Duke GPSC - Let's get rid of United Health care - Comments

failure to pay

tmb5 — Mon, 17 Aug 2009 17:40:14 -0400

I recently purchased new glasses and sent the claim letter for $100 hardware reimbursement to UnitedHealthcare SR. As it's been over a month, I called to see about my check. The customer service rep told me they didn't received my letter/claim and to resubmit. Funny how they never got my letter, but they sent me paperwork denying my claim.

As a marine lab student, I'm glad that Duke is working with SR to provide more physicians. However, between the lack of providers and terrible customer service, I'm not sure this is the right company for our insurance.

I want to lodge my complaint against UHC

mjr17 — Mon, 27 Jul 2009 18:36:02 -0400

I too have had a TERRIBLE time with this new plan. I absolutely despise it. As another student mentioned, I too have had to pay out of pocket for cortisone shots (that used to be covered by BCBS) because they are considered "surgery." Can you believe that?

Also, prescription drugs that used to be covered without any problems now have to be reviewed before they can be approved. Ridiculous! I would like to spend more of my time working on my dissertation and a lot less of it fighting with the insurance company & going back and forth between my doctors, pharmacist, etc.

My wife and I -- both

mpw8 — Tue, 21 Jul 2009 11:26:04 -0400

My wife and I -- both graduate students -- have had an awful experience with UHC, and we would love to participate in any efforts to return to BCBS.

Women's Birth and Wellness Center?

pmm21 — Tue, 21 Jul 2009 11:21:43 -0400

Could you confirm that it was the Women's Birth and Wellness Center in Chapel Hill that you found to be in-network? I am being told that it is out-of-network, so that information would be really helpful to me.

Thanks!

Patrick

pmm21@duke.edu

Will injections still be surgeries next year?

nah7 — Thu, 16 Jul 2009 19:59:16 -0400

Does anybody know if the cortisone shot policy will be changed next year?? I had to cough up a ton of money in november, because united health considers shots to be "surgeries" (even in this post-modern age of re-interpreting everything this seems like a stretch). I need another shot, but can wait until September, if the policy does in fact change, as I was told it would by the administration. Also, does anybody know what else is considered a "surgery?"

Waivers

dmk16 — Mon, 18 May 2009 16:28:44 -0400

I'm sorry you were unable to locate this. Here it is:

http://gpsc.duke.edu/business/internal_committees/health_insurance

Duke has an insurance requirement. If you have comparable insurance,
you do not need to have this plan. This must be done before the end of
the open-enrollment window at the beginning of each academic year. The
electronic forms are located at:
http://www.srstudentcenter.com/duke/ .

For the coming year you should apply for a waiver at the start of the open-enrollment (mid-July) and no later than September 15, 2009.

For the record, the committee has no stake in the enrolment in the Duke plan; the more people who do enrol the cheaper, typically, the rates can become, but this would not influence us as committee members. The interest of the committee is to represent the Graduate and Professional students, and to some extent, help the Undergraduates.

As far as the decision to change, the reason that it is made so early is because that is how long it takes to change. All of the problems that were experienced with Blue Cross and Blue Shield had to wait until we could prepare adequately for a change.

You can add dependents

dmk16 — Mon, 18 May 2009 16:14:08 -0400

You can add a spouse and child(ren) to the plan following any qualifying event (as per state law). If you do this at the beginning of the year it can be done online, otherwise call customer service to have the rates pro-rated.

Failure to process grievance. Awesome!

nlt3 — Mon, 18 May 2009 13:15:52 -0400

Maybe I am the only person who has had to go so far as to file a grievance, but I am told they have 45 days to process such and issue a final determination. Funny, they have record of receiving it, but then never did anything about it. Today is day 49 and there has been absolutely no action on this grievance. Meanwhile, I have been putting off the hospital bills since September. This is ridiculous.

Also, they appear to have no official grievance policy in place, at least as far as their insurance booklet has outlined or can be found on the SHC or UHCSR website. (Is it just me or is it also ridiculous that I have to check THREE separate places for this information?) I am now going to file a complaint with the Department of Insurance for failure to acknowledge a grievance and failure to process within the 45 days allowed to them.

Right now payments are made

nlt3 — Tue, 12 May 2009 18:25:53 -0400

Right now payments are made directly to United and I'm not sure how Duke reimburses you for the different network.

It's important to note that the graduate school will only pay for your health insurance if you use the United plan. If you choose something else, you get to pay out of pocket for it and are not reimbursed for anything.

http://gradschool.duke.edu/documents/financial_support/Grad%20Sch%20Payment%20of%20Health%20Insurance%2009.pdf

I, for one, remain absolutely appalled by my experience with United.

Where is our money going? To pay the lawyers!

dam28 — Wed, 06 May 2009 10:22:48 -0400

If nothing else, perhaps we could at least get some of the grads from the law school jobs on this case since we are helping to fund it anyways...

From the AmLaw Litigation Daily
http://www.law.com/jsp/tal/digestTAL.jsp?id=1202430463692

UnitedHealth Discloses (Another) $17 Million in Legal Bills for Options Backdating Defense
By Andrew Longstreth
May 05, 2009
You didn't think UnitedHealth Group's humungous $895 million securities class action settlement of options backdating allegations last year meant the end of the company's options backdating legal expenses, did you? Of course not! United's legal bills continue to mount, as Michelle Leder notes at Footnoted.org. Leder reports that in United's recent proxy statement, the company says it spent about $16.8 million on legal fees for the defense of current and former officers and directors who have been named in various options backdating suits. Leder calculates that United has spent nearly $50 million defending the individuals since 2006.

Frankly, we thought it would be more, especially considering that the since-settled class action named 18 individual defendants. After all, Brocade (grudgingly) paid more than $46 million to Skadden, Arps, Slate, Meagher & Flom to defend one individual--former CEO Gregory Reyes--for his role in the backdating scandal at that company.

We assume that a significant chunk of United's $50 million payout has gone to Latham & Watkins, where partner David Brodksy has been representing former United CEO William McGuire. In 2007, Brodsky represented McGuire in a settlement with the Securities and Exchange Commission. And last year, with the help of Brodsky, McGuire agreed to pay $30 million to settle the class action claims against him. Brodsky did not immediately return our call for comment

Health Insurance options

kmc11 — Tue, 05 May 2009 10:31:58 -0400

So, according to one of the health insurance meetings, David Kahler said that the decision to remain with United for 2009-2010 was made in July 2008. I don't know why the decision was made way back then, way before Duke even had a chance to try out United and grow to hate it, but that's what the committee decided. The committee for the Duke Health Insurance is made up of these people:

David Kahler

Claire Gordy

Matthew Vandenberg

Alana Belcon

Whitney Shaffer

Kristin Maloney

Brian Lutz

Karen Lai

Heather Endriss

Amanda Kasper

Erin Bressler

Michelle Tougas

I'm assuming that the 2010-2011 health insurance decision will again be determined in July, so if you want the committee to have your input, I would suggest emailing them directly. You can find their contact information here: http://gpsc.duke.edu/uc/shiac Or, through a search of the Duke database.

If you really hate United and do not want them for 2009-2010, there is another option: Just don't sign up for United. Duke allows that graduate students can find a comparable network, so if you want to go back to BCBS you can, or you can find another plan. It means a bit more work in finding the plan you want, and will probably be another $100-300 more, but it does mean that you don't have to deal with United. I believe there is a waiver that you need to fill out before September 15. Right now payments are made directly to United and I'm not sure how Duke reimburses you for the different network. I asked David Kahler to put up information on the website so students would know about this option, but he hasn't yet. I'm assuming the committee would rather people not know about this option.

Maternity? Coverage? I don't think so.

jrw56 — Tue, 05 May 2009 08:39:14 -0400

As a soon-to-be dad I would also like to follow-up on comments posted about the appaling maternity coverage offered by United. My wife is under coverage as a spouse and lets just say that I am less than thrilled at the idea of placing my child under the care of a United plan. I thought insurance was supposed to cover medical expenses in the case of the unexpected. My wife and I never planned to get pregnant, but it happened and we are thrilled to be parents. United is obviously not thrilled about paying for appointments and exams. As I understood, a full fetal ultrasound was standard procedure at 18-20 weeks postconception. Why this $700+ charge was not covered is beyond my understanding despite continual calls to United Healthcare for information. I am sick of paying $888 every 4 months for pitiful coverage. This is our last round with United. Once our baby is born, adios.

2009-2010 Decision

sch11 — Tue, 05 May 2009 08:13:28 -0400

It seems to me that UHCSR has struck the nerves of many graduate students throughout the year so has a decision been made about our health care options for the upcoming school year?

I agree

jsj11 — Mon, 04 May 2009 16:46:49 -0400

Coverage is horrible!

As a soon to be father, I have had a chance to review Uniteds coverage for maternity and found it to be the one of the worst for maternity coverage. Granted, not all students plan to add spouses or to have children, but wouldnt it be nice if it were at least possible!

Never in my life has health

nlt3 — Tue, 28 Apr 2009 10:33:05 -0400

Never in my life has health insurance taken this much of my time and made me this frustrated. It reaches new heights of ridiculousness every time I incur a medical expense.

Now they're telling me that in order to get any payment for an out-of-network claim, meeting the $300 individual deductible is not sufficient. No, since I have a dependent, I need to meet the $900 family deductible before they make any payment on my claim.

Great news. And conveniently, a manager was NOT available. As per usual.

Let's get rid of United Health care

kmc11 — Fri, 14 Nov 2008 15:31:47 -0500

Hi,

I've heard about a lot of graduate students having bad experiences with United Student health care. I thought I'd open up a forum for folks who would like to see a return to Blue Cross Blue Shield next year or some other *better* plan. So, If you have a complaint or rant or just want to weigh in, please post under here. Maybe if there enough disgruntled grad students we can force a change for 2009-2010. Vote for change!