anything UHC 2023 first look ?

[AugustaMi]

My quick take. Have to take off in a minute. Saw that gamut yesterday...UHC, Wellcare, HAP, Humana, Priority

Humana in my area, only going to be for healthy people. Ded on both Rx and Medical (including little visits for cough or cold, not prevention obviously). Dental lower. Higher copays. Give back only worth it for HEALTHIEST TIP-TOP people.

I'll only be re-thinking for the DSNP, might do more only as I come across them.

UCH, what everyone else is saying. The card will be nice, theyre calling new card UCard. Can be used for everything. Has a long bar code on back that covers everything.

Not much will change in my area, it's Humana, Aetna, HAP country in my counties. No need for me to worry too much about Switchers either.

 

[AugustaMi]

My quick take. Have to take off in a minute. Saw that gamut yesterday...UHC, Wellcare, HAP, Humana, Priority

Humana in my area, only going to be for healthy people. Ded on both Rx and Medical (including little visits for cough or cold, not prevention obviously). Dental lower. Higher copays. Give back only worth it for HEALTHIEST TIP-TOP people.

I'll only be re-thinking for the DSNP, might do more only as I come across them. Beefed those way up.

UCH, what everyone else is saying. The card will be nice, theyre calling new card UCard. Can be used for everything. Has a long bar code on back that covers everything.

Not much will change in my area, it's Humana, Aetna, HAP, BCBSM country in my counties. No need for me to worry too much about Switchers either.

 

[goillini52]

Talking to yourself again?

 

[AugustaMi]

Taking to yourself again?

It's Common. Went back in edit a quick thing....mustve hit quote to myself. Well, shiit.

 

[DonP]

It's Common. Went back in edit a quick thing....mustve hit quote to myself. Well, shiit.

What county and state are you in ?

 

[AugustaMi]

What county and state are you in ?

Michigan
Gratiot and Isabella main counties I work. Although bc my office was in Genesee years ago, I still work Genesee and Oakland and a few others. I am trying hard to just stick to my close counties. Clare, Mecosta (Priority) and a few others south near Lansing and north 127.

Priority is a big contender, but in my first year I tried to stick with what I was doing and keep it as simple as possible. Hearing aids though if thats a main priority for a client, Priority is nicer. So many things to keep track of...holy heck. At some point very soon going to look closer. Just at a glance though, and what I've been hearing on the street UH isn't much of a thing although my hubs has it on U65

Whenver though I put HAP and Priority side by side it ended up being HAP, you don't do that one I'm sure, but has fantastic Rx formulary.

Our local hospital is a U of M hospital. Aetna works out well here too, U of M dental good with this...too much else to put in here. Bt, I will add Humana is WIDELY known in these parts, as they come through HEAVY in the local markets like VFW, Elks, Senior housing.

In the area I am in, MANY people also still like BCBS. Diehards. So happy I have contracts/commish all sorted as of months ago now. This is big-time farm country. Many deal with local Farm Bureau and one other Big Insurance company I hooked up with to be primary Medicare/Health person.

This first year has been single handedly one of the busiest work-wise. Im feeling old at the moment and after yesterday with the meeting I attended, I'm actually overwhelmed and still need to sort through it all. But I'm off for some DKs and an appt right now. Thanks Don (and everyone else) for all the help over the months.

Humana will be a big deal, just not sure how much of it will matter in the end with those deductibles. I'm sure I need to do the math with some people right down to the penny.

 

[hockeyday]

Michigan
Gratiot and Isabella main counties I work. Although bc my office was in Genesee years ago, I still work Genesee and Oakland and a few others. I am trying hard to just stick to my close counties. Clare, Mecosta (Priority) and a few others south near Lansing and north 127.

Priority is a big contender, but in my first year I tried to stick with what I was doing and keep it as simple as possible. Hearing aids though if thats a main priority for a client, Priority is nicer. So many things to keep track of...holy heck. At some point very soon going to look closer. Just at a glance though, and what I've been hearing on the street UH isn't much of a thing although my hubs has it on U65

Whenver though I put HAP and Priority side by side it ended up being HAP, you don't do that one I'm sure, but has fantastic Rx formulary.

Our local hospital is a U of M hospital. Aetna works out well here too, U of M dental good with this...too much else to put in here. Bt, I will add Humana is WIDELY known in these parts, as they come through HEAVY in the local markets like VFW, Elks, Senior housing.

In the area I am in, MANY people also still like BCBS. Diehards. So happy I have contracts/commish all sorted as of months ago now. This is big-time farm country. Many deal with local Farm Bureau and one other Big Insurance company I hooked up with to be primary Medicare/Health person.

This first year has been single handedly one of the busiest work-wise. Im feeling old at the moment and after yesterday with the meeting I attended, I'm actually overwhelmed and still need to sort through it all. But I'm off for some DKs and an appt right now. Thanks Don (and everyone else) for all the help over the months.

Humana will be a big deal, just not sure how much of it will matter in the end with those deductibles. I'm sure I need to do the math with some people right down to the penny.

I'm in Michigan too, just down the road from you, probably was at the same training, your spot on with HAP,PRIORITY AND BCBS, the Humana dsnp plan is great, the uhc plan for spend down people is strong,I like there dsnp too network is an issue. The Humana give back plan is a wide card. Every call center will be pushing that plan hard, better be talking to your current book because they will, be getting hammered with that thing

 

[AugustaMi]

I'm in Michigan too, just down the road from you, probably was at the same training, your spot on with HAP,PRIORITY AND BCBS, the Humana dsnp plan is great, the uhc plan for spend down people is strong,I like there dsnp too network is an issue. The Humana give back plan is a wide card. Every call center will be pushing that plan hard, better be talking to your current book because they will, be getting hammered with that thing

I never shut up. Def be chatting with them all. Esp this time thru. My book isn't giant.

I thought I'd rethink the DSNP just bc of humana bringing on the better bennies. Believe Aetna DSNP in Gratiot now. But not Isabella yet. Anyway....UHC- not too interested in that although I might need to rethink that as well. I did see the spenddown though. That was kind of cool. That was the only thing that made me think of possible contracting. If I have time I might.

Omg poke my eyes out on all these mtgs and trainings. Are u going to the GR BCBS two day event? Ill for sure be there. But thats it for me. Last one to do. Done with certs just wanna go for extra training. And have to figure out how to get my enrollment books. Small issue with that at moment.

For me I am trying to stay away from dsnp. More on the HAP BCBS train even if Humana is strong. In the beginning I wasnt humana prone. But after talking and working with them all year. Im def all in on some plans. Even so, certain Rx better on the other two. That could change. I also get fabulous feedback on HAP CR (even over Priority for the ones I've talked to) People really like HAP, even over BCBS (except the diehards).

Ugh. Done with Medicare today. Going to other job now.

Oh if you were there yesterday. Thoughts on all the talk about HMO-POS and some HMOs not needing referrals. I kept hearing this. Have people on HMO-POS? Zero complaints and yes they use it. Neurologists, psychiatrists, urologists etc. Zero complaints. Of course ppo is (was) always better but is this changing even more? Esp priority so far said all networks the same regardless dsnp, hmo. Ppo...but think pretty much my tops are like this

 

[Bill_Kiray]

Bill since your up on this how’s the dental going ti work with United and Humana ? I talked to Humana brass . So if you go oon it pays the bucket toward usual and customary. So cavity is $300 they say usual and customary is $270 . You owe dentist office $30. Will most dentist offices bill that ? Will they know at time of service what client owes? Humana rep told me client just sends bill in . No claim form . Does United’s dental work same way ?By the way I like your videos . Very informative and no bs

Circling back on this one Don. And thanks for the compliment on the videos. We work really hard to build out content that may offer some value...

Here's the way UHC dental works. I also confirmed this with multiple contacts I have at United:

If OON benefits are offered in association with the plan, seeing an OON dentist may cost more, even for plans with no cost sharing. This will be called out in detailed documents (e.g., the EOC and Enrollment Guide). Greatest value comes from leveraging contracted rates and support at an INN dentist, and UHC MA members have access to the largest Medicare dental network in the industry. Our office gets way less calls from our UHC Agents about dental network than any other national MA carrier.

Out-of-network dentists are not contracted to accept plan payment as payment in full, so they might charge more than what the plan pays, even for services that have $0 copayment. Many UHC dentists' contracted rates are about 50% of billed charges, which means that seeing an UHC network dentist can nearly double buying power as opposed to a competitor plan that pays at billed charges.

UHC reimburses non-par dentists from a non-par fee schedule vs UCR. For example, if the providers charge was $300 and UHC paid $270 from our non-par fee schedule, then the dentist could decide to balance bill the member the extra $30. Participating dentists are not permitted to charge the member above what our allowance is, but there is nothing preventing a non-par dentist from billing the difference.

It is up to the individual non-par dentist to either bill UHC directly or require the member to pay. If the member pays, then they would need to submit a request for reimbursement or claim form. The following information must be included in the member’s request for reimbursement:

The claim submission must contain the following information:

• Full member name and member ID number
• Full provider name and address
• List of dental services rendered with the corresponding ADA code(s)
• Proof of payment in the form of a receipt, check copy, EOB, or a ledger statement from the provider showing a positive payment against the services rendered

 

[LostDollar]

Here's the way UHC dental works. I also confirmed this with multiple contacts I have at United:

If OON benefits are offered in association with the plan, seeing an OON dentist may cost more, even for plans with no cost sharing. This will be called out in detailed documents (e.g., the EOC and Enrollment Guide). Greatest value comes from leveraging contracted rates and support at an INN dentist, and UHC MA members have access to the largest Medicare dental network in the industry.

If the UHC MA dental network is the same as the network for Stand Alone UHC/Golden Rule dental coverage, I don't believe that is true for my location. Delta Dental KS and BCBSKS dental both have SIGNIFICANTLY more dentists in network, in my city, than my stand alone UHC plan does. (I attribute that to UHC's lower reimbursements.) If the MA plans work with a different network, then I can't speak to that.