Help me navigate UnitedHealthcare
August 5, 2024 9:00 AM Subscribe
I had to switch insurance from Kaiser (where I've been all my life) to UnitedHealthcare. Everyone raves about how great it is, but I'm lost and confused as to how to navigate "you can pick ANY DOCTOR YOU WANT!" and how to get things transferred over.
I'm used to just "here are four doctors, pick one and here's what they wrote about themselves for you to pick" and having your PCP refer you to whatever afterwards, and having a dedicated pharmacy, and frankly having SO MUCH CHOICE and SO MANY OPTIONS is annoying the bejeezus out of me. There's no one headquarters/facility, there's tons of them, I don't know which facilities have which services, there's 299 options for picking doctors and hardly any information about them gets posted.
* I was assigned a PCP in my town. However, given that I now work out of town and I'm not allowed out for medical appointments for six months, I chose a PCP a few miles away from my job so at least I don't have to drive back and forth and take up more time for that. However, they are taking awhile to switch the doctor and I found out today the doctor isn't official until September 1! What the heck?
* I need to transfer my medical records over, and specifically I need to transfer my shot prescription over like, ASAP because it's due this month. I asked my new psychiatrist (that was easy to set up, at least) and she said that should be easily done with a PCP. I got my medical records sent over from Kaiser and I can send them to someone, but not for a month?
* How does one set up other doctors, like say, a gynecologist?
* If I just want to find a local optometry office so I can drop in and get a nose pad replaced on my glasses, how do I do that? With Kaiser I could just walk in if I had to, now I don't even know where you do that. (I'm keeping my regular optometrist that has Saturday appointments, but I can't go for another month.)
Ugh. This is too much choice and options for me. How the heck am I supposed to do these things? Please advise.
I'm used to just "here are four doctors, pick one and here's what they wrote about themselves for you to pick" and having your PCP refer you to whatever afterwards, and having a dedicated pharmacy, and frankly having SO MUCH CHOICE and SO MANY OPTIONS is annoying the bejeezus out of me. There's no one headquarters/facility, there's tons of them, I don't know which facilities have which services, there's 299 options for picking doctors and hardly any information about them gets posted.
* I was assigned a PCP in my town. However, given that I now work out of town and I'm not allowed out for medical appointments for six months, I chose a PCP a few miles away from my job so at least I don't have to drive back and forth and take up more time for that. However, they are taking awhile to switch the doctor and I found out today the doctor isn't official until September 1! What the heck?
* I need to transfer my medical records over, and specifically I need to transfer my shot prescription over like, ASAP because it's due this month. I asked my new psychiatrist (that was easy to set up, at least) and she said that should be easily done with a PCP. I got my medical records sent over from Kaiser and I can send them to someone, but not for a month?
* How does one set up other doctors, like say, a gynecologist?
* If I just want to find a local optometry office so I can drop in and get a nose pad replaced on my glasses, how do I do that? With Kaiser I could just walk in if I had to, now I don't even know where you do that. (I'm keeping my regular optometrist that has Saturday appointments, but I can't go for another month.)
Ugh. This is too much choice and options for me. How the heck am I supposed to do these things? Please advise.
Oh and many optometry offices will still do your minor glasses adjustments for free, just pop in and ask.
posted by nat at 9:53 AM on August 5 [1 favorite]
posted by nat at 9:53 AM on August 5 [1 favorite]
I understand. I switched from Kaiser to a different insurance and it's overwhelming.
I really love CVS. They work with most insurances and hospitals etc and they have been fabulous. Like them more than Kaiser pharmacy.
I ended up getting assigned a patient advocate because (not going to get into details) but it wasn't until I got this advocate assigned to me that she helped me with referrals for doctors. I had a few criteria and she emailed lists of three of each type of doctor to me. Ask for a patient advocate to help you navigate, get all your doctors in place. Call the number on your card. They should have folks who can help you out to establish care.
If united Healthcare has an app, use it to see if you can find doctors that way. Just pick one honestly. I got so overwhelmed I just picked whoever was in town and available to new patients.
I found that there is a doctor shortage and it took a while for me to find one who had appointments. So it's hard to be too picky.
posted by mxjudyliza at 10:49 PM on August 5
I really love CVS. They work with most insurances and hospitals etc and they have been fabulous. Like them more than Kaiser pharmacy.
I ended up getting assigned a patient advocate because (not going to get into details) but it wasn't until I got this advocate assigned to me that she helped me with referrals for doctors. I had a few criteria and she emailed lists of three of each type of doctor to me. Ask for a patient advocate to help you navigate, get all your doctors in place. Call the number on your card. They should have folks who can help you out to establish care.
If united Healthcare has an app, use it to see if you can find doctors that way. Just pick one honestly. I got so overwhelmed I just picked whoever was in town and available to new patients.
I found that there is a doctor shortage and it took a while for me to find one who had appointments. So it's hard to be too picky.
posted by mxjudyliza at 10:49 PM on August 5
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The bit about setting a primary care makes it sort of sound like you have an HMO, so check; their rules tend to be more restrictive.
If you have the second kind, indeed there is a lot of choice. If you are coming from Kaiser, you might like a large system, such as Stanford Heath Care. They have main clinics in Palo Alto, Santa Clara, and various other Bay Area places.
Since they are a large system, they will have easier cross-access to medical records and may be better able to help you extract them from Kaiser. Some of their primary care facilities have on-site specialists or imaging too.
I can’t specifically recommend them, since I never used them myself and haven’t lived in CA in over 15 years. But if you give your work location maybe other people can give some recs for large systems that may feel more Kaiser-like.
I expect there’s several other such systems (I go to a similar one in AZ now).
Depending on your specific UHC insurance, you may be able to see certain specialists without a referral, so especially for the shot you can’t delay, see if that’s one you can get in to without a referral.
Note Ob/gyn is one of the more common specialties you can go to without a referral, but I don’t know your insurance or your state’s laws to know if that’s true for you.
Last, optometry is almost certainly not covered at all, in most of the US it is under separate vision insurance. You could ask your HR if there is a vision plan available (although honestly for most people vision insurance isn’t a great idea; the premiums you pay are usually more expensive than just saving up for new glasses).
posted by nat at 9:53 AM on August 5 [1 favorite]