Yes this would be true. I was not thinking and shooting from the hip. It was late in the day (for me ) and earlier in the day I was reading about another JHH doctor for pain and his site said they don't take MA plan. I know my brother-in-law went to the Cleveland Clinic for transfusions for melanoma. I remember my sister talking about not being able to afford them. I need to call her anyhow, I'll ask.Not necessarily . . .
The hospital clinics you mention are either out of network to all but a few local MA plans or don't accept any of them. Mayo has been for MA then against them and then for them. I can't keep up with them any more.
For the rest of that gang, if you search their website for MA insurance they accept you see things like this . . .
If you are enrolled in a managed care plan (HMO, PPO or POS), your treatment at MD Anderson may be covered by insurance. Before scheduling an initial appointment, please call your health plan/insurance company and ask if you have access to health care services at MD Anderson. We encourage you to refer to Questions to Ask Your Insurance Company when speaking to your insurance provider.
If MD Anderson is not a participating provider, you may still be able to receive treatment here. Contact your insurance company and ask about obtaining authorization. It is important to note that some benefit plans utilize what are referred to as "narrow" or "limited" networks; that is, they further narrow or limit the choices of doctors and hospitals that their customers can use. Often, these networks exclude MD Anderson. Additionally, some plans, such as HMO’s, have primary care physician referral and/or other authorization guidelines.
Your MD Anderson patient access specialist will help you obtain the full benefit from your insurance plan by:
Answering your questions about insurance verification and/or prepayment requirement
Responding to insurer requests for additional medical information.
DISCLAIMER: MD Anderson's participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. A patient’s level of coverage depends on the specific benefits outlined in their plan.
To ensure that MD Anderson and its physicians are in-network, it is the patient's responsibility to verify that MD Anderson is a participating provider and their benefit plan allows them access as of the day of a visit and/or admission. Please contact your insurance plan to obtain this information.
Revised 2/23/2023
Insurance Plans
If you are enrolled in a managed care plan (HMO, PPO or POS), your treatment at MD Anderson may be covered by insurance. See the list of accepted insurance plans here.www.mdanderson.org
We MAY admit you but you will need to jump through a bunch of hoops plus sign an agreement that you are responsible for paying claims that are denied or where there is a spread between what your carrier pays and what we bill.
My guess is very few people are willing to take that kind of beating and are willing to sign on for an OOP without caps . . . which is essentially what this kind of arrangement turns out to be.
There are any number of reasons why specialty clinics refuse to participate in MA plans, or only contract with a very small number of plans.
Here is another phrase that comes to mind, but it did not originate in the south. Put some lipstick on that pig . . .
There is not enough lipstick to make these hospitals want to accept MA plans into the fold.
And yes, I can see you are singing a different tune but you are tilting at windmills.
The article in the link mentions our city / county hospital, the big main hospital dropped some MA plans. The hospital is one of two hospital's but they are the hospital with ancillary locations all over the country, they are and have been the big dog.
Before MA plans came along with their Sirens song, I did have some good traditional gap insurance companies in my file cabinet to offer. I think the people need to hear the "this could be you story" and traditional gap policies have to back the bigger stage.
"Hospitals are dropping Medicare Advantage plans left and right
Jakob Emerson - Updated Thursday, December 14th, 2023
"Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. "
Hospitals are dropping Medicare Advantage plans left and right
Hospitals nationwide are dropping Medicare Advantage plans due to excessive prior authorization denial rates and slow payments from insurers. Scripps and St. Ch
www.beckershospitalreview.com