A friend of mine who wants to stay anonymous (for now at any rate) had a crazy waste of time proving that he was eligibile for a medication on his plan. I thought his story might trigger a few of you! And yes Optum is of course part of United HealthGroup–Matthew Holt
Here is the ridiculous situation I had with filling a prescription through COBRA a few weeks back.
I spent 33 minutes on the phone on January 8th, 2025 before I finally navigated the maze that is American healthcare to the extent that a medication that has been prescribed for me by my doctor regularly for several years could be delivered to her office in time for my next appointment. OK, there is a need to verify health insurance coverage, but one might expect this to be a simple matter of checking eligibility->coverage->currency-with-premiums, and something that can be done asynchronously. Not so. Optum needed to verify the “paid-through date.” I pointed out that I’d already made four attempts to resolve this situation since December 19th, including on the last occasion by providing details of my COBRA policy to the Optum agent so that she could follow up with them to verify whatever it is they needed to verify. Apparently she hadn’t bothered, so here we were again.
What was required to resolve this in the end was literally a four-way conference call, which of course is absolutely ridiculous in the Information Age. With the primary Optum agent on the line, I conferenced in the COBRA hotline, but the automated voice confirming my “paid-through date” was not good enough for her to be able to vouch for me. I needed to get a human agent on the line. Meanwhile, the primary Optum agent conferenced in someone from their payments division. With all four of us on the phone, I did the introductions, then the second Optum agent asked the COBRA agent to repeat the paid-through date, give his name and a confirmation number, and that was enough information for the Optum payments person. The primary agent and I twiddled our thumbs on the line for another 5-10 minutes until the payments agent came back online to tell us that she had completed her work–at least for the coverage part.
But wait. There’s more. Now I needed to confirm my consent to the terms and conditions, which the agent had to read out to me in full, taking several minutes of her reading the small print, before I confirmed that I accepted. The final stage was for me to wait on hold again while she set up overnight delivery and then reconfirmed my appointment with my doctor. In the end, this was successful, but it cost me nearly 35 minutes in a process that is absolutely unnecessary.
Delay, Deny, Defend were the words inscribed on Luigi Mangione’s bullets. This was his point. They haven’t gotten the memo.
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