United Healthcare, Obamacare, Franz Kafka, and the 'Positive Healthcare Experience'

United Healthcare was excited to have me

The letter from United Healthcare was dated December 9, 2013. It said as follows:

Dear GARY WEISS,

Thank you for choosing United Healthcare. We are excited to be able to provide you a positive healthcare experience and to ensure that you understand your benefits and payment requirements.

I was very pleased to receive this letter.

As I recounted a few weeks ago, United Healthcare had previously provided me with differing and inconsistent versions of my 2014 health insurance, which I had purchased in early November on the New York Health Exchange. The letter included a bill for the premium, which correlated with the amount of the premium previously disclosed to me.

Since the payment was due on January 1, I felt that there would be no problem with waiting until Dec. 28 to make my payment. I did so. My payment, which was by credit card, was acknowledged.

There was only one problem. At no time after receiving that letter did I receive anything else from United Healthcare--such as, most importantly, insurance ID cards  that would permit me to actually use my health insurance. That was a matter of some concern to me, as my previous healthcare coverage expired on December 31.

On January 2, I telephoned United Healthcare at the Member Services phone number (877-856-2429). That put me into its automated service, which asked me whether I had questions about "benefits" or "enrollment." There were no other categories. I pressed the number for "enrollment," which seemed closest, and after a while a person answered.

I explained my situation. I expressed concern that I could not actually use the health insurance for which I had enrolled and actually paid for.

The United Healthcare person expressed sympathy. He was here to help me. So I asked for assistance. Could he tell me when I would be receiving my cards?

He could not. He said that apparently (he was not sure himself) cards are only sent out after payment is tendered, so I would have to wait another "seven to ten business days."

In the interim, I asked, could I have my member and group number? That way I at least could sign up online, and actually give this information to any doctor I may need to utilize prior to receipt of the membership card.

Expert assistance was available

No, he could not.

However, he told me that if I called the billing information line, 800-708-2848, I could obtain the information that I requested.
I telephoned that number. A very nice lady said to me that she did not have the information that I requested, but that it would be available at another number that she provided: 877-856-2429. In other words, the number that I had just called.

At that point I  decided to go to the website that I had used to pay my bill.  There was a link on the left: "Ask the Expert." I decided to do so. At that link there was a form that could be used to contact United Healthcare. Four categories were given: "Account changes," "Coverage questions," "Payment Inquiry," and "Website Assistance."

Nonreceipt of insurance (and prescription, I imagine) cards and ignorance of one's member number did not seem to be covered by any of those choices. The closest seemed to be "Coverage questions," and below that, the subject that seemed closest was "confirm coverages." In the message field, I asked as follows

I have not yet received my ID cards for my wife and myself, and do not know my Member or Group Number. Please advise when the cards will arrive and, in the interim, please provide me with my Member and Group Numbers. Thank you.

I pressed the send button. At that point the "send" on the button turned into "please wait." I did. After a few seconds, the screen stated that my message had been submitted. That was good. "Please keep this request number. . . " it said. I reached for a pencil. But then I read on:

". . . (Error code 101) for Future Reference" it said.  My reference number was an error code? Below were the words "Unable to submit your request. Please try again later."

I tried again later and received the same result. I did so on subsequent days, and received the identical error code and message.

When I had spoken to the person at Member Services, he was reassuring. Not to worry, he said. I have insurance, he said. Even if I hadn't paid, he said, payment by Jan. 10 would assure me of coverage retroactive to January 1.

But in the interim, I asked, what do I do if I get sick? How do I prove to the doctor that I have coverage? How do I obtain prescription drugs? He did not have an answer to those questions.

© 2014 Gary Weiss. All rights reserved.
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My latest book is AYN RAND NATION: The Hidden Struggle for America's Soul, published by St. Martin's Press. Click here to order the book from Amazon.com, and here to order it from Barnes & Noble. Follow me on Twitter: @gary_weiss

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Franz Kafka, Obamacare, and Me

He worked for two insurance companies.

I should preface this by saying that when I signed up for my 2014 health insurance last month on the New York exchange, four United Healthcare plans were available to me, in ascending order of price: Bronze, Silver, Gold and Platinum.

I couldn't help but notice that the Silver plan was substantially better than the Gold plan. The annual deductible was less--just $500 for two people, vs. $1200 for the Gold plan. Copayments were less, as was the maximum out-of-pocket ($4000 vs. $8000).  Yet the Gold plan cost $235 a month more.

It made no sense whatsoever. I also thought it odd that this peculiarity was nowhere noted in any of the news media accounts of the New York debut of Obamacare. But my feeling at the time was that this was the System, and it was not to be questioned. I signed up for the Silver plan.

On Friday the first monthly bill for 2014 arrived in the mail. It contained no details of my insurance coverage, just a bill. The bill matched the amount stated on the website when I signed up for the plan some weeks ago. It described the Silver plan for which I signed up as "Silver EPO Rx 10/35/70 87AV CS."

A perusal of the United Healthcare website for New York health exchange plans showed plan documents for 12 New York Silver plans. However, "Silver EPO Rx 10/35/70 87AV CS" was not there.

A Google search for "Silver EPO Rx 10/35/70 87AV CS" revealed that it did not exist.

The plan I signed up for did not exist

I telephoned the toll-free number provided on the website. I was connected to a customer service person after a short wait. I described the discrepancy to her. I pointed out to her that no health plan called  "Silver EPO Rx 10/35/70 87AV CS" was listed on the United Healthcare website.

The existence of this discrepancy  appeared to annoy this person. She behaved as if I was somehow withholding information readily available to me, or was too dimwitted to read plain English.

"Can you please tell me the plan that you signed up for?" she asked.

I pointed out to her, again, everything I had previously told her, including that the website called the plan merely "Silver EPO" but that I was billed for "Silver EPO Rx 10/35/70 87AV CS."

That was impossible, she said to me. The website surely must have a more complete description of the plan than "Silver EPO." No, I responded, it did not.

She did not believe me.  She told me that no plan called "Silver EPO Rx 10/35/70 87AV CS" existed for New York State, and that no Silver plan had such a low annual deductible.

No supervisor was available

"If that's true, then what plan did I sign up for? What am I being asked to pay for?" I asked.

"I don't have that information," she said.

Would it help if I called the phone number listed on the bill?

"That's just the billing number," she said.

Could I speak to a supervisor?

"They have all gone home," she said. She promised that one would call me Monday morning.

I telephoned the New York Health Exchange. After an hour of waiting, during which time I was told repeatedly by a mechanical voice, "Your call is important to us," I was disconnected.

My call was important to them

I called back United Healthcare. I was promptly connected to a customer service representative. Her manner and tone were so different from the previous one that it was if she was from a different planet.

After hearing about the discrepancy, she pointed out to me that the New York Silver plan that I signed up for did indeed exist, but was not "Silver EPO Rx 10/35/70 87AV CS" but was actually " Silver EPO Rx 9.20.40 87AV CSR."

Yes, she said, the information on the New York Exchange website is and was correct. The deductibles are correct, as are the copayments and annual spending limits.

She said she did not know why it had a different name than the one stated on my bill, but assured me that it was the same one.

My fate remains uncertain

I questioned her closely. Her answers were clear and reassuring. Yes, the Silver plan is cheaper than the Gold plan. Yes it is better.  She had no explanation.

"A number of people have asked about that," she said.

I wasn't sure what to make of these two conversations. Was the System toying with me? Was I being punished? But if so, for what? What did I do? What was my crime? How would this end?

I will find out on January 1.

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© 2013 Gary Weiss. All rights reserved.
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My latest book is AYN RAND NATION: The Hidden Struggle for America's Soul, published by St. Martin's Press. Click here to order the book from Amazon.com, and here to order it from Barnes & Noble. Follow me on Twitter: @gary_weiss

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