I have been an AARP member for a lot of years.  In fact if you do the math you will say it does not add up.  I retired from the State of Florida 2 years ago and continued to participate in their Group Health Insurance Benefit.  I am 64 plus 1 month and have been very actively trying to understand Medicare for the coming age of 65. The reason I think I look forward to Medicare is as a retiree I pay $550 a month or approx. $7000 a yr. to participate with the State.  Half my pension goes for Health Insurance.  I have 2 choices in Lee County, Fl.  Florida Blue (BC/BS) or United Health Care.  I have had United Health Care for 3 years.  One yr. in rural Florida with my long time doctors and 2 yrs. when I moved to one of Florida's more Urban environments.  Since moving to the big city and having to seek new Medical Providers I am having about a 50% success rate finding Ethical Medical Providers in U.H.C. Network.  Ft. Myers/Cape Coral at one time was 2nd. in the Nation with Foreclosures and the Doctors appear to have stooped to any level to maintain their lifestyle. AARP is connected to U.H.C.  I have probably all the literature to make U.H.C. my Medicaid Carrier at 65 although I am told as I near 65 the mail box will be filled with options.  Here is my problem. My question for me is: If U.H.C. is so irresponsible with the State of Florida's money how is it treating the Nations Citizens Money with Medicare?  For what I see not very well. I found a Chiropractor in U.H.C. Network.  On the 3rd. visit I was directed to a Nurse Practitioner in his office.  Without consultation and without medical necessity she did an Ultrasound of the Circulatory System.  U.H.C. was billed $2700 for the Office Visit and the Ultrasound was sent out for reading and U.H.C. was billed $3315.  So on the 3rd. visit to a Chiropractor U.H.C. was billed approx. $6000 and paid about $4700.  The State of Florida is SELF INSURED which means U.H.C. is only an Administrator.  What money was paid was not theirs. The kicker was the $3315 was Out of Network and at first U.H.C. held me responsible. They reconsidered. The Test? The Ultrasound is routinely done in Lee County for $150 x 3 or $450. Recently a Goupon: All 3 tests $190. The State of Florida paid 10 to 15 times the going rate.   I complained to UHC and they said everything is on the up and up.  I have over 5 hours on the phone with them and have claimed fraud to no avail.  They had me call their Fraud Tip Hot Line and it is handled by a India call center.  I could not understand 80% of what was asked.  I filed complaints with UHC, State Group Health, Dept. of Health, Agency Health Care Admin, Div. Insurance Fraud.  My only victory was the $3315 Provider was unlicensed and upon investigation was shut down but they would still have their money.  UHC and most all of the State agencies basically say, "Come steal our Money!" I know a long way to get to my question but,  just asking What is up with this United Health Care. Since I was going to sign up with UHC at 65 I now feel if they don't care about the States Money how do they handle the Nations Tax Payers Money. Their Network includes unethical Medical Practices using Unlicensed Medical Providers and they don't care. Is Fraud just a given just like shoplifting is a given?  Is UHC any better in Medicare than they are as a State Provider? You check some of the progress at http://www.floridaprobationofficer.com page 10.       
Posted by echummell1