Last month, a woman called me, worried about her UHC Medicare Advantage plan. The letter arrived in the mail, informing my father about the reduction of services, including his head physician, which will take place shortly. UHC claimed that her father had found new suppliers, since most of it would have been reset. Frustrated and confused, this woman didn’t know what to do, and I suggested the Medicare supplement compared to looking for another Medicare Advantage plan. Unfortunately, her father only recently left the hospital, leaving him unqualified from a medical point of view. Insurance carriers need to provide a notification only for 30 days to their beneficiaries, but for many this 30-day notification is not enough.
The father will lose 8 of his doctors in the context of the supplier. By January 1, he will not be able to afford any of his current suppliers.
After learning about this phenomenon, I began to study Medicare Advantage cuts for 2014, my thought was that the UHC had a reason to give some doctors the shoes.
I was right. Due to changes in the public funding of Medicare Advantage plans, the company took measures to optimize the network of providers only for MA plans. These restrictions will not be affected by UHC Medicare insurance policy holders.
Doctor Fix is part of a $ 156 billion Medicare Advantage 10-year cost reduction plan. For those who have MA plans, you know that funding is already tight. While premiums will only increase slightly, there will be other cuts for AI plans. These include new plans related to payment provider. There is a new legislation (well, new for me and you), which will show the doctors, but will contain a new formula. This formula will be the method by which Medicare determines payment to individual providers. The doctor will be evaluated in several areas that are designed to assess the quality of the supplier. Currently, the doctor sets a flat patient monitoring rate and flat rates for the various services they provide.
With less funding from its Medicare Advantage plans, UHC was “forced” to reorganize its network of providers, which means that 14 million Medicare Advantage beneficiaries can get new providers. In the news article from USA today Susan Jaffe from Kaiser Health News writes that Medicare officials are currently considering UHC provider networks, which could lead to a different reconfiguration, hopefully for the better. Jaffe also calls for the “loss of a doctor not to create an exception” for a special registration period. The registration period is available only for external situations. For example, moving from your network or filing an insurance agent for bankruptcy are situations in which you could qualify for a special registration period outside of the open registration.
Unfortunately, for many Americans, Part C is the only additional insurance they can afford. There are also many Medicare beneficiaries who stick to their Advantage plans for health reasons. I wish I could say that I see that these plans are turning out in the future, but this does not look promising. We hope that everything will change for the better.
As for those people who can afford to move from your current Advantage plan, now may be the right time. Of course, you will have to wait until the annual registration period (from January 1 to February 14 for 2014).
Medicare Supplement plans are not currently affected by this legislation or the Law on Accessible Health Care. Medigap recipients will be able to continue to use current suppliers, and their coverage will not change.
