Mounting confusion about United Healthcare coverage

11:59 PM, Oct 16, 2012   |    comments
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CLEARWATER, Florida - 10 News has been flooded with phone calls and Facebook posts over letters sent out to those who are on Medicare and have United Healthcare insurance, stating they can no longer use Baycare Hospitals.

Maureen Dabeck of Safety Harbor says she feels caught in the middle after receiving a troubling letter from Baycare Health system informing her that, as of Nov. 26, certain United Healthcare Medicare plans are no longer going to be accepted at any of the 10 Baycare hospitals spread across the Tampa Bay area. The reason appears to be financial.

Dabeck says, "Simply because the insurance company owed them 11 million dollars and wouldn't get off the dime."

She has emphysema and says she chose United Healthcare to help supplement her Medicare coverage. She moved to her home because it's practically right next door to Mease Countryside Hospital. Dabeck adds, "If I didn't have emphysema, I could walk there."

Dabeck says if she gets sick she doesn't know where she'll go and how she'll pay for it. She's afraid it could have her doing without the basic necessities, even doing without the one thing she's ever owned. She says, "It would cost me my home."

Elizabeth Calzadilla-Fiallo is a spokeswoman for United Healthcare. She says, "This potential network change does not affect coverage for Medicare beneficiaries enrolled in United Healthcares's Medicare Advantage plans. United Healthcare will honor claims for care received at Baycare facilities through December 31, 2013." 

Dena Brannen, a spokeswoman for BayCare Health System, says, "At this time, BayCare has not been able to come to an agreement with United Healthcare. Starting Nov. 26,  there will no longer be a contract between BayCare's hospitals and United Medicare Advantage products. We will not have a contract for its Medicare Advantage plan in 2013."

Brannen adds, "Please know that for an emergency medical condition, United's customers can still access care at BayCare's hospital emergency departments. However, after Nov. 26, 2012, we will not have a contract to provide care to United Medicare Advantage customers for non-emergent services."

The back and forth has Dabeck on edge. She says she knows being able to get care when she needs it is a life and death situation. "It's really not fair. It bothers me that I heard from BayCare before I heard from the insurance company."

Dabeck doesn't have to worry about one thing, though. Baycare's ad explains that regardless of customers status with United Healthcare, they can always seek treatment in the emergency room.

BayCare says if you have this plan: United Medicare PPO members and United Medicare Supplemental C,F you still have access to BayCare hospitals through out of network benefits.

United Medicare HMO members will have no access to BayCare hospitals except through the emergency department.

United Medicare Supplemental A, B, C2, F2, K, L or N members you still have access to BayCare hospitals the same way you always have.

Traditional Medicare members or members of any Medicare Advantage plan other than United you still have access to BayCare hospitals the same way you always have. 

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