Health Insurance Plans That Hide Their Data

Health Care Insurance Ratings

What a fiasco health insurance is for EVERYONE! I have the advantage of medical billing and problem follow-up experience in a medical office, but am currently sitting here trying to figure out the mess with my own insurance only 5 months after Medicare eligibility.

My husband is younger than me, so United Health Care was primary and Medicare secondary until he lost his job in 9/08. We were on Cobra until 11/01 which meant, and I have no idea why, Medicare then became primary insurance and UHC 2nd. In the meantime, I signed up for a AARP Medicare Advantage Plan which was to begin on 11/1 (I read the application carefully before signing it.) A few weeks ago I got a letter from the AARP plan saying they errored and my plan was supposed to go into effect 10/1, (HUH?) not 11/1 and had notified Medicare of the change.

Unfortunately I had a TIA 9/5 and several tests and doctor's visits ensued. My billing for October is now a mess and I am getting calls from the hospital and doctors offices informing me claims were denied and asking what is going on. AARGHHH!!!

We all know what a mess the medical and medical insurance industries are in. Try calling and wait for upwards to 30 minutes and get a foreign speaking CSR in India, because your insurance company has outsourced their customer service (???????) to India to save money so their shareholders make more profits, and who only knows enough English to answer common questions and is useless if your billing situation is complicated. This happens not only to patient's, but also to those handling insurance in medical offices.

Next, the insurance companies will make outrageous demands for information in an attempt to put off paying claims for as long as possible, and when they do pay, often pay less than contracted to pay which requires many more hours telephoning to speak to another CSR in India who has no clue what the is going on.

It is very confusing for the average patient and purposely so. I have the advantage of medical office experience, feel sorry for the many elderly people who are confused and have no clue how their insurance is supposed to work, end up paying bills they shouldn't, which brings about another serious problem.

There are private practice docs who are "double dipping." Patients pay bills received from the doctor saying they owe a balance (the patient shouldn't be paying because the insurance company hasn't paid yet), not knowing any better. Then the insurance company pays the doctor. I can say from experience I worked for a doctor who keeps both payments stating the patient has to write and request the refund. HUH??? (One patient has $657 refund due since 11/06) This is insurance fraud, so if you think this happened to you, call your doctors office to request an itemized statement and compare it to your Explanation of Benefits which is time consuming. If you suspect fraud, report it to your State Insurance Agency or District Atty.

God help us!!!

RATEING

I ALSO AM UNITED HEALTH PLAN, WHERE DO THEY RANK,EVER CARE IS THE PLAN

High time to overhaul our broken payment system

As one of a dying breed of primary care physicians, I commend U.S. News for bringing some accountability to the insurance industry. This industry has been allowed to consolidate unfettered to the point that one health plan controls more than 30% of the market in 95% of U.S. markets. The resulting oligopoly of power allows the large insurers to ramp up premiums at will, reduce coverage at will, and control payments to providers who have NO bargaining power. Their rules are often arbitrary and proprietary (hidden) and they get away with unbelievable tactics that amount to passive aggressive robbery. This is an example of capitalism at its worst and has resulted in the impending demise of the preventive primary care base (over 60% of residents training in primary care are foreign graduates and only 2% of current U.S. medical students intend to enter primary care practice). Health outcomes in the U.S. are dismal (32nd in world leading health indicators, 28th in healthy life expectancy) with a per capita expenditure that exceeds any other nation on earth. Healing health care in this nation is an economic and social imperative and will begin by putting a leash on the insurers via requiring transparency and allowing low cost competition, allowing providers to negotiate on EVEN FOOTING with the plans, and building a health infrastructure with primary care at the core (every nation in the top 10 of WHO rankings has a primary care centered system) where every man, woman, and child in the US has a stable, defined source of primary care. It would cost approximately $124 billion to insure every uninsured family and less than $160 billion to provide evidence proven preventive and catastrophic care to every citizen. The Iraq war has cost over $500 billion so far... As Churchill said, "healthy citizens are a nation's greatest asset." He also said, "you can always count on American's to do the right thing, AFTER they've tried everything else." Time to wise up America!

Cost? CEO compensation?

Why didn't this study look at average copays they charge for their services? Why isn't executive compensation listed? What about complaints from their consumers? Why isn't anyone discussing how most insurance companies are deregulated and no one is looking at their enormous profits that most put over their people? I would love to see the ranking of CEO's executive compensation for each company and pharmaceuticals as well......

aarp

why is aarp not even mentioned?

health insurance

I like to know what's the standing of my health insurance.I am in florida but the plan is in S.C.

My health ins. is as follows:

UNITED HEALTH CARE.

STANDING?

Insurance at koch indusreies

I'm a member of employed and ensured at koch industries, one of the wealthests fameliys and their system for care is bad bad bad.