United Healthcare Buying People's Health

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I was wondering when this would go public

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Apparently today. Been rumored for close to a year, and I heard last week was pretty much a done deal (pending regulatory review). I guess today they finally felt like they could say something.

Wrong. There are a lot of us old people here.

Baton Rouge Clinic doesn’t take People’s.

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I've been wanting this topic to come up for a while. If there are indeed a lot of older people on here than you need to know RIGHT NOW that you SHOULD NOT EVER go with People's or Humana. They will surely "manage" your Medicare all right, they will manage it by giving you approximately 25% of what you are entitled too! Go Straight Medicare (old fashioned Red, white and Blue) all the way...Never fall for the "let us manage that Medicare policy for you" or "Do yourself a favor and 'reward' yourself with Humana''. It always shocks me when I have little old people tell me, "I've got Humana GOLD". Awful! If you want to take out a little supplemental from BCBS or Mutual of Omaha, then go for it, they aren't that expensive. Ask any MD out there, they will tell you Humana and Peoples are the worst! Lots of doctors don't even deal with them because they are so money oriented, and not patient oriented.

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Im pretty sure you don’t know what you are talking about

When you get a manged plan, you don’t give up your basic Medicare. Your managed plan will be additional to traditional Medicare

United and Humana are known to be low reimbursement payors and are very resistant to approve services beyond acute care.

You need to be transferred to a skilled nursing facility or inpatient rehab?........good luck to you.

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When you get a manged plan, you don’t give up your basic Medicare. Your managed plan will be additional to traditional Medicare

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Respectfully, YOU Are Mistaken Sir! You DO Give Up Your Medicare For These Plans! You Are Thinking Of A Supplemental Plan That Is Purchased In ADDITION To Your Medicare Benefit. That Would Be The Add On. Humana, Peoples, Wellcare, Coventry, Etc. TAKE YOUR MEDICARE And Give You Their Shitty Insurance Instead. You Then Become Much More Restricted In The Benefits You Will Receive. Less Home Health, Less Days In Rehab Hospitals, Less Choices For Physicians, Less Choices For Tests And Imaging Studies That Will Be Performed (They Tell Your Doctor No!). When you have good "ole-fashioned" Medicare, you don't have all of those restrictions. People have been brain-washed into believing they must get a "managed plan". Trust me, I Work With Medicare And Managed Care Plans And Understand What I Am Talking About. Also, just Ask Any Physician Who Works With Any Of These Managed Plans And You Will Get A Better Understanding Of What's REALLY Going On.

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What is the 75% more you get with Medicare that you don’t get with Medicare advantage plans?

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This comes in the form of proper and "correct" care for your illness. Not the abbreviated, half-arse care you'll get with Humana and Peoples. There's a reason why Wal-Mart is looking to purchase Humana. Humana is already the WM of insurance NOW!!

Humana and United don’t set the reimbursement fee schedule, medicare does. If they are in a contractual agreement with a provider or group that that both parties agree to be less than 100% of the Medicare reimbursement rate and the provider or group is unhappy with it, that’s kind of them for signing the contract. They should either ask for a higher % or term the contract.

In regards to approval for skilled nursing or acute care, sure they have more prior authorization requirements than Medicare but paying for uneccsary services is a big part of the reason Medicare is broke and pays Medicare advantage companies to coordinate care. Provided the ordering physician can adequately explain and provide documentation why the care is appropriate, they shouldn’t have a problem getting the appropriate services authorized.

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Not the abbreviated, half-arse care you'll get with Humana and Peoples.

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Can you give examples or just talking points? Are these firms not required by their respective accrediting bodies to have a defined policy for appeals and grievances?