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Old 01-26-2008, 06:22 PM
 
179 posts, read 551,307 times
Reputation: 69

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Hi,
We will be retiring and moving to Davidson later this year. My company health plan (which follows me in retirement) is UnitedHealthcare. Can anyone tell me if they've had any problems finding physicians who participate in UNC ? Their website seems to show quite a few, but a friend who moved to Pinehurst has had some problems. He claims affiliated hospitals were easy, but was having a hard time finding doctors. I realize he's in a completely different part of the state, but was just interested in what, if any experiences any of you may have had.

Thanks, Bill
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Old 01-26-2008, 09:43 PM
 
Location: Moon Over Palmettos
5,978 posts, read 18,644,471 times
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Bill - check with your employer if your United Healthcare plan will change once you retire. Some insurance companies change the plans for retirees, which may include a change in network name or plan offering. UHC has a separate group for its seniors called Ovations so the network where you are right now may or may not necessarily be the same as to the one you will move to. Also, different plans are offered depending on the state where you will use the services. Once you get these answered, then you can go to the UHC website, pick the plan you will be on, and then search the provider directory that way. Because UHC constantly adds providers to its network but can't keep up with the update on the internet, call a provider you want to see and let them tell you if they are in network with UHC. This is more reliable than you calling the customer number on the website as providers are contacted by a group different from customer service.

I'm sorry if this is clear as mud. Insurance is really complex!
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Old 01-27-2008, 10:41 AM
 
16,308 posts, read 26,756,449 times
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Well good luck with UHC

My wife's employer switched to UHC in 2007, It was a nightmare trying to get any claim paid, and most claims were denied on first pass, requiring calling UHC multiple times, resubmissions, and playing their "little games".

After that claim was paid (3 months late) I went to the doctor again, and this time it was denied because the said that I had other primary health care coverage, and this time it took 4 months, letters from my previous provider (BCBS from the same employer). It is my firm belief that they just deny automatically assuming a certain percentage of people will not challenge it or just give up in utter frustration of playing their game.

Though my wife changed jobs and we have far superior coverage from her new employer, it was so bad for all employees at the first job that they have dropped UHC like a hot potato and gone back to BCBS.
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Old 01-27-2008, 11:46 AM
 
Location: NC's southern coastline
452 posts, read 2,213,579 times
Reputation: 366
This thread is making me nervous. My husband's employer just dropped BCBS as of January 1 this year and we now have United Health Care.

Our coverage is SO much less than when I carried my own insurance when I was working...we both used to have BCBS and coverage was being cut down every year until now we were forced to UHC. Our UHC coverage is not very good so I hope NOT to have trouble in getting things covered if we make it to the high out of pocket deductible.

We're not in Charlotte anymore and there aren't as many of certain specialists in this area, so I think we don't have to worry about doctor being in network, I think we can see whatever doctors we want to for this reason..for example, my daughter needs a pediatric opthalmologist and there is only one that I know of in this area- he is not on UHC's network. But because he is the only one of such type in this area for a good distance (like 2 hours away), we can see him and have it covered supposedly. Now I worry that UHC will give us trouble.

From what I remember when I worked in Charlotte and had 3 insurance choices from my employer- an HMO, BCBS and UHC...a lot of people were having trouble with the options except for BCBS- just as described, claims being denied every time on first pass, people having to call over every single claim and haggle it out to get their coverage.
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Old 01-27-2008, 02:49 PM
 
179 posts, read 551,307 times
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Bibit612, Thank you for your response. For me at the company I work for, the coverage and name will be the same, so I will follow your suggestion about contacting the physician if necessary.

BlueLily7, I wouldn't get to excited yet. As bibit mentioned, UHC has quite a few different programs, so I'd wait until you know exactly what you have. We switched about 5-6 years ago (AT&T), and to be honest it's either the best or close to it, coverage we've ever had, at least in my experience (42 years). I've yet to have ANYTHING even questioned, much less denied. Again try and find out your policies name and go to the UNC web site, but as far as my experience, they've been great !!

A few things I forgot. In 5-6 years I've never even seen a UHC form, much less had to fill one out. Also we do NOT require any referrals from a Primary Care Physician. Asheville Natives' situation is very aggravating to say the least, but unfortunately probably not all that uncommon. I believe a lot has to do with what the company you work for negotiates with the policy carrier. Hope this helps some.

Bill

Last edited by billjr; 01-27-2008 at 03:24 PM..
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