Two years ago, Robby Martin got an unsettling call from his father, Jackie. The 82-year-old told his son that a representative of the insurance giant UnitedHealth Group had barged into his nursing home room at 2.30 in the morning, announcing that he was going to be checked out at the end of the week.
Jackie Martin – who had been getting rehab at the nursing home after suffering a back fracture – still could not take more than a few steps without being out of breath.
But Jackie’s care there, which had started two weeks earlier, was eating into UnitedHealth’s bottom line.
The retired paper plant foreman was enrolled in UnitedHealth’s Medicare Advantage program, a federal privatization initiative that offers insurers a lump sum to cover services comparable to those under traditional Medicare. But the program’s pay structure means that the more care insurers deny, the more in taxpayer dollars they get to keep for themselves.
Now, UnitedHealth was pushing to terminate the 82-year-old’s rehab coverage.
Jackie and his son appealed UnitedHealth’s decision and won. But the corporate giant issued another coverage termination letter the following week, then another one the week after that.
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