Wellness

[Icegoddess]

Locally, one of the hospitals recently announced that they were breaking ties with UHC.  They did have some exceptions but didn't mention Medicare.  However, if the hospital accepts Medicare they have to accept any Medicare supplement even if they don't accept that insurance Co. so I wasn't concerned for myself.  Of course each side had a story blaming the other side for the issue.  By Thanksgiving they had resolved their problem apparently and it's back to business as usual.

Hopefully, it will work out for you that way.  As someone else said, I think it would be prudent to talk to your health care provider.

[Nightowlz]

It says this on the Aetna site. Under the info below they have where you enter your zip code to see other plans.

It’s time to enroll

Your Aetna Medicare Advantage plan won’t be offered in 2025. But don’t worry, we can help you find another Aetna® plan that’s similar to your current plan. We’ll help you every step of the way to find and enroll in the right Aetna plan for you.

I Googled if Aetna is leaving Advantage Plans. Here's the AI response.

No, Aetna is not selling out their Medicare Advantage plans, but they are exiting some Medicare markets in 2025: 

• Plan discontinuances

  Aetna may discontinue some plans to make room for new plans or to update benefits. If your plan is being discontinued, you can enroll in a new plan during the Special Enrollment Period (SEP) from December 8, 2024 to February 28, 2025. 
• Market exit

  Aetna is exiting some Medicare markets in 2025. If you're losing your Medicare Advantage coverage, you qualify for guaranteed issue rights for Medicare Supplement Plan A, B, C, D, F, G, K, and L. 
• Product portfolio

  Aetna will continue to offer a variety of products, including: 

  • Medicare Advantage Prescription Drug (MAPD) 
  • MA-only 
  • Prescription drug plan (PDP) 
  • Special Needs Plan (SNP) 
  • Medicare Supplement 
  • Ancillary products 

Aetna's Medicare Advantage plans include medical and prescription drug coverage, plus other benefits and services. 

[Nightowlz]

Medicare Advantage, contrary to popular opinion, is not Medicare; it is a substitute for Medicare where you forfeit your rights and protections of Medicare Part A & B in exchange for a managed care plan (HMO/PPO) where the health plan dictates your coverage for you.

[Kachina624]

@Trailrun23.  Call your state insurance regulatory agency.

[Carmie]

@Trailrun23   Yes, they can legally do this, but that stinks.

My guess is that the providers decided not to renew their contract for next year and Aetna just found out.

Does your Advantage Plan has benefits for in and out of network providers?

If so, your husband can go out of network, but he might be responsible for a balance not paid by insurance.

It's worth checking into.  Sometimes it's more trouble than not  to change providers....and sometimes the providers will again participate with your insurance plan at a later date.

[Carmie]

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@Nightowlz wrote:

Medicare Advantage, contrary to popular opinion, is not Medicare; it is a substitute for Medicare where you forfeit your rights and protections of Medicare Part A & B in exchange for a managed care plan (HMO/PPO) where the health plan dictates your coverage for you.

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Wrong!  Advantage plans are Medicare Part C.

In addition, there is Traditional Medicare Parts A and B.

Both types are Medicare.  They are just different, but both cover the same things.  Part C offers additional coverage and usually RX drug coverage.

[CelticCrafter]

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@Carmie wrote:

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@Nightowlz wrote:

Medicare Advantage, contrary to popular opinion, is not Medicare; it is a substitute for Medicare where you forfeit your rights and protections of Medicare Part A & B in exchange for a managed care plan (HMO/PPO) where the health plan dictates your coverage for you.

---

Wrong!  Advantage plans are Medicare Part C.

In addition, there is Traditional Medicare Parts A and B.

Both types are Medicare.  They are just different, but both cover the same things.  Part C offers additional coverage and usually RX drug coverage.

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Lots of strings attached to Advantage Plans that aren't with original Medicare, a Supplement and a separate Part D plan .  

[teganslaw]

I have a supplement plan, not Advantage. However, all the commercial advertising Medicare Advantage plans list in small print that they are a non-governmental entity. That must mean they're independent plans; Medicare approves them, but they separate and private plans. 

[Q-Checker]

@Tralrun23 Sorry to hear that - it is why I have traditional/original MC Parts A and B in addition to a supplemental and will not be at the mercy of any PPO/HMO. I receive a high quality of medical care, selecting my own physicians from a huge pool of highly qualified doctors both in and, for when I travel, out of this metropolitan area. My med's are covered under my supplemental plan.

[karabeth]

Hi @Trailrun23,

Go to medicare.gov plan-compare. I know links are not allowed here so hopefully what I wrote isn't considered a link and you'll be able to find the site using this information. Make sure you are on the official Medicare.gov website.

Once on the plan/compare page, your husband should log into his medicare account and then enter the zipcode where you live for 2025 coverage. Once he does this, he'll get a list of all of the medicare advantage plans available in your area.

I had to do this, too, because my medicare advantage plan is discontinued in 2025. Make sure your husband checks that the hospitals, doctors, drugs, and lab facilities he uses are covered under the new plan he selects. He can call the phone numbers listed for the different plans and a representative will be happy to check all his information for him.