Today, I took my nephew to a new Doctor. He was asked for his Health Insurance cards. He handed the girl his Medicare and Medicaid coverage cards. She said "No I need your United Health Card." He said he doesn't have United. She insisted he did because that's what Medicare is telling her. She printed off the info for him. So when I got home, I called his case worker who gave me a number for NJ care who handles Medicaid insurance. That woman tells me her system shows he is covered by Medicaid in all ways and sees nothing concerning United Health care and she tells me I need to call Medicare. The man I talked to at Medicare confirmed my nephew had United Medicare Advantage. I told him that was impossible because neither I nor my nephew had changed his coverage. Man didn't seem surprised this happened. I was then sent to a woman to make changes and I was told I was lucky I was still in the enrollment periods for MA. She canceled it and set back up his Medicaid. Had to re-enroll him in his United prescriptions because that was dropped when he was enrolled in the MA. So hopefully we have him all straightened out.
I then called United Healthcare to find out who enrolled my nephew in this plan. Yes, went thru at least 2 people before I got an answer. Seems that the enrollment was done on-line. The email they had on file was neither mine nor my nephews. The 3rd person was the one who took my complaint so they could research how this happened.
I am the only person who handles my nephews Medicaid stuff. I was told by Medicaid that they never make changes. What you sign up with when you receive Medicaid is what you have unless you choose to change then you go thru NJ Care. I was surprised when talking to Medicare that my situation is not unusual. And the man I talked to kept mentioning it was MA open enrollment time. But I didn't enroll and don't want a MA. So my first question is...is Medicare pushing these MAs because it means less work for them. Because nephew has prescriptions with UH did someone there think it was OK to switch him to a MA which covers his prescriptions anyway? And hoping that I would just say, keep it that way? No, I spent all afternoon getting everything back to normal. And what would have happened if we had not gone to the Doctor during enrollment period? Does that mean nephew would have been stuck with this MA he never signed up for? And no, he didn't not sign up for it because the contact every place has is my phone#, I verified that. Up till 1/1/23 I had not talked to anyone from United because they always try to have me switch to them. So I ignore the calls. Mail from them gets looked at to see if it refers to his prescriptions and if not, goes in the trash. He does not get mail from them.
I think there is a scam going on here. Someone has to be able to get into someone's system to get basic info on my nephew to do an on-line application. Are there employees that work on commission from home and are making changes because it means more money for them? I am hoping that UH gets back to me but I doubt it especially if one of their own making these changes. So what I am saying here is, do not even talk to these insurance companies on the phone. I was told all I had to do was say "yes" to a question and they can use that to set up a policy. Like, are you sure you don't want to switch, yes I am sure.
Good save JoAnn. Your nephew is lucky to have your oversight.