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The other huge problem with Universal Health Care that hasn't been mentioned in this thread is their provider relations. The problem was, they didn't have any! (There are several articles I could link from Fla. papers, but I don't know the policy here for linking things like that or posting them).
Apparently it was quite common for Universal members to go to the doctor only to be told that the plan wasn't accepted there. Imagine the shock for the folks who had enrolled in the ANY, ANY, ANY plan who had been told that they could go to any doctor, any hospital, anywhere in the USA! I'm surprised that CMS allowed them to market it as Any, Any, Any anyway because it oversimplifies things and can lead to confusion. Now it is true that from the insurance company's perspective with an MA PFFS that a member can go to any doctor, hospital, etc., but since there is no contract with the provider (unlike an HMO or PPO) no provider is obligated to accept it. Since Universal was new to many providers, they weren't familiar with it and apparently declined it, refusing to see the patient until they learned more. From what I read, regulators and politicians were breathing down Universal's neck in Florida and they pulled the plug.
This serves as a wake up call to both Medicare members considering MA and agents marketing it. Don't assume a provider will accept a PFFS without checking into it first. With the enrollment guidelines as they are, you don't want to make a mistake that might take nearly a year to fix, or that could result in a complaint against you if a member feels they were misled. There are a lot of new MA plans out there this year being offered by companies that are basically new to that market. Some of them look good on paper, but it's worthless if your provider does not accept it.
Apparently it was quite common for Universal members to go to the doctor only to be told that the plan wasn't accepted there. Imagine the shock for the folks who had enrolled in the ANY, ANY, ANY plan who had been told that they could go to any doctor, any hospital, anywhere in the USA! I'm surprised that CMS allowed them to market it as Any, Any, Any anyway because it oversimplifies things and can lead to confusion. Now it is true that from the insurance company's perspective with an MA PFFS that a member can go to any doctor, hospital, etc., but since there is no contract with the provider (unlike an HMO or PPO) no provider is obligated to accept it. Since Universal was new to many providers, they weren't familiar with it and apparently declined it, refusing to see the patient until they learned more. From what I read, regulators and politicians were breathing down Universal's neck in Florida and they pulled the plug.
This serves as a wake up call to both Medicare members considering MA and agents marketing it. Don't assume a provider will accept a PFFS without checking into it first. With the enrollment guidelines as they are, you don't want to make a mistake that might take nearly a year to fix, or that could result in a complaint against you if a member feels they were misled. There are a lot of new MA plans out there this year being offered by companies that are basically new to that market. Some of them look good on paper, but it's worthless if your provider does not accept it.
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