The reason the calls keep coming is simple. Insurers that cover Medicare Advantage patients receive payments from Medicare based on the number of "diagnostic codes" in the patient's file. Insurers want to collect information to report additional diagnostic codes to Medicare to increase the payment that Medicare makes to the insurance company. Some of us remember a few years ago when Humana launched a similar program through which it wanted to send a case manager into each person's home to conduct a medical exam, evaluate the individual's overall health and living situation. In that case the contractor that had been hired to provide this service told insurance company executives at an industry meeting ( acccording to reports in the industry press) that insurers were "leaving money on the table" by not reporting more diagnostic codes, which the contractor proposed to find. There seem to have been many complaints about this proposed intrusion, including mine, and it appears that this new telephone counseling initiative replaces that effort. I have looked over the program website and determined that I do not need any of the services that are being offered since I am robustly active, have a large supportive family and excellent immediate access to my doctors' office if I need assistance or have questions. I have told several callers this and asked that the calls stop.They have not stopped. The service may indeed be useful for some people, however it also seems that the calls should stop when one asks that they stop. I have to conclude that they do not stop because in addition to offering help to individuals this is an activity that can also increase insurance company revenue.
Its Humana medicare and they want you to tell them all your personal information so that they can "coordinate your care" basically so they can report back to the government/ CMS what your up to. I told them basically I have Doctors and I pay them to take care of me. I pay Humana to pay the Doctors so what I do is my business and to quit calling. They are contracted by the government, other than that I don't have to talk to them unless its concerning a claim or a bill. Period.
This is NOT a sales call, it is a Humana Care call. They call to check on you and see how you doing, health wise. It's part of their contract for managing your Medicare and your insurance policy from Humana. If you need help from counseling to being able to afford your medications or even to quit smoking, the lady will help you. She may also ask you how they are doing to see if they are helping you with whatever it is you may need.
If you have a problem that Humana is not solving, and you think it's their responsibility, tell her, she will get to the right person and help you with it. If they don't solve it, you can appeal to Medicare and they can, and will, override Humana if they decide in your favor.
She called me this morning to see how I was doing and if I might need help next week when I go to the hospital for a kidney operation or if I might need help when I come home. She told me that under the insurance contract, I could get nursing help at home if I needed it and that I would also receive 10 free meals, delivered to me. The number of meals is probably tied to whatever the operation is and how long you are in the hospital. Mine is Laparoscopic surgery and typically I would be in the hospital anywhere from 1 to 3 days.
The lady that calls me is named Barbara and she is sincerely concerned about me and how I am doing. We always chat and make jokes between us while she's doing her job to check on me. She calls once a month and always asks if it's a convenient time for me and if it's not, she asks me when would be convenient.