5,000 Medicare patients say they suddenly lost access to their doctors

Sep 14, 2018

  1. Northeast Agent
    Offline

    Northeast Agent Guru

    Posts:
    305
    Likes Received:
    71
    State:
    Pennsylvania
    5,000 Medicare patients say they suddenly lost access to their doctors

    AUSTIN (KXAN) — About 5,000 Medicare Advantage patients in Central Texas say they've suddenly been cut off from their go-to doctors.

    Austin Regional Clinic told us they knew they wouldn't be an in-network provider with United Healthcare for Medicare Advantage patients beginning next year.

    ARC expanded some programs, and those changes led to ARC and United Healthcare respectfully and mutually deciding to end their contract.

    United Healthcare told us ARC providers remain in their network and are available through their directories for the remainder of the 2018 year.

    However, that's not what K.C. Cerny and other patients experienced this week. He said he received a letter from United Healthcare this week, saying he's been assigned a new doctor beginning October 1st.
     
  2. somarco
    Offline

    somarco That Medicare Guy

    Posts:
    28,491
    Likes Received:
    1,883
    State:
    Georgia
    Too often agents believe the MA vs Medicare and Medigap is strictly a matter of monthly premium

    Those same agents fail to understand and appreciate the dynamics of continuity of health CARE and how most seniors abhor disruption.
     
    somarco, Sep 14, 2018
    #2
  3. Chazm
    Offline

    Chazm Guru

    Posts:
    4,568
    Likes Received:
    627
    State:
    Florida
    2 years ago, medicare supplement clients in The Villages woke up to find out their doctor would only take UHC mapd. Nearly all the doctors in the Villages.

    While not common, it shows anyone can lose their doctor.
     
    Chazm, Sep 14, 2018
    #3
  4. Northeast Agent
    Offline

    Northeast Agent Guru

    Posts:
    305
    Likes Received:
    71
    State:
    Pennsylvania
    It would make sense for CMS to allow a SEP in cases such as this.

    I remember reading about the deal with The Villages not accepting Med Supps beginning 1/1/2017, I believe. But I think they at least had some notice.

    When educating clients about Medicare I tell them, "ALMOST any doctor or hospital in the country who accepts Original Medicare will accept a Supplement. There are a few exceptions to this. With Medicare Advantage, however, they can drop out of the network at any time."
     
  5. somarco
    Offline

    somarco That Medicare Guy

    Posts:
    28,491
    Likes Received:
    1,883
    State:
    Georgia
    I understand MA penetration is quite high in Florida. How many OM patients "woke up to find their doc would only take UHC MA" plans?

    UHC/AARP targets certain areas of the country and are able to be the 800 pound gorilla without breaking a sweat. They have enough money plus the AARP endorsement to do whatever they want. It doesn't surpise me they would target a community where most of the residents are on Medicare or nearing that age.

    With 50,000 residents, almost all white and 50-50 by gender, it's like shooting fish in a barrel if you have the ability to dominate the market.
    The Villages, Florida Population 2017, 2018

    Looks like 19 MA plans in Sumter county for 2018. All but 4 are $0 premium.
    2018 Medicare Advantage Plans in Sumter County Florida
     
    somarco, Sep 14, 2018
    #5
  6. Chazm
    Offline

    Chazm Guru

    Posts:
    4,568
    Likes Received:
    627
    State:
    Florida
    Sumter surprisingly doesn’t have as many plans as we do and they’re not nearly as good.

    To the OP it says they lose their doctor 1/1/19 but the clients probably got a letter and misread it. I’m not saying med supps don’t have many more doctors but a doctor can choose to not take Medicare at any time.
     
    Chazm, Sep 14, 2018
    #6
  7. somarco
    Offline

    somarco That Medicare Guy

    Posts:
    28,491
    Likes Received:
    1,883
    State:
    Georgia
    It depends . . .

    But there is a big difference in a doctor making the decision, the patient making the decision, and the CARRIER making the decision for the patient.
     
    somarco, Sep 14, 2018
    #7
  8. MedicareMillionair
    Offline

    MedicareMillionair Super Genius

    Posts:
    206
    Likes Received:
    159
    State:
    South Carolina
    When a MA plan drops a hospital, it will normally maintain that facility in network until the end of the plan year. In which case the insured can enroll in another plan to maintain that Hospital.

    The problem usually arises when the insured does not pay attention and doesn’t speak with an agent. They never notice they lost their hospital until it’s too late.
     
  9. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,396
    Likes Received:
    376
    State:
    Kansas
    But the article says that UHC is forcing a patient to have a new doctor eff 10/1 even though the UHC / provider agreement says the changes do not happen until the end of the year.
     
  10. LostDollar
    Offline

    LostDollar Guru

    Posts:
    2,396
    Likes Received:
    376
    State:
    Kansas
    will the potential care disruption issues experienced with MAPD's be eliminated with the MSA MA plans that have recently been discussed in other threads?
     
Loading...