3 ms·
I think this gets to part of the issue at UHC. People are filing claims, thinking it is covered, but it gets denied. I have read anecdotal reports that peopl
by capybaraStorm 2y ago
I think this gets to part of the issue at UHC. People are filing claims, thinking it is covered, but it gets denied.
I have read anecdotal reports that people working in government roles with UHC insurance have switched to identical plans in the private sector and got much worse denial rates with UHC plans offering the same coverage.
This fuels a completely speculative view that UHC might shift the 85% required healthcare costs towards favoring places where they may gain more market share and really shafting hard in other parts of the market. They can shit-can something like 15% of premiums so unequal allocation of that could lead disproportionately to some very pissed off people, even working within a system where profit is bounded by accepted claims. All of this would fit in well with a profit optimization strategy.
- nradov 2y agoI'm not an expert on this but my understanding is that CMS enforces the MLR for each insurer on a per-state basis. So insurers don't have much opportunity to chase market share by shifting claim costs around between plans. Regular federal government employees are all on private insurance plans, unless they're in the military or old enough to be covered by Medicare. So your comment about "switched to identical plans in the private sector" makes no sense. But the different private insurance plans offered to federal employees do have different benefits and different claim processing policies.