Medicare Advantage question

[Rob Lion]

What happens when you run into a plan without a network? is it accepted by any doctor that accepts Medicare?

 

[somarco]

What happens when you run into a plan without a network? is it accepted by any doctor that accepts Medicare?

Medicare Advantage without a network? You mean PFFS?

 

[Rob Lion]

Medicare Advantage without a network? You mean PFFS?

Yes AARP has two around me and i was confused i thought MA plans were big on having networks to provide for clients.

 

[TwoCents]

In the case of PFFS, the member has to ensure the doctor will accept the terms of the plan ON EVERY VISIT. At least that's what the evidence of coverage language usually says.

 

[somarco]

Yes AARP has two around me and i was confused i thought MA plans were big on having networks to provide for clients.

Almost all MA plans are mangled care and have networks.

I was not aware that AARP was an issuing carrier . . .

 

[GreenSky]

I was not aware that AARP was an issuing carrier . . .

That's because you don't specialize in Medicare and frankly because you're old.

Give me a call and I'll 'splain things to you.

Rick

 

[LostDollar]

The plans are listed in Medicare and You as AARP MedicareComplete Plan # and CMS sends one to AARPMedicarePlans dot com for information. (Although they are listed under a UHC HMO Main Heading.)

There are also 2 UHC PFFS plans that just say select counties so I don't know precisely where their coverage is.

 

[sshafran]

The plans are listed in Medicare and You as AARP MedicareComplete Plan # and CMS sends one to AARPMedicarePlans dot com for information. (Although they are listed under a UHC HMO Main Heading.)

There are also 2 UHC PFFS plans that just say select counties so I don't know precisely where their coverage is.

Without this vital info, I'm not sure I could've survived AEP.

Thank You!!

 

[LostDollar]

Yes AARP has two around me and i was confused i thought MA plans were big on having networks to provide for clients.

I see two more beyond the ones I mentioned above-they are listed under UHC HMO's but they say Erickson Advantage and Erickson Campuses. Is it possible that those are what you are running into just restricted to Erickson locations?

If so, that would get into a more extreme example of the types of MA plan limitations which somarco has talked about on many occasions.

 

[goillini52]

Almost all MA plans are mangled care and have networks.

I was not aware that AARP was an issuing carrier . . .

Yes, but I wouldn't feel comfortable representing a company without knowing their A.M. Best rating. Would you happen to know what it is?