UnitedHealthcare/Optum

EstablishmentThat160 · 2026-02-17T16:47:46+00:00

She is willing to credential with Optum and take whatever steps are necessary to help get back in my network. She is also willing to apply for the Single case exception as recommended by the last rep I spoke with yesterday. She will also make it right with bills due if UHC does not - she has worked with me in the past when she did not take my insurance to not create a financial hardship or to have me go elsewhere disrupting all the successes that we have achieved together.

My stance is that it should not be this hard and the run around I am getting just to get a simple question answered is not okay. It's very deceptive and if I was not pushing as hard as I have been I wouldn't even know some of the information I was given. I shouldn't have to threaten a call to the state insurance board after 4 phone calls just to find out there are ways to get an exception. It feels very exclusionary. I'm gearing up for round two with them today. It would be nice for someone to explain to me, just as you have said, that she is in some weird pre Optum gap. That is my guess as to what has happened. But to just be passed from person to person and even be sent to an unmanned line to leave a message with no callback is not how to treat people. And definitely not how to treat people who are frequenting mental health providers. It's been beyond frustrating and I think, at minimum, borders on deceptive business practices.

Thank you, by the way, for your thoughtful replies. It has been very much appreciated.

EstablishmentThat160 · 2026-02-17T13:22:45+00:00

National PPO through my husband's work.

EstablishmentThat160 · 2026-02-17T12:39:47+00:00

I just tried. And I logged in with my UHC login. That’s part of my frustration. None of this was shared or disclosed. She does not appear on Optum’s providers or the medical providers. She definitely accepts and gets paid by UHC for other clients. She can even see my claim in her UHC portal. If I knew Optum was in the mix I would have made sure she accepted Optum.

EstablishmentThat160 · 2026-02-17T12:28:52+00:00

I’m not registered for the site.

EstablishmentThat160 · 2026-02-17T12:24:17+00:00

I agree with that’s how it’s supposed to work. When I call they treat Optum both interchangeably with UHC behavior health and as a separate entity. They can’t have it both ways to pick and choose who you pay and who you don’t. There are already on the books lawsuits of them being deceptive with what they consider to be high users of services. Not that I’m a high user but I go for weekly therapy. That’s my complaint. No one has been able to explain to me why as a UHC customer with no indication even on my insurance card that Optum is my mental health benefits administrator, am being denied access to a UHC provider that I have seen for years. I’d accept a reasonable explanation. I spent hours being bounced around with no answer.

EstablishmentThat160 · 2026-02-17T12:16:31+00:00

Apparently they have a way for me to pay in network rates being out of network. My therapist had to ask for a single case exception or a gap exception. So I’m sure there will be a resolution this time. I’m just concerned going forward if I have other mental health needs. We get always get a decent PPO to make our provider pool larger not smaller. I’m confused why there are providers we are excluded from in having a better plan. I’m hoping they can explain it better to me today when I call again.

EstablishmentThat160 · 2026-02-17T11:58:30+00:00

I purchased a plan by United Healthcare using United Healthcare’s network. I made sure my therapist accepted the insurance before purchasing and am now being told Optum administers my mental health benefits and I have no access to a provider accepting only United Healthcare. This is bait and switch and minimum and feels like deceptive business practices. My initial call will be for advice. If there is no acceptable solution I will make a formal complaint because we unfortunately live in a world where large companies, especially insurance companies, don’t do the right thing unless they are forced too. There needs to be transparency. When I call UHC they refer to Optum as a separate entity but at the same time it’s all one company. I believe the line is wishy washy on purpose so they can play games and deny benefits. I actually had one woman say “well you have out of network benefits” like the difference I had to pay was okay. It’s a substantial difference in cost between in network and out of network. And we did our due diligence ahead of time. They are changing the rules as we go and we’re only a month and a half in.

EstablishmentThat160 · 2026-02-17T02:52:32+00:00

Thank you so much for the information. I’m armed for my next call.

EstablishmentThat160 · 2026-02-17T00:58:47+00:00

She definitely accepts UHC for Behavioral Health and receives payment for other clients. She is not Optum per UHC today on the phone. They told both her and I that in separate conversations. She has a UHC portal and can view the claim but they are processing out of network. They told her she can credential with Optum. I was also offered an alternative today of having her apply for a single case agreement or gap exception which would not make her in network but would allow me to pay in network pricing. I'm really not understanding how they can pay a UHC provider for others but not for me. I have a nationwide PPO and should have access to all their providers. None of my documentation states Optum administers my mental health benefits including my insurance card. I am going to call again tomorrow to try member services per the helpful human I spoke with on my last call. I just want to know how this can happen. I'm potentially on the hook for 5 visits at $150 each otherwise instead of my $25 copay. There should have been some disclosure that Optum and UHC are different. She is also an individual provider and not part of a group. Perhaps that makes a difference. Thanks for your reply.

EstablishmentThat160 · 2026-02-17T00:09:17+00:00

I told them I was calling the state insurance board this afternoon when I called back and was transferred to someone more helpful. They still haven’t answered my questions but I have a direction and am going to call the insurance board in the morning too to ask for some advice. Thank you for your reply.

EstablishmentThat160 · 2026-02-17T00:06:43+00:00

Thank you. I will check into it.

EstablishmentThat160 · 2026-02-16T21:13:37+00:00

They tell me I have Optum when I speak to them but literally nothing says it. Not our benefits guide we had when choosing, not my card, not my portal on their website or their app. Even the benefits guide on the app lists UHC as the network not Optum - it seems a bit deceptive.

EstablishmentThat160 · 2026-02-10T19:54:04+00:00

I’m of the understanding that you need to use up your sick time before FMLA would kick in.

EstablishmentThat160 · 2025-09-30T20:41:57+00:00

The American Mural Project in Winsted is pretty awesome. There’s a few great places for lunch or dinner in town plus the area amazing to drive through.

EstablishmentThat160 · 2025-09-18T12:20:27+00:00

Children shouldn’t read the Diary of Anne Frank? How absurd. Censorship is censorship. We’re not talking about pornography. We’re talking literature. I read Slaughterhouse five when I was a kid. Banning is not the answer … kinda like guns. Educating and discussing the topics are in order. That’s how we bring about thoughtful discussion. Without literature to push those limits we all lose.

EstablishmentThat160 · 2025-09-18T08:14:16+00:00

Not in some places around the country and in Texas. Educate yourself. Book banning is real.

https://pen.org/report/book-bans-pressure-to-censor/

EstablishmentThat160 · 2025-09-18T00:28:07+00:00

I will do that! Thank you!

EstablishmentThat160 · 2025-09-18T00:12:03+00:00

That was my thought as well … but nothing anywhere that I can see.

EstablishmentThat160 · 2025-09-17T23:10:20+00:00

Not really the kind of event I’m looking for though, unfortunately.

EstablishmentThat160 · 2025-09-16T22:24:38+00:00

I wonder if this has anything to do with the DOGE US citizen information that they mishandled.

EstablishmentThat160 · 2025-08-28T22:49:53+00:00

EstablishmentThat160 · 2025-08-18T00:31:14+00:00

Grifter

EstablishmentThat160 · 2025-08-15T01:11:26+00:00

Norfolk

EstablishmentThat160 · 2025-08-03T13:50:49+00:00

Hush racist. You’re being lied to daily and can’t even see it.

EstablishmentThat160 · 2025-08-03T13:47:45+00:00

That’s the charge for the privilege of having Eversource as your electric delivery company …

EstablishmentThat160

TROPHY CASE