Problems with Medicare ‘flex card’ system

By Thomas Goldsmith

Electric cooperative and public-power groups across North Carolina are reporting that a UnitedHealthcare “UCard” sent this year to dual Medicaid and Medicare enrollees doesn’t work as advertised to pay utility bills. 

According to energy officials and publications, the flex-card program has caused weeks of difficulty for specific utility customers who often have “complex health and social needs.” 

The situation has resulted in complaints to federal regulators at the Centers for Medicare and Medicaid Services from people who were referred there by the state Department of Insurance.

Logan Rains, a government affairs specialist with ElectriCities, an organization that represents more than 70 of North Carolina’s public utilities, emailed the state this month on behalf of New River L&P, a nonprofit electric utility that has served Boone residents since 1915. The problems with UnitedHealthcare NC, or UHC, were having a negative effect on “many of New River L&P’s most vulnerable customers,” Rains wrote to the Department of Insurance.

“Since January, New River L&P has spent considerable time reaching out to UHC and advocating for their customers without a resolution,” he wrote. “The only guidance New River L&P have received is that customers need to call the UHC UCard program, provide their utility information, and then UHC would issue payment in the form of a check. 

“Unfortunately, it is now March, and New River L&P has not received any payments.”

The situation reported by several North Carolina electric cooperatives, by some of the state’s public power companies, and by other suppliers as far away as Washington State, raises another question about the Medicare Advantage program, in which private health insurance companies collect billions in taxpayer dollars to insure older people and others with specific conditions.

The popular program insures about half of Medicare enrollees in North Carolina and nationally, and will cost taxpayers more for the same level of treatment as traditional Medicare this year, according to a new report this month from MedPac, a monitoring panel of the U.S. Congress.

“Medicare spends 6 percent more for MA enrollees than it would spend if those beneficiaries were enrolled in (fee for service) Medicare, a difference that translates into a projected $27 billion in 2023,” the report said.

Medicare Advantage programs have attracted potential enrollees with its extras, such as gym memberships, basic vision and dental care, and flex cards that can be used for food and over the counter health products.

‘Prices of everything just keep going up’

On a web page, UnitedHealthcare promises that its flex cards, called UCards, can help Dual-Special Needs enrollees — people who qualify for Medicare because of their age or disability status and Medicaid because of their income — with utility bills. North Carolina has about 370,000 dually eligible residents.

The site reads: “It seems like the prices of everything just keep going up these days. But it’s people on a limited income who really feel the squeeze. … Even paying for necessities like food, over-the-counter (OTC) health care products, heat and electricity can be a challenge. So, for those who have both Medicaid and Medicare, a dual health plan can provide welcome relief.”

UnitedHealthcare introduced the UCards in January, and those beneficiaries quickly started having trouble using them to pay bills. 

“The issue New River L&P is having is that UCards are not debit or credit cards and do not have an indicator of how to make utility bill payments manually,” Rains wrote. “I hear this program was initiated with little information to customers and without providing information to the local utilities.”

In addition, the Albemarle Electric Membership Corporation, which covers Camden, Chowan, Pasquotank and Perquimans counties, placed information about UCards in its online newsletter.

“Several Albemarle EMC members have received a United Healthcare UCard in the mail and have tried to use the card to pay their power bills,” the utility said. “Because the Ucard is not a Master Card, Visa or Discover, we cannot accept the card as a form of payment.”

History of complaints

UnitedHealthcare emailed North Carolina Health News a statement on March 24 in response to questions about weeks of complaints from consumers and utilities about issues with UCards.

“Recently, we were made aware that some utility companies are not able to accept electronic payment from the UCard,” the company said. “While we work to address this issue, members can still pay in-person for most utility companies at a Walmart MoneyCenter or customer service desk.”

However, Rains’ email described the problem as a “widespread issue affecting smaller utilities that cannot take payments through a third-party vendor like WalMart.”

The statement from UnitedHealthcare communications said members of the plan can still shop for over-the-counter products and food with the cards. 

This isn’t the first time North Carolina has received complaints about the treatment of dually eligible enrollees by Medicare Advantage companies. In August, the state insurance department’s response to a query appeared in a congressional committee’s report on deceptive marketing to Medicare Advantage recipients. 

“The North Carolina Department of Insurance shared that its Seniors’ Health Insurance Information Program (SHIIP) had received a number of complaints involving dually eligible beneficiaries who had their enrollment changed to a different [Medicare Advantage] plan even though neither the beneficiary, family member, or power of attorney had been engaged in an enrollment discussion with the plan or an agent,” the report read. 

Federal officials field complaints

Public power companies are also complaining about UCards, said Elizabeth Kadick, spokeswoman for ElectriCities.

“We had heard from several of our members that their customers were having trouble using the UCards to help pay their utility bills,” Kadick said in a phone interview. “So we reached out to UnitedHealthcare to see how ElectriCities might be able to help streamline the process.”

The state Department of Insurance does not regulate Medicare Advantage companies, which are funded with federal dollars and regulated by federal officials. Nonetheless, state officials have received complaints about UCards from individual customers and from the New River Light & Power cooperative in Boone and Hamilton North Carolina Electric Utility in Martin County.  

“The Department/Seniors Health Insurance Information has reported these complaints to (the Centers for Medicare and Medicaid Services), as it is the federal authority over Medicare Advantage plans,” said Barry L. Smith, a Department of Insurance spokesman.

UnitedHealthcare advises enrollees that they can go through a hub on the company’s website if the utility company doesn’t accept a UCard. Carolina Country, an online publication of the state’s electric cooperatives, reported that Tideland Electric Membership Corporation in Pantego investigated the process and offered advice to customers who learn that the UCard is not affiliated with Visa, MasterCard or American Express. 

“If the UCard is not associated with one of those networks and you choose to make a UCard payment via a third-party payment processing vendor like Walmart, please take into account that it can take up to seven or more business days for the payment to be received by Tideland,” the utility said. “Therefore, if you are past due on your electric account or within a week or two of your due date, you may want to avoid the use of a third party vendor.”

Tideland’s coverage area includes Beaufort, Craven, Dare, Hyde, Pamlico and Washington counties.

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