United Healthcare terminates contract with Houston Methodist; 100,000 plan members affected

[Northeast Agent]

United Healthcare terminates contract with Houston Methodist; 100,000 plan members affected

The move would affect anyone with a UnitedHealthcare employer-sponsored plan as well as those covered under the insurer’s Medicare Advantage program for seniors, both the hospital and the insurance company confirmed on Thursday. Medicare Advantage enrollment for 2020 begins next week.

UnitedHealthcare, the nation’s largest insurer, has also said it would drop roughly 800 Methodist-employed physicians from its network on April 1, 2020.

 

[somarco]

I am not a fan of mangled care networks or UHC. But this kind of public grandstanding happens too frequently as carriers try to rally public support and put pressure on providers to accept lower reimbursement.

Gotta protect shareholder profits.

 

[vic120]

This is why I say these plans are not stable just because there is a plan that is amazing one year doenst mean it will stay that way year after year

UHC did this in Fl one year MID year clients were flipping out and it was more then just one maj hospital

I Sell MA and have more buis for it, I have buis that would otherwise have gone elsewhere, However there is always something somewhere, I have a bunch of Aetna clients in a couple of states that have plans discontinued, They don't send me a notice, There are plans similar to the ones discontinued available, I only know because clients call me, But I lose some

Fewer Issues with Medsupp, but for me having MA available is a necessary evil

 

[Northeast Agent]

There was a nasty issue in the Pittsburgh area between UPMC and Highmark MA plans, fighting over hospital networks. My State AG had to step in, sort it out and demand a truce. But last AEP/OEP was a field day for some indy agents in western PA! I heard they moved a lot of beneficiaries to UHC plans, as they had the hospitals that were being fought over.

Still always best to have a Med Supp, this just being one reason.

 

[somarco]

Back when I handled U65 health insurance one of my clients was also a good friend. His health was good when I took the application. Less than a year later he was diagnosed with stage 4 melanoma. He lived about 3 years after the diagnosis. UHC must have paid close to $200k.

Towards the end he was spending a lot of time in a local hospital. UHC and the hospital made it known the contract was going to expire without a resolution. Ted called me almost every day to ask if they were going to work things out. He did not want to change docs and/or hospitals while in treatment.

The contract expired at midnight, then the next day they announced an agreement. No harm, no foul . . . other than the additional stress of possibly losing access to your docs and hospital.

 

[Northeast Agent]

I have a TX NR license (not sure if that's why I received this email, or if everyone appointed with them did):

Announcing a 5-Star Rating!

UnitedHealthcare is excited to share that Medicare Advantage and Dual Special Needs Plans in Texas received a Star Rating of 5 out of 5 stars for 2020 from the Centers for Medicare & Medicaid Services (CMS)!

A very rare event, we are extraordinarily proud to deliver a 5-Star Rated contract in Texas. Having achieved this in 2017, we are extremely proud to achieve it once again in 2019.

Star Ratings are one of many tools available to help Medicare beneficiaries evaluate the quality and performance of their Medicare plan. You can find more information on Medicare.gov.

TAKE ADVANTAGE OF THIS OPPORTUNITY


HIGHLIGHT STAR RATINGS WITH YOUR MEMBERS AND CONSUMERS

How You Can Impact Star Ratings

You can influence our Star Ratings by supporting a positive experience for our members during sales seasons and by encouraging them to take advantage of their covered services to live healthier lives. Here are some direct ways you can make an impact:

• Collect all information on the enrollment form to ensure completeness and accuracy.
• Help your member to complete a Health Assessment during a LEAN application.
• Explaining thoroughly the benefits and copays of a member’s plan.
• Communicate to members how to contact their Primary Care Physician (PCP) to schedule an annual Wellness exam.
• Reassuring members that when UnitedHealthcare contacts them periodically, it is to assist with assessing preventive care needs, such as flu shots, mammograms and medication reconciliation

After the Annual Enrollment Period (AEP) ends on Dec. 7, 2019, consumers have a Special Enrollment Period (SEP) to enroll in this 5-Star plan from Dec. 8, 2019, through Nov. 30, 2020, using the 5-Star SEP.

 

[vic120]

I have a TX NR license (not sure if that's why I received this email, or if everyone appointed with them did):

Announcing a 5-Star Rating!

UnitedHealthcare is excited to share that Medicare Advantage and Dual Special Needs Plans in Texas received a Star Rating of 5 out of 5 stars for 2020 from the Centers for Medicare & Medicaid Services (CMS)!

A very rare event, we are extraordinarily proud to deliver a 5-Star Rated contract in Texas. Having achieved this in 2017, we are extremely proud to achieve it once again in 2019.

Star Ratings are one of many tools available to help Medicare beneficiaries evaluate the quality and performance of their Medicare plan. You can find more information on Medicare.gov.

TAKE ADVANTAGE OF THIS OPPORTUNITY


HIGHLIGHT STAR RATINGS WITH YOUR MEMBERS AND CONSUMERS

How You Can Impact Star Ratings

You can influence our Star Ratings by supporting a positive experience for our members during sales seasons and by encouraging them to take advantage of their covered services to live healthier lives. Here are some direct ways you can make an impact:

• Collect all information on the enrollment form to ensure completeness and accuracy.
• Help your member to complete a Health Assessment during a LEAN application.
• Explaining thoroughly the benefits and copays of a member’s plan.
• Communicate to members how to contact their Primary Care Physician (PCP) to schedule an annual Wellness exam.
• Reassuring members that when UnitedHealthcare contacts them periodically, it is to assist with assessing preventive care needs, such as flu shots, mammograms and medication reconciliation

After the Annual Enrollment Period (AEP) ends on Dec. 7, 2019, consumers have a Special Enrollment Period (SEP) to enroll in this 5-Star plan from Dec. 8, 2019, through Nov. 30, 2020, using the 5-Star SEP.

Don't know why I didn't get this I do some in tx with them

Don't know why it's 5 stars What does that mean?

Their plans are OK nothing special good not great in TX

 

[Northeast Agent]

vic120 said:

Don't know why it's 5 stars What does that mean?

I don't know what's so special about them there, but maybe someone from TX who sells UHC will jump in and tell us. I just have the license from working in a call center. Ironic after the kerfuffle going on about Houston today.

And with the (rare) 5 Star Plans, it creates an SEP for beneficiaries to change plans during Lock-In. The closest one to me is with KP now, in the DC Metro area. I think some Aetna plans are 4 or 4.5 Stars.

 

[vic120]

vic120 said:

Don't know why it's 5 stars What does that mean?

I don't know what's so special about them there, but maybe someone from TX who sells UHC will jump in and tell us. I just have the license from working in a call center. Ironic after the kerfuffle going on about Houston today.

And with the (rare) 5 Star Plans, it creates an SEP for beneficiaries to change plans during Lock-In. The closest one to me is with KP now, in the DC Metro area. I think some Aetna plans are 4 or 4.5 Stars.

I sell enough of them and I do a lot in TX,

They have one PPO where the copays are the same as in-network and out, But it is over $40 per month and the copays are fairly high, I have some clients go with that because the out of network is better than others but the in-network is notwhere as good as others

They have a lower PPO at $0 but the Aetna PPO's seem to have better benefits,

they have an HMO that is OK but depending Humana can be much better plan benefits

 

[CrustyVet]

I'm in Houston. I got both emails today. First one about the contract with Methodist , and then the one about the 5 star rating. The last thing is kind of a big deal because the only other 5 star plan here is with a local hospital group that built their own MA plan, but as far as I know they don't contract with independent agents. With AEP just arriving there may be other announcements like this coming in other areas. I'm just guessing at that though.