Author Topic: Lots of Brooklyn Dr. to stop accepting United Healthcare  (Read 6572 times)

Offline mgarfin

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Lots of Brooklyn Dr. to stop accepting United Healthcare
« on: February 06, 2019, 10:22:04 AM »
A few Dr. in Brooklyn have notified me they will stop accepting United healthcare Community plan.

Does anyone know what's going on?
Seems as prior approved services will be a big issue.
Does our in house expert @ExGingi  have anything

Offline whYME

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #1 on: February 06, 2019, 11:11:33 AM »
A few Dr. in Brooklyn have notified me they will stop accepting United healthcare Community plan.

Does anyone know what's going on?
Seems as prior approved services will be a big issue.
Does our in house expert @ExGingi  have anything
FWIU they just don't pay well and are hard to work with so many specialists are stopping to take them.

Offline Jorjito11

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #2 on: April 02, 2019, 04:48:15 PM »
What's a good alternative for the basics?

Offline ExGingi

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #3 on: April 02, 2019, 05:15:52 PM »
What's a good alternative for the basics?
It depends on your Dr., I've heard that the largest medical office in Crown Heights is stopping to accept UHC community plan and will only accept Fidelis.
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline Jorjito11

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #4 on: April 02, 2019, 05:21:47 PM »
It depends on your Dr., I've heard that the largest medical office in Crown Heights is stopping to accept UHC community plan and will only accept Fidelis.

Yeah, that one...

Offline whYME

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #5 on: April 02, 2019, 06:16:02 PM »
and will only accept Fidelis.
I'm not sure that's correct. I believe they're recommending it, but I don't think that's the only one.

Offline ExGingi

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #6 on: April 02, 2019, 06:18:54 PM »
I'm not sure that's correct. I believe they're recommending it, but I don't think that's the only one.
I don't know. I didn't hear it directly from them. Just heard it yesterday from someone as repeated by a third party, so I take it with a grain of salt.
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline whYME

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #7 on: April 02, 2019, 06:30:36 PM »
I don't know. I didn't hear it directly from them. Just heard it yesterday from someone as repeated by a third party, so I take it with a grain of salt.
According to someone who heard it from them firsthand, They're definitely stopping to take UHC, (IINM only the adult office at this point, the pediatric office not yet) but they don't want to announce it officially until they do all the paperwork etc (or something like that)

Offline Moe Ginsburg

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #8 on: April 02, 2019, 07:53:45 PM »
Is there a difference in this regard between UHC Medicaid/Essential Plan (Community Plan) and the UHC Qualified Health Plan?

Offline ExGingi

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #9 on: April 02, 2019, 08:09:49 PM »
Is there a difference in this regard between UHC Medicaid/Essential Plan (Community Plan) and the UHC Qualified Health Plan?
UHC Qualified Health Plan has been using a different network (I am assuming it’s Oxford’s Metro which is subpar). Maybe UHC is moving the Community Plan to that network. IDK.
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline Moe Ginsburg

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #10 on: April 02, 2019, 09:37:16 PM »
UHC Qualified Health Plan has been using a different network (I am assuming it’s Oxford’s Metro which is subpar). Maybe UHC is moving the Community Plan to that network. IDK.

UHC offers a better network with their Medicaid/Essential Plan than with their QHP?

Offline gozalim

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #11 on: April 03, 2019, 04:10:53 PM »
I'm not sure that's correct. I believe they're recommending it, but I don't think that's the only one.
they mention fidelis and blue cross
any info on comparison?

Offline steroplasma

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #12 on: April 05, 2019, 11:55:43 AM »
To give a practical understanding of medicaid HMO
Fidelis = verizon
Empire/healthfirst = ATT
Metroplus & affinity = t mobile
UHC  = sprint

Offline ExGingi

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #13 on: April 05, 2019, 12:02:59 PM »
To give a practical understanding of medicaid HMO
Fidelis = verizon
Empire/healthfirst = ATT
Metroplus & affinity = t mobile
UHC  = sprint

Based on what criteria?
I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline Moe Ginsburg

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #14 on: April 05, 2019, 12:05:22 PM »
To give a practical understanding of medicaid HMO
Fidelis = verizon
Empire/healthfirst = ATT
Metroplus & affinity = t mobile
UHC  = sprint

That doesn't make sense. A majority of the frum community in Brooklyn that has Medicaid or EP chooses United HealthCare Community Plan even though any of the choices are equally free. Why would they all willingly choose UHC if UHC is supposedly worse than the other Medicaid Managed Care carriers?

And why would you rate Fidelis as better than Empire and Healthfirst?

Furthermore, are you sure you're not confusing the Medicaid Managed Care (and EP) plans with the Qualified Health Plans from the NY State of Health marketplace?

Offline steroplasma

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #15 on: April 05, 2019, 12:56:02 PM »
That doesn't make sense. A majority of the frum community in Brooklyn that has Medicaid or EP chooses United HealthCare Community Plan even though any of the choices are equally free. Why would they all willingly choose UHC if UHC is supposedly worse than the other Medicaid Managed Care carriers?

And why would you rate Fidelis as better than Empire and Healthfirst?

Furthermore, are you sure you're not confusing the Medicaid Managed Care (and EP) plans with the Qualified Health Plans from the NY State of Health marketplace?
2 theories as to why the frum community has mainly UHC: First the cynical reason
1. The majority of the frum community unlikely choose anything they are chosen by the whichever  organization the individual uses to "make" his medicaid which usually receives a commission for signing up the patient and I'm assuming United health care pays the highest commission and that is why they are chosen by the organization.
More practical reasoning:
2. It could be back in the day when medicaid was farmed out to the various mentioned companies and you had to sign up with an HMO, probably UHC had a strong drive to sign up the community and their reps went to the heimishe doctors to try to get the patients to sign up with them and with minhag avosaynu biyadainu they continued to sign up with UHC. In Rockland county for example the majority of the frum community is signed up with fidelis even though there are many other free plans including UHC, because of similar reasons that fidelis had a strong signing up drive with the heimishe community.
Other examples include in the north brooklyn (williamsburg) health first and metroplus is very strong in the latin american and africam american community and a good number of heimishe have healthfirst as well, but UHC is probably the lowest represented in that section of brooklyn. Its all dependent on their member sign up drives and maybe commissions.

And why would you rate Fidelis as better than Empire and Healthfirst?
Ans:  I find fidelis's attitude more generous with their medications and not needing prior auths for everything. The reality is all 3  Fidelis, Empire and Healthfirst are generally equally good some heimishe boro park providers never signed up with healthfirst as they dont have too many members in the boro park community but a much stronger presence in williamsburg.
Example for epipen, with fidelis, patients are given the real epipen or the generic made by MYlan which is practically the same company that makes epipen, with healthfirst you need a PA even with the generic and with empire you only get adrenaclick which is a sorry tuches copy of epipen and confusing to use.

Another example for asthma sufferers there are a variety of inhalers  that are allowed to be prescribed. As soon as FDA approved the genereic airduo, UHC dropped all their inhalers in that class and only allows airduo. I have no problems with generics (beggars cant be choosers) but when the company has real shortages of airduo which is a reality now in brooklyn the patients need choices. BTW did I mention doctors hate prior auths.

BTW I dont know if you remember every pharmacy in boro park had a sign "WE STILL ACCEPT UNITED HEALTH CARE" that's because UHC has a knack to randomly throw providers off their network and they threw some local places off. That's usually not issue with the other insurance companies as much as it is with UHC.

Take it from someone in the business You wont go wrong with Fidelis, empire or health first but stay away from UHC.

 
« Last Edit: April 05, 2019, 01:04:08 PM by steroplasma »

Offline Moe Ginsburg

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #16 on: April 05, 2019, 01:11:31 PM »
@steroplasma Just to clarify, your points are specifically regarding Medicaid/EP plans and not QHP plans, correct?

My understanding is that there are significant differences between the Medicaid/EP plans versus the same insurance carriers' QHP plans.

And, to reiterate, are you saying that the heimishe crowd in Boro Park can find doctors and specialists that take Fidelis, Empire and Healthfirst as easily as they can find doctors and specialists that take UHC? The main thing going for UHC, as I understood why the heimishe chose it, was that UHC had one of the best (if not best) number of good doctors and specialists that accept it, from among the Medicaid plans.
« Last Edit: April 05, 2019, 01:18:36 PM by Moe Ginsburg »

Offline steroplasma

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #17 on: April 05, 2019, 01:28:13 PM »
@steroplasma Just to clarify, your points are specifically regarding Medicaid/EP plans and not QHP plans, correct?

My understanding is that there are significant differences between the Medicaid/EP plans versus the same insurance carriers' QHP plans.

And, to reiterate, are you saying that the heimishe crowd in Boro Park can find doctors and specialists that take Fidelis, Empire and Healthfirst as easily as they can find doctors and specialists that take UHC? The main thing going for UHC, as I understood why the heimishe chose it, was that UHC had one of the best (if not best) number of good doctors and specialists that accept it, from among the Medicaid plans.
Absolutley I'm only talking about medicaid and EP plans, UHC is whittling away their network.

Offline ExGingi

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I've been waiting over 5 years with bated breath for someone to say that!
-- Dan

Offline gozalim

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Re: Lots of Brooklyn Dr. to stop accepting United Healthcare
« Reply #19 on: May 06, 2019, 10:07:41 PM »
I've heard that the largest medical office in Crown Heights is stopping to accept UHC community plan and will only accept Fidelis.
I hear that's canceled?