AARP United HealthcareMedicare Advantage

[MrGG]

Jurisdiction

Florida

I signed up for this plan in 2020 because it had all my doctors listed. I could have gone with other plans that were cheaper but I did not want to lose any of the doctors or specialists I have used for years. Every year a new enrollment period starts and you can switch providers at that time if you wish. I checked on November 2021 to make sure all my doctors were still listed. I renewed. I have a doctor's appointment coming up in April with a specialist and was just informed by the doctor's office that they no longer accept that insurance. The doctor's office told me they informed united healthcare last Oct 2021 that they would no longer take their insurance. My doctor along with other doctors in the same office is still listed on the United healthcare site. Do I have any recourse against united healthcare to force them into paying me for the visit since I have to pay on my own to go to this specialist?

 

[army judge]

Do I have any recourse against united healthcare to force them into paying me for the visit since I have to pay on my own to go to this specialist

NO
NEIN
NEE
NON

 

[adjusterjack]

Agree.

No medical insurance company can keep track of thousands of doctors on a day to day basis.

It's entirely up to the patient to ask the doctor's office if that insurance is still valid.

 

[hrforme]

I think you are slightly too early.... the No Surprises Act that goes into effect in 2022 does have a portion that does address this very issue. Insurers will have a much shorter period of time to make changes to online provider directories under that federal law (just got done in a webinar with UHC a few weeks ago on this with their internal legal counsel).

That said, as an HR professional, one of my colleagues changed her whole employee group's insurance carrier in Texas to a specific provider only to have them freeze services with one of the largest hospital groups in Texas right after the start of the plan year. At analysis and open enrollment, the hospital group was contracted and within days after the start of the new year, they weren't.....**it happens.