Friday, July 11, 2025

dual advantage? not so much

Here’s that page. Does it have what you were looking for?
UnitedHealthcare Virtual Assistant
- 11:01 AM

No, I want to talk to advocate.
You
- 11:01 AM

We appreciate your patience while we connect you with the first available advocate.
UnitedHealthcare Virtual Assistant
You are now connected to Champagne.
- 11:01 AM

Hello and thank you for contacting UnitedHealthcare. My name is Champagne, and I am here to assist you with your dental questions. How may I assist you today?
Champagne
- 11:01 AM

I have a problem with a claim for my in-network dentist.
You
- 11:02 AM

I am sorry to hear that. Has the claim been submitted to us already.
Champagne
- 11:03 AM

Yes, it has.
You
- 11:03 AM

May I ask what the issue is please. Thank you
Champagne
- 11:03 AM

The claim seems to have been denied.
You
- 11:04 AM

May I have the date of service please.
Champagne
- 11:04 AM

This was for teeth cleaning and dental X-rays service on June 30.
You
- 11:04 AM

Did you receive a bill for the services.
Unfortunately, I don't see any dental claims that have been submitted to us this year.
Champagne
- 11:06 AM

I have not yet. However, I see here at the website that I have to pay $300.
On the UHC website, it says the claim has been reviewed.
You
 - 11:07 AM

One moment please. Thank you
Champagne
- 11:09 AM

Claim #2xxxxx
Date of visit:06/30/2025
providerId=000007919420 Delivered
You
 - 11:11 AM

May I ask is your Medicaid still active at this time.
Champagne
- 11:14 AM

Yes, it is.
You
- 11:14 AM

Because it is showing that it's not, so that could be why you received a bill. You may have to contact the Medicaid office to see if it's still active.
Champagne
 - 11:15 AM

No, wait, you said Medicaid. That application is still awaiting a decision. It has been waiting for over two months, but is still not finalized.
You
- 11:15 AM

Yes, I understand because you will only have a $0.00 co pay when your Medicaid is active.
Champagne
- 11:16 AM

I don't understand. The dental is being billed to my UHC Medicare plan.
You
- 11:18 AM

You have a dual plan so it will be billed to UHC dual plan, and the dual plan requires you to have active Medicare and Medicaid.
Champagne
- 11:19 AM

I would NEVER have gotten my teeth cleaned if I had known I would have to pay. I do not have money for that.
I do not understand how this works. I would not have chosen this Medicare plan if I had known that.
You
- 11:22 AM

I understand 100 percent,
The best thing to do is to contact your local Medicaid office to check the status because you want to make sure that you also don't lose your dual plan and its benefits.
Champagne
 - 11:23

What happens when my Medicaid application is reviewed and accepted? Does that date go back to the date I had applied or to the date of the approval?
You
- 11:23 AM

You can also contact UHC Dental department using the dental number on your member id card for further assistance as well.
Champagne
 - 11:24 AM

This is a terrible situation. I am supposed to return to the dentist for two fillings, but I cannot afford to do that if my UHC Medicare is not going to cover the cost.
Is this going to be a problem for any other medical issues? Will the pending status of my Medicaid application (dated May 6, 2025) going to affect other claims to UHC Medicare?
You
- 11:29 AM

I understand and I am sorry to hear about the mishap. I can't say that it will affect your claims, however some of the claims may result in a co pay.
Champagne
- 11:30 AM

Preview attachment.
I had checked my Medicaid application status earlier this week. The screenshot was of the current status.
You
- 11:33 AM

Thank you, yes, I see it's still in a pending status. You may want to contact them to see if more information is required to make a determination.
Champagne
- 11:33 AM

I did call them about it and they have all the documents they need from me.
You
- 11:34 AM

I understand.
Unfortunately, Medicaid is a separate entity so unfortunately, we have no control of their processing. I'm sorry Ms. Smith.
Champagne
- 11:36 AM

So, what do I do now? Should I change to a different UHC Medicare plan? Should I continue to wait out the Medicaid application status? And what do I do about that dental claim?
You
- 11:36 AM

Unfortunately, the claim was processed correctly at this time due to your Medicaid status. I can't advise on whether to switch plans, but you may have to eventually if the Medicaid isn't approved only because this is a dual plan Ms. Smith
Champagne
 - 11:39 AM

Thank you. I will continue to wait for Medicaid to finish what they are doing. I cannot begin another application until they have finished with that one.
You
- 11:41 AM

Yes, I agree, that sounds like a good idea Ms. Smith.
Champagne
 - 11:42 AM

Thank you.
You
- 11:42 AM

You are more than welcome Ms. Smith
I wanted to remind you that the Health Risk Assessment is available for you to complete at this link: Welcome to the Health Assessment | United HealthCare (uhc.com) This short assessment will help you get the most out of your health plan and can help you reach your wellness goals. Medicare requires us to update your health history every year. Answering these questions will have no effect on your plan membership.
It was my pleasure to assist you today. After our chat ends you will be presented with an option to complete a survey about your experience with me. I look forward to your feedback, as I want to be sure that you are satisfied with your experience.
Please do not hesitate to reach out to us if you have any further questions or concerns. We are available by chat M-F 7am-10pm CST and Sat-Su 7am-7pm CST. Thank you for being the best part of UnitedHealthcare. Have a lovely day!
Champagne
 - 11:44 AM

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Well, there's forty-three minutes of my life spent online for nothing.
I'm still apparently liable for paying $300 for a teeth cleaning I never would have scheduled had I known it would cost me.
My Dual Advantage Medicare plan says the dental is all covered, but mentions nothing about that being predicated by me having Medicaid.
My premiums for the UHC Dual Advantage plan have been deducted from my Social Security check for the past three months, ever since my Medicaid went into 'pending' status back in May.
That has not been good for my budget.
I would have talked to my PCP today about all this, but that 1 PM appointment was canceled, due to a smoky fire at the Savannah VA Center.
That was not good for me.
As I told Ms. Barker's nurse, I will run out of Levothyroxine on the 21st and the prescription is listed on the VA website as expired.
I hadn't been concerned because I had the appointment with Ms. Barker and I knew she would take care of that during our time together... but not that won't happen.
I also was going to speak with her about the Community Care Authorization for my annual mammogram... but that won't happen.
Plus, I needed to talk with her about the Community Care Authorization for the appointments with Dr. Cobb to get the heart monitor and his follow-up visit to review the results of that study... but that won't happen.
I was to get the heart monitor on the 14th, but that has had to be canceled because of the lack of the CCA.
This day has certainly been frustrating.
I am definitely going to the 2 PM "Superman" movie.
That will at least be 'free' as its part of my A*List.

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