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12-03-2024 02:17 PM
Today, Dec 3 DH got a letter from Aetna where he has a medicare advantage plan; never had any issues with it. The letter says Aetna is dropping his network and he will need to get a new provider....this four days before the enrollment deadline! He has a heart condition, serious, cancer survivor, etc and sees specialist throughout the year to manage his health issues.So far, none of the companies they suggested moving to are accepted by any of his doctors. Can they do this? Have spoken with a broker....no help.
12-03-2024 02:25 PM
Didn't the broker mention that there's an open enrollment period specifically for advantage plans that runs from Jan 1 to March 31?
Source: AARP, "Can I Change Medicare Advantage Plans at Any Time". Original article is dated 4/20/22, updated 1/9/2024. Can't post the link here as they're not allowed.
Have you called Medicare to ask for their assistance in finding a new plan?
Sorry this is happening to you. I know it must be frustrating to no end.
12-03-2024 02:25 PM
That does not seem like it should be allowed at this late date.I hope you can quickly find an insurance agent to assist.
12-03-2024 02:26 PM
It's really crappy that they waited until the last minute to notify him.
JMO but it's probably the doctor that dropped Aetna because they couldn't come to an agreement and not the other way around.
12-03-2024 02:29 PM
Have you tried calling his doctor to see which plan they are accepting? When I lived in Colorado, they did the same to me but later they did put my PCP back on the plan. By that time, I had changed to another provider. I hope everything works out.
12-03-2024 02:33 PM
I would do as @elated suggests. Call the doctors' offices and find out what insurance they take and switch.
This does seem wrong.
12-03-2024 02:36 PM - edited 12-03-2024 02:39 PM
Call your state's SHIP office and speak with a professional who will help you negiotate the various options. They are unbiased and have all the information available.
I've been reading about this in my state, as well (Nebraska). It's happening everywhere as the medical community is no longer doing business with the insurers questioning billing codes and/or making very late payments, etc., etc. OR the insurance industry is having a horrible year and wants to eliminate groups which lower their P&L for their shareholders benefit.
ETA: Is this an Advantage Plan? From my reading, that seems to be the main problem with the medical communities.
12-03-2024 02:41 PM
From what I understand a lot of PPO plans are leaving Advantage plans because of the changes being made.
I read for those that do not pick a new plan if yours is leaving they will automatically put you on Medicare.
12-03-2024 02:42 PM - edited 12-03-2024 02:43 PM
@Trailrun23 Sorry to hear, that would be very upsetting to me also. As someone who has worked with Medicare and just about every secondary insurance out there for many years, I would recommend looking into AARP. They were one of the very few insurers that always paid us what we billed them, and paid quickly. AARP is pretty universal in that most Doctors accept it.
I also recommend that you let Medicare know you want your secondary insurances to auto cross over. This not only insures a more quick and efficient billing process, but you are always assured that your secondary is billed by the Provider, and not billed to you because the Provider failed to send it over to your secondary. Yes, it can and does happen. I think most secondary insurances are now set up to auto cross, but it's best to check just to be sure. Good luck to you.
12-03-2024 02:48 PM
@KittySoftPaws wrote:@Trailrun23 Sorry to hear, that would be very upsetting to me also. As someone who has worked with Medicare and just about every secondary insurance out there for many years, I would recommend looking into AARP. They were one of the very few insurers that always paid us what we billed them, and paid quickly. AARP is pretty universal in that most Doctors accept it.
I also recommend that you let Medicare know you want your secondary insurances to auto cross over. This not only insures a more quick and efficient billing process, but you are always assured that your secondary is billed by the Provider, and not billed to you because the Provider failed to send it over to your secondary. Yes, it can and does happen. I think most secondary insurances are now set up to auto cross, but it's best to check just to be sure. Good luck to you.
@KittySoftPaws Advantage Plans are not the same as Medicare/Secondary(Supplement)/Crossover.
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