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United Health Care leaves Preferred Care Partners behind in South Florida

UNITED HEALTH CARE FAILS TO PROVIDE INFORMATION
Feeling Sorry For Preferred Care Partners Members
8 February 2014
By David Arthur Walters
MIAMI MIRROR
MIAMI BEACHI believe I may have made a bad mistake during the latest
Medicare Advantage enrollment period by sticking with Preferred Care Partners.
I chose Preferred when I became eligible for Medicare a few years ago after
carefully considering the lively competition in South Florida. I was somewhat
alarmed a year ago when I heard that Preferred had been purchased by United
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Health Care, a company that had been last on my list when I shopped for health
care coverage prior to become Medicare eligible. But I hate to change horses
once I make a decision, so I decided to stick with Preferred in hopes it would not
change its benefits.
I should have known better.
The first sign of trouble was during the enrollment period late last year when I did
not receive as usual a list of providers for my Preferred Choice Dade (HMO-POS)
Plan, a plan that gives member the most options.
I called Member Services towards the end of the enrollment period, to be told
that a list of providers had not been compiled yet, and that I must call doctors to
see if they are continuing to participate with Preferred because only they would
know. That would entail calling dozens of providers.
In mid-January, long after the passing of the enrollment period, Member Services
told me that a directory would soon be sent out to members along with new
identification cards, since the current identification cards were no good.
I have yet to receive a provider directory. I did receive a new identification card,
and was a little taken aback to see that it was a flimsy paper card with a
complicated member number instead of the usual sturdy plastic card that gives
one a feeling of permanence.
They are cutting costs, getting cheap, taking the peanuts off the bar, I said to
myself, recalling my fundamental economics lesson, that the dominant strategy
of capitalism is to undercut competitors until they go out of business or are
absorbed. They call that letting the market decide what it wants until there is no
competition left. Once a virtual monopoly or duopoly is established, the
objective is to maximize profits for the owners by providing the least benefits
possible for the highest cost. Any governmental intervention in this process is
inherently evil.
I asked Member Services for the usual booklet about the kind of plan whereby the
members Part B premium for doctors is fully reimbursed with a credit to the
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insureds SSA from which it is ordinarily deducted. Provider choices were more
limited under that plan, and there were co-pays. I was told that the plan was no
longer offered, and there were no booklets on optional plans available, that
inquirers must ask Member Services about benefits on the telephone.
I noticed that the people whom I spoke at Member Services with seemed harried,
unhappy. One customer service representative even took a dictatorial, take it
or leave it approach when something was misunderstood, treating me like a
child. I pitied elderly people who might ask her for an understanding of their
plans.
I called Member Services for a list of dental providers and a schedule of benefits,
and was referred to the Preferreds new dental administration company, Solstice
of Plantation, Florida, which advertises itself as winning all sorts of Best awards.
From my perspective as a dental patient the previous administrator, Argus Dental
Plan, was terrible in terms of communications, handling claims, and record
keeping. I related my horror story with the Argus network dentist and Argus to
the Solstice representative, and asked if Solstice would reimburse me for
whatever it would pay its network dentist after I paid Isadoros Mereos, the
excellent dentist who had solved the dreadful issue I had with Argus and its
provider, for a future service. No dice, said Solstice, he was out of the network.
I received a list of dentists via email, and was pleased to see that there were two
network dentists in my neighborhood instead of none as before, but I had actually
heard complaints loudly voiced on the street right in front of one providers
office.
After repeating my request for a schedule of dental benefits and policy terms, and
after waiting for several days, I was told that there was no extended schedule of
procedures covered as before or policy terms available to members, just a brief
one-page general description. I was incredulous, therefore I asked again,
identifying myself as a reporter, but I received no reply, and I began to wonder if
Solstice was as bad with communications as Argus.
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Dental coverage and gym benefits had been very important considerations in my
choosing Preferred. But GOLDS, Preferreds gym benefit provider in my
neighborhood, had gone broke, so I had returned to my local CRUNCH FITNESS
gym where I was paying a $60 month fee. The administrator there told me that
CRUNCH had become a member of the United Health Care network of gym
benefit providers, and that some people with Preferred Care Partners cards like
mine were getting their memberships fully covered, but it was not advertised, and
I should call Preferred Care Partners.
I was excited by the good news. I called Member Services and was told that my
county was not included in that benefit, so I was stuck with the old gym benefit,
which included an exercise CD, or membership in gyms that would entail my
riding the bus an hour each day at a bus fare cost of $5 roundtrip. I work out
every day to stay healthy, and seldom go to the doctor, so we are talking about
$150 per month bus fare and 60 hours wasted on crowded busses.
I still figured Preferred might provide me with a CRUNCH membership since it was
now owned by United Health Care, so I emailed a person in Member Services who
had been very helpful to me before. She had always responded to email. Email
wasted. No reply. I suppose I shall call, but I hesitate because talking to Member
Services is no longer a pleasant experience.
Oh, come to think of it, my main HMO doctors office used to call me twice a year
to inquire about my health and remind me to get a checkup. No more. I wonder if
he is still my doctor.
Preferred Care Partners is walking dead, sucked dry by United Health Care. I feel
sorry for Preferred Care Partners members and other victims.
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