Medicare Advantage Scrutiny Continues - Part 3 (straw in the wind)

We have been posting about Medicare Advantage plans - such as the plan UC offers retirees through UnitedHealthcare. As blog readers will know, these plans now cover over half of all Medicare participants - due in part to what appears to be overpayment by the feds. The MA plans have been heavily advertised to seniors as low-cost options that offer bells and whistles such as gym memberships. The question is what happens when you are really sick - and gym membership might not be relevant. And what happens if Congress tightens up on what is paid to MA plan insurers?

Here's a straw in the wind from Minneapolis: Beginning next year, HealthPartners will no longer be an in-network provider for UnitedHealthcare Medicare Advantage plans due in large part to UnitedHealthcare's high denial rate. 

In a letter to patients Tuesday, HealthPartners said the decision came after a year of negotiations.

"UnitedHealthcare delays and denies approval of payment for our patients’ Medicare Advantage claims at a rate unlike any other insurer in our market. At times, this denial rate has been up to 10 times higher than other insurers we work with. UnitedHealthcare’s practices create unnecessary waits and delays for you, and they interfere with our ability to provide you with timely and appropriate care," the press release stated.

HealthPartners will remain in-network for those with UnitedHealthcare through the end of 2024. The co-executive medical directors say they are making sure patients have as much notice as possible, and that people can consider options that would allow them to receive in-network care in 2025...

Full story at https://www.kare11.com/article/news/local/healthpartners-will-stop-accepting-unitedhealthcare-medicare-advantage-plans-in-2025/89-8d08e632-0ba7-4ca2-9b9f-29ffe90a4cdc.