HEALTH CARE FOR THE ELDERLY

Stipulating  from the top.  Yes, I am very fortunate to have health care coverage.  Since turning 65 we have used Medicare Advantage plans.  There are many and we have a person we see annually to help us choose which is best for us depending upon projected health care needs and their various coverage options.  Also which one has successfully negotiated a contract with the providers we see.  

And so begins the completely screwed up profit-driven health care system in the United States.  

This year the Medicare Advantage plan we've had for the past few years (and which we were happy with) did NOT end up with a contract with our health care clinic and other providers so our choice was to find all new doctors under the old plan, or join a new plan that covered our current providers. We decided the logical thing would be to change insurance rather than change our doctors, dentist, etc.

Our new coverage began January 1 and I immediately got a letter from the new insurance company assigning me a new Primary Care Physician, with the helpful advice that if I did not want that person as my PCP, just call their handy 1-800 number to talk to a representative who could help me choose another. Easy, peasy.

This morning I placed that call at around 7:20 a.m. to let them know I already had a PCP I've been seeing for many years and plan to keep her and that she is "in network", meaning covered by my new Medicare Advantage plan, United Health Care.  I dialed the number in the letter and of course got a recording with a raft of meaningless (to me) information about their website, app, etc, which I'd already downloaded and accessed.  

I made it through the initial automated maze, to finally be asked why I was calling.  I said "update primary care physician".  But the A.I. voice was stumped and said, "It sounds like you are calling about a referral or appointment."  I said "No". And "she" repeated her query about why I was calling, so I repeated my response and she went back to "It sounds like you are calling about a referral...etc etc."  I was in the loop of non-communication with a robot.  Frustrated, I hung up.  That number in the letter was not working for me.

So I went to their handy dandy app.  I found the chat option and opened a chat.  The responder actually sounded like maybe a real person, but who knows?  I explained my situation, as well as my frustration with getting through to a real person.  It seemed like I was being heard and understood, but "Prince" (not his real name, I'll bet) kept asking me to "give him 2-3 minutes to access my file", then to "give me 2-3 minutes to update your PCP", then "still working, please give me 2-3 minutes more", on and on.  Twenty minutes into it he said he could not add my PCP's name because she is not accepting new patients.  I KNOW THAT!  I'm not a new patient; she's been my doc for years; I just want her name in my file to avoid any confusion when I go to my annual physical later this month.  He said he could not add her name, but to "call this number and they will help you" and he gave me another 800 number to call, assuring me he had sent them info on my request and they would know what to do.

I called.  I got another automated menu of meaningless info and then it asked if I was calling as: 1) a member of United Health Care.  Or: 2) if I was calling about the UHC plan.  I said yes to being a member. The response was for me to call the "member line" which was the FIRST number I called to start with -- the one who did not understand my request.  And then it said, "This call will now be disconnected."  And it was. So I hung up and called again, thinking I'd just choose the other option.  So I did that and it seemed to work until the voice said, "First, are you calling as a UHC member?" And again I said yes in order to not get a sales pitch.  Again I was told to call the member number and was disconnected.

I was now about 45 minutes into this fiasco.  

I called the original number and when it asked what I wanted I finally remembered what I'd learned in Automated Hell recently on a trip, that I could say, "Speak to a representative".  I really kicked myself for not remembering that, when almost immediately I was told a rep would be right with me.  Well, maybe not right away, but eventually a guy came on and I went through my whole thing again.  I say this calmly now, but in the moment, my voice shook with frustration, overwhelm, and a bit of rage.  He was sympathetic but confused and need more information and queried me about why the AI voice did not understand my request and I said, (I'm not proud of this) "Because I didn't fit the list of problems it could respond to!!! It's not a fucking human!!!"  (I apologized immediately and I might have heard a soft chuckle on his end.)  He said he would file a complaint about the AI issues because they take customer service interface very seriously.  Fine.  

Then he asked who my PCP was, name, address, phone, etc. and put me on hold "for a minute" while he checked on my file.  It was actually many, many minutes and when he came back he said he couldn't update because he went to the Optum website and that doctor is not accepting new patients.  "OMG!!!!  I KNOW THAT!  I have said over and over I am an existing patient; I only want to let UHC know the name of my current, actual PCP!"  He said, "Oh, you are an existing patient?" like it was the first he'd heard that.  "Let me go check on something and get back; can you hold?"  Of course.

Thirty minutes later, he was back with "good news".  After calling my doctor's office (and no doubt navigating their animated and frustrating system) he was able to confirm I am, in fact, an existing patient and he was able to update my United Health Care file.  He said this with such pride.  I had to laugh.  I said, "Wow, they don't pay you enough, do they, to listen to frustrated "members" rant and then have to fact check what they tell you."  Again, he might have chuckled but did not engage and I recalled that "(your) call may be recorded" and he'd likely catch hell for commiserating with my frustration.

So with that 45 minute call, along with 30+ minutes on the chat, and all the "call this, call that" numbers and automated deadends, after over an hour and a half I was finally able to complete my mission -- which should have taken 10 minutes, tops.  There were many moments when I was "this close" to just hanging up.  But I was determined not to give in, not to quit.  The System was NOT going to defeat me!!!  Not today, MF!

This is a crazy world, isn't it?  There are times I feel like I'm living in a nightmare maze of wrong turns, false hopes, kicks in the shin, tiny victories, and a pre-recorded ever-repeating ear worm 'on hold' jingle that never ends.

At least that's the view from here...©

Photo Credit: Just saw it online, not sure of source.  But if I knew I'd immediately acknowledge cuz it's so true and funny.

P.S.  I may have offended some of you with my swearing in this post.  Oops.  I will now go sit in blissful peace on my meditation cushion to make amends.  Ohmm.......🙏🏽