Why United Healthcare Is Losing My Business
Health insurance companies are inherently parasitical-- they are why the American people pay more for healthcare, and get less. They all, being corporations, will invariably choose the most profitable course of action regardless of any ethical considerations, up to and including the life or death of multiple human beings. Being corporations, they are incapable of doing otherwise. It is foolish to believe that one such device (because that is what a corporation is) is morally better than another.
So why am I dumping a particular health insurance company for doing something unethical? The short version is that I am dissatisfied with their prescription service. In simple amoral, cost-benefit terms, their product sucks. To be more precise, 1) they have either spun off or selected* a prescription provider that chooses whether or not to fill a prescription based on the price of the prescription, rather than the fact that they are contractually obligated to fill the prescription, an unethical business practice that will only change if it becomes less profitable than behaving ethically; and 2) I am tired of my projections being delayed every month because they check the price and see if they can get out of filling the prescription before they fill it, and tired of having to fight with them every month.
The straw that broke the camel's back for me was this month, when my coverage was temporarily switched to the Medicaid coverage that I use because I am a college student with a very expensive pre-existing condition. However, I still had prescription coverage, and prescription coverage that Prescription Solutions had agreed to accept. You see, they are officially Medicaid participating providers, and when you are a participating provider, you have to accept their reimbursements, even for expensive medications, even if by stalling and delaying critical daily medication, you can get a bigger reimbursement. If you don't like it, you don't have to be a Medicaid provider, but they chose to be a Medicaid provider, and then try to pick and choose what they will provide. It doesn't work that way.
When I called them (in advance, because I know Prescription Solutions is slower than CVS/Caremark), they claimed to have an imaginary file that said I wasn't covered. I know that I was covered, because I called the benefit line, because CVS had no problem filling another prescription of mine (Copaxone has to go through a specialty pharmacy). The really astonishing thing is that they also insisted (again, citing this mysterious "file") that I was not covered by Medicaid, to the person who called them from Medicaid, to tell them that I was covered by Medicaid. Yes, you read that right. She called them to say "this person is covered by us. If you send us a claim, we will pay it," and they said, in essence, "we have a file that says you don't, and the file is always right."
Some idiot that works for them then called me to say, essentially, "Medicaid thinks we're price checking, but we want you to know that we're really not. It's just that we have this file, you see, and the file says you're not covered under Medicaid, and we have to listen to the file, rather than, say, what Medicaid says to us. It isn't the cost of the medication, it's just the file. We can't do anything if the file says you're not covered. We're not responsible" (paraphrasing, of course -- a literal transcript was not exactly feasible under the circumstances-- but that was pretty much what she said, and "we're not responsible" is, I'm pretty sure, verbatim. She kept repeating that, almost like a mantra); and then, when I didn't believe her, said I wasn't listening to her, and the Medicaid employee who called them to tell them that I was covered under Medicaid also didn't want to listen to her, and how can we both be so obstinate? (I'm not kidding, she actually said that) According to this woman, failing to believe an insultingly obvious lie is not listening. I think somebody needs to spend some quality time with a dictionary.
It gets better, because they appear to have a record of doing this. When you try to get them to fill prescriptions if they don't want to fill, they always say that they've checked their files and they're sure they're right-- and then it turns out that the problem was them. It's about to become very inconvenient for them, because they were a little obvious this time.
Anyway, I finally got my prescription, over a week late (which is far from the first time they have delayed my prescriptions), and I'm switching MCOs so that I won't have to deal with these sleazoids anymore. Meanwhile, check your prescription provider, because you don't want to have to deal with them either.
*Okay, a little background on the puzzling relationship between the company or companies involved.
United Healthcare has a prescription benefit service (officially another company, but probably just a department) called Prescription Solution, and mail-order pharmacy (which has the same board as Prescription Solution) called Prescription Solutions. It seems to me that they are probably all just subdivisions of United Healthcare that were spun off for liability purposes, but no matter. The important part is that United Healthcare is losing my business because the prescription provider that is printed on my membership card has provided consistently, and often outrageously, terrible service.
So why am I dumping a particular health insurance company for doing something unethical? The short version is that I am dissatisfied with their prescription service. In simple amoral, cost-benefit terms, their product sucks. To be more precise, 1) they have either spun off or selected* a prescription provider that chooses whether or not to fill a prescription based on the price of the prescription, rather than the fact that they are contractually obligated to fill the prescription, an unethical business practice that will only change if it becomes less profitable than behaving ethically; and 2) I am tired of my projections being delayed every month because they check the price and see if they can get out of filling the prescription before they fill it, and tired of having to fight with them every month.
The straw that broke the camel's back for me was this month, when my coverage was temporarily switched to the Medicaid coverage that I use because I am a college student with a very expensive pre-existing condition. However, I still had prescription coverage, and prescription coverage that Prescription Solutions had agreed to accept. You see, they are officially Medicaid participating providers, and when you are a participating provider, you have to accept their reimbursements, even for expensive medications, even if by stalling and delaying critical daily medication, you can get a bigger reimbursement. If you don't like it, you don't have to be a Medicaid provider, but they chose to be a Medicaid provider, and then try to pick and choose what they will provide. It doesn't work that way.
When I called them (in advance, because I know Prescription Solutions is slower than CVS/Caremark), they claimed to have an imaginary file that said I wasn't covered. I know that I was covered, because I called the benefit line, because CVS had no problem filling another prescription of mine (Copaxone has to go through a specialty pharmacy). The really astonishing thing is that they also insisted (again, citing this mysterious "file") that I was not covered by Medicaid, to the person who called them from Medicaid, to tell them that I was covered by Medicaid. Yes, you read that right. She called them to say "this person is covered by us. If you send us a claim, we will pay it," and they said, in essence, "we have a file that says you don't, and the file is always right."
Some idiot that works for them then called me to say, essentially, "Medicaid thinks we're price checking, but we want you to know that we're really not. It's just that we have this file, you see, and the file says you're not covered under Medicaid, and we have to listen to the file, rather than, say, what Medicaid says to us. It isn't the cost of the medication, it's just the file. We can't do anything if the file says you're not covered. We're not responsible" (paraphrasing, of course -- a literal transcript was not exactly feasible under the circumstances-- but that was pretty much what she said, and "we're not responsible" is, I'm pretty sure, verbatim. She kept repeating that, almost like a mantra); and then, when I didn't believe her, said I wasn't listening to her, and the Medicaid employee who called them to tell them that I was covered under Medicaid also didn't want to listen to her, and how can we both be so obstinate? (I'm not kidding, she actually said that) According to this woman, failing to believe an insultingly obvious lie is not listening. I think somebody needs to spend some quality time with a dictionary.
It gets better, because they appear to have a record of doing this. When you try to get them to fill prescriptions if they don't want to fill, they always say that they've checked their files and they're sure they're right-- and then it turns out that the problem was them. It's about to become very inconvenient for them, because they were a little obvious this time.
Anyway, I finally got my prescription, over a week late (which is far from the first time they have delayed my prescriptions), and I'm switching MCOs so that I won't have to deal with these sleazoids anymore. Meanwhile, check your prescription provider, because you don't want to have to deal with them either.
*Okay, a little background on the puzzling relationship between the company or companies involved.
United Healthcare has a prescription benefit service (officially another company, but probably just a department) called Prescription Solution, and mail-order pharmacy (which has the same board as Prescription Solution) called Prescription Solutions. It seems to me that they are probably all just subdivisions of United Healthcare that were spun off for liability purposes, but no matter. The important part is that United Healthcare is losing my business because the prescription provider that is printed on my membership card has provided consistently, and often outrageously, terrible service.