thru a plan negotiated thru a Union, not PPO. From my experience, there were very few blips on the radar. The co-pays have gone up over the years (currently 20/dr, 60/hosp) there are many many sub specialties avail , their cancer services are Above Supreme (sloan ketttering etc). But again, that is all negotiated. As far as UHC as a whole, I think they would be rated very well and perhaps you can try BBB in your local area or call them direct with Your Q's about your specific plan being offered. They'll prob not give you much but may be worth a try. For the most part, any employer that offers PPO's usually have less cost to them, more cost to you, with less choices Is your company offering a meeting to "review" the offer to you guys??
Good Luck, hope it works to your benefit.

 

[ameraumi]

We had UHC a few years ago and I hated them. It sounds like things have gotten better, but our experience was not good. At the time certain meds we were on were not covered and the big one was processing claims were slow. There were many times we had to talk to the drs office so they would not turn us over to collections because UHC had not processed the claim yet.

 

[Shmily1]

We've had them for years. On the plus side, the OOP is cheaper. On the down side, they kept telling me my children aren't eligible. They've even argued that they aren't full time students, which they definitely are. It's just ugly!!

Now, we have BCBS and the OOP is higher but so far, they don't tell me I don't have kids!

 

[j's m]

Our business was considering them until I realized our local hospital is out of network. Check carefully that your doctors/providers are in network.

 

[daughtersrus]

Check and see if your doctors and medical facilities are still accepting UHC patients. Here in the Chicago area, a lot of them pulled out of the contracts because UHC was not paying the providers. At several of my DD's doctors offices, they have signs saying that they no longer accept UHC and the patient has to pay OOP for the appointment.

 

[jackskellingtonsgirl]

We have a UHC PPO through DH's work, but like others have said, the coverage is up to the employer. For us, we get one well check covered at 100% each year, and we get cancer screenings (mammogram, etc.) and routine labs covered at 100%. If we are sick we get slammed. Our deductible is $750 per person, so we pay 100% of the cost of the office visits until we hit the $750.

Our prescription coverage is COMPLETELY separate - it is through MedCo and has NOTHING to do with the health insurance.

 

[MelissathePooh]

We had UHC for 3 years through dh's employer. It was relatively reasonable premium wise for family of 4. Co pays did go up each year along with the premiums. The selection of physicians and hospitals were fine for us, but we had mulitple issues of them denying claims. We would have a typical visit and it come back denied. We'd wait on hold and eventually get through to someone to find out the "billing code" was wrong. We'd call the Dr's office and they had used the same billing code as always - UHC would code it differently - basically change how they wanted something coded and they did it frequently. The Dr's offices couldn't keep up. It would ultimately get reimbursed, but it was a headache.

My biggest argument with them was when I had an emergent appendectomy. I went in through the ER - which would have been a $75 co-pay (unless you're admitted then its waived). I had surgery at 2am, admitted to a room by 3am - stayed that night and all the next day and night - discharged after 12 noon the 3rd day. Because I wasn't in the actual room for 48 hours UHC considered it outpatient - they default appy's to outpatient. The wanted the $75 ER visit copay. In the scheme of things $75 isn't bad for the incident, BUT its not what the policy guidelines said and I never could find where the 48 hour rule was ever written.

We just switched to CIGNA this January - as dh's employer dumped UHC due to costs. We're paying over $100 extra each month, higher copays, less coverage. We had to get a statement that I have no other coverage NOTARIZED along with 2 forms for the same thing. Ended up back in the ER after a nasty fall and sprain to my ankle - the whole thing was denied. Called about it a day ago and it was denied because they wanted a verbal confirmation AGAIN that I don't have any other insurance.

While I'm thankful to have coverage, I'm over thinking that any company is really concerned about anything other than profit.

 

[Jaklackus]

Definitely check to make sure your local providers and facilities are in network. There were contract disputes in this area within the past few years...the local news would interview 8 month pregnant women with no hospital to give birth in, women stuck with 30k hospital bills after giving birth because of the same contract dispute.

Someone on another forum I read was freaking out because mid way through a pregnancy UHC decided they weren't going to cover a medication for a life threatening blood disorder anymore.

 

[disneywithfive]

This. UHC has millions of subscribers and there are thousands of different plan variations.

What type of plan/coverage is being offered?

Choice Plus Edge

Our deductible is already high with our current provider/plan and it will be even higher with United but I know there are other plan options, just not feasible for our company. I was just interested in the network, how fast they processed claims, customer service, etc.

 

[SOnotLayuh]

We had UHC for the past 10 months. I had to go to the ER once during that time, which was a while ago, and we are STILL fighting them to pay it. I paid the copay, they are supposed to have paid the rest as per our policy.

It was costing us 527$ a month (only DH and I) for this crap. They have awful customer service. AWFUL. I've spoken with at least 20 people, and I'm always friendly (you catch more flies with honey!), but they are always rude - they've also "suggested" that I could be attempting to commit insurance fraud when I pointed out that my ER visit was well covered through our policy.

I also couldn't get generics through their plan.

As of February first we are off of UHC (which was offered through DH's employer) and took out a private plan with Blue Cross Blue Shield. We're paying half as much as we were - we had BCBS in the past and have always looooooved them.