The NewYork State OAG is investigating out-of-pocket expenses charged by the United Health Group. Well, I am one of many NYS-MTA employees residing in Pennsylvania who is being defrauded by another kind of United HealthCare (UHC) out-of-pocket expense scheme.
In 2007 NYS forced all non-represented employees living in Pennsylvania to switch from Aetna to the Empire Plan" with medical provided by UHC Options PPO. NYS warned in a letter that if we did not switch we would experience a drastic reduction in benefits".
Under Aetna, we could go to any one of their network HMO physicians and pay a small co-pay. In PA UHC continually refuses to recognize their own network of Options PPO doctors as participating in the Empire Plan, so we are expected to pay thousands annually in deductibles & coinsurance (in addition to the thousands we and NYS already pay in annual premiums). According to UHC, the doctor must be an "Empire Plan" doctor to be considered participating.
When Aetna provided the medical we used their "existing" national network of HMO physicians. When UHC took over they pulled a swindle and started a "special" network in the tri-state area just for Empire Plan participants (the states that didn't buy into the swindle have an open UHC Options PPO network). The kicker is my family and I would have to travel into New Jersey to find an "Empire Plan" Family, OB/GYN or Pediatric practitioner, so we have no choice but to pay the extra fees. I know this all sounds crazy, but the best is all of the represented (union) NYC employees living here still have Aetna.
UHC continually refuses to provide a legitimate network of doctors because it will cut into their profits. To add insult to injury, after I met my 2007 deductible, UHC demanded that I forward their monies to pay the balance owed their own Options PPO network doctor. I informed UHC that I am not their bill paying department (especially when it comes to their own network doctors) and as a result my credit rating has suffered because they have not paid their share of the balance.
Every individual I have spoken or written to in NY, PA and at UHC (including an Executive VP) has just blown me off. My coworkers have said the same.
1 of many UHC victims
New Tripoli, Pennsylvania