Wellness

[Mindy D]

See post below. Somehow, the text didn't go through in the first text box under my title.

@wagirl @@Imtep @Malcontent@alliswell 

[wagirl]

OK-----so is that a good thing or a bad thing? A very mysterious post @Mindy D 

[Mindy D]

UPDATE ABOUT A PREVIOUS POST

My primary care doctor is honest and forthcoming. I had been notified that her offices would not be accepting my Medicare Advantage Plan or any of the Medicare Plans from this insurance provider.

Just Added for clarification.The doctor said that one reason is that plan users were not visiting the office enough. 

In a previous post, we speculated as to why. We proposed that the doctor was dropping the insurance company. Many posters proposed this was because the insurance company didn't pay the doctor enough. I proposed that the insurance company was dropping the doctor because I was guessing about patient survey scores that showed the offices did not meet the criteria that the insurance company wanted, for example office visit waiting times. I do not know what the survey scores actually show for the doctor. 

Well, it's none of those things. The insurance provider is dropping their busy offices because the office doesn't  generate enough business for the Medicare Advantage Plan provider.

The provider failed to consider that so many older persons made less visits to their doctors because of the pandemic. There has also been many younger residents moving into our area with the older residents selling their homes to take advantage of the increase in property value...so there are less older residents than just before the spike in property values. 

I'm one step away from switching insurance providers. I have to wait though, because my advantage Plan provider is the only only offering an HMO or PPO Advantahe Plan in my county and I will be going to the dermatologist. The dermatologists that are the top in this area accept PPOs but not the HMOs. 

I'll probably switch to my husband's Advantage Plan after I finally see a dermatologist, which won't be for awhile. His Provider, Preferred Care Partners, part of United Healthcare, does not offer a PPO Advantage Plan. It is an HMO Plan but this plan does not require referrals from a primary care to see specialists...which is good...but none of the dermatologists on my list were taking any HMO plan. 

[wagirl]

@Mindy D -----I knew there had to be some more to this----

I am about to start using my medicare benefits too. Had insurance thru my now ex ,so at the end of last month, I am no longer part of that. Kind of wondering how to jump into the medicare pool now.None of this surprises me--this pandemic just knocked any normalcy out of the water and now we are all trying to figure this out. but glad you figured it out--we all need to research things these days and not let things go.

[Effie54]

Soooooo.......what provider is this?? Anthem? My understanding is that if a provider will not accept the certain insurance company, it's because they don't pay enough. It's usually not because of lack of business. That's what the office manager told me in my doctors office. They no longer except anthem Blue CrossBlue Shield because of their low pay fee schedule.

[ECBG]

Definately good info to remember.  We all deal with insurance and doctors.

[ID2]

I'm soooo glad i was advised against signing up with the Advantage Plan. I heeded their warnings and am very happy with my regular Medicare choice.

[On It]

It shouldn't be this difficult, but it is.  I am covered by a United Healthcare PPO that was provided by the Teacher Retirement System in Texas. We were forced to give up our Medicare benefits plus a supplemental policy several years ago. We would have had to withdraw from the TRS insurance program if we did not switch. I am afraid to abandon the program for fear Medicare could be eliminated. Teachers were promised health insurance as part of our incentive to remain in the field despite low wages and meager benefits. 

[kaydee50]

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@ID2 wrote:

I'm soooo glad i was advised against signing up with the Advantage Plan. I heeded their warnings and am very happy with my regular Medicare choice.

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And I'm so glad I switched to AARP's Medicare Advantage plan with United Healthcare.  $38/month includes dental, vision and many other benefits.  I have a choice of doctors.  And just one card to deal with.  With my previouse choice plan, had Medicare, BC/BS, dental and vision cards.  Much easier and simpler this way.

[cindyNC]

I went to a seminar on Medicare and Medicare Advantage plans just befor I turned 65. It was thru the local senior center. 

We live in a rural county and the physicians here are not highly rated.  Since we see so many doctors in another county, it was a better choice to select standard Medicare vs a Medicare Advantage plan.