Wellness

[geezerette]

It sounds like the confusion arose from the wording of the doctor's office statement.  They made it sound like the doctor was no longer accepting that insurance, when instead it was the insurance company that was dropping that doctor from its coverage.

[Mindy D]

@Effie54 @My doctor told me why. She told me that the insurance company quit them because their offices do not generate enough business ($) for the insurance company. 

She is telling the truth. I have known her before she even graduated medical school. She is a very sincere person. It is not because her offices quit the provider. She was genuinely sorry about this when I went into the office yesterday. She was very courteous when I asked what happened. I never expected an answer. I thought she would say she was not able to discuss it. I get the feeling that being dropped hurt the feelings of the doctors and staff. I believe that they don't generate enough Medicare Advantage money for this one insurance provider because of older people not going in or going in to see the doctor or going in much less due to the pandemic and because of the huge amount of older residents selling to younger residents not on Medicare yet. We are in Florida. So many long time residents sold their homes when the home prices shot up sky high. They have taken their profit and have relocated. Those moving in are younger and not on Medicare yet.

The office still takes many other Medicare Advantage Plans from other carriers. 

 Her offices are amongst the busiest in terms of patients using them for primary care in the area and the doctors are exceptionally respected by long time patients. They have a stellar reputation. Most of the patients are on insurance through their jobs, as I was when I first started using this practice. Most of my friends are still working so they are using the office through their work insurance and not Medicare. Her dad is the senior doctor and the founder of the practice. They have four, very well run offices. The doctors are all graduates of top medical schools and all did residencies in top hospitals. 

[Mindy D]

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@kaydee50 wrote:

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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.

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@ID2 This does not mean that your carrier won't start dropping doctors that don't generate enough income for them. The doctor is still taking all the United Medicare Advatage Plans. So far United is still keeping this doctor. 

[CAcableGirl2]

@geezerette  I have a major insurance company and it was dropped from the medical practice that I have gone to for 40 years.  No notice, nothing until I tried to make an appointment.  I have a PPO.   

[Still Raining]

If you are in an area with some choice, even more important than a PCP is to understand exactly where the hospitals have their services.

Where is ambulatory infusion? Or specialized Neurosurg?  Might be in for a surprise.

[Tinkrbl44]

@Mindy D 

Huh.  Thanks for the elaboration .... I wouldn't have guessed that one!

[Growing]

Where I live, plain old regular  or original Medicare is taken by almost all docs whereas the Advantage plans have limited physicians taking it. Husband was always out of network on a well known Advantage plan. I am under age 65 and on a marketplace plan or obamacare. Many hospital systems here do not take these plans so I pay a huge montly premium to have a plan that is taken by most doctors. I use a large religious hospital system that takes these plans. Right now, they are all HMOs and I can't wait to get on regular or original Medicare and be free from the need for referrals to go to any specialist. 

[Mindy D]

@Growing @There are many Advantage Plans, both HMO and and PPOs that do not require referrals to see specialists. My Blue Cross PPO does not require them and neither does my husband's HMO from United Healthcare. Doctors, including specialists, take Original Medicare with a  supplement plan, also called a Medigap Plan. Hospitals take plain, Original Medicare, part A, by itself. 

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@Growing wrote:

Where I live, plain old regular  or original Medicare is taken by almost all docs whereas the Advantage plans have limited physicians taking it. Husband was always out of network on a well known Advantage plan. I am under age 65 and on a marketplace plan or obamacare. Many hospital systems here do not take these plans so I pay a huge montly premium to have a plan that is taken by most doctors. I use a large religious hospital system that takes these plans. Right now, they are all HMOs and I can't wait to get on regular or original Medicare and be free from the need for referrals to go to any specialist. 

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[Drythe]

Point of information since United Health was mentioned in 

@Mindy D 's post.

DH and I have had United Health as Private Health Care, and as

supplemental Insurance.  Never have we had a claim denied.

Seems to be United Health Care Advantage plans.

Just hate for them to get a bad rep. for their products which have

given us excellent service for years.

Just sharing information.