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TexasProgresive

(12,157 posts)
Wed Aug 5, 2020, 06:06 PM Aug 2020

One of the arguments used for insurance based health care, "You get to keep your own doctor."

WRONG!

Last year the Medicare Advantage plan offered through my former employer changed from one insurance company =thief to another. I checked and my wife and mine primary care physicians were both in network as were our ophthalmologist, cardiologist and orthopedist.

Here we are 8 months into the year and we've lost our PCPs, ophthalmologist and orthopedist. If we were to change to a plan that covers them we lose our cardiologists and my wife's cardiac surgeon.

This pisses me off and it is worse for my wife because she does not like change and she is so very comfortable with all of her doctors.

Yeah, you get to keep your doctor - HA!
32 replies = new reply since forum marked as read
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One of the arguments used for insurance based health care, "You get to keep your own doctor." (Original Post) TexasProgresive Aug 2020 OP
You are talking about Medicare Advantage not standard Medicare. El Supremo Aug 2020 #1
It's way cheaper than the suplement plan we had TexasProgresive Aug 2020 #3
Exactly! Andy823 Aug 2020 #20
Every single year (at LEAST) every single person on every single insurance plan mr_lebowski Aug 2020 #2
I know, just needed to vent. TexasProgresive Aug 2020 #4
You are obligated for the year, they are obligated to nothing. SharonAnn Aug 2020 #14
Every time I change employers I get a new insurance policy DBoon Aug 2020 #5
Medicare Advantage is a choice for those on Medicare. Demsrule86 Aug 2020 #6
Your point? TexasProgresive Aug 2020 #7
It is part of 'government insurance' . It is not private insurance. Demsrule86 Aug 2020 #17
Medicare Advantage is a sort of hybrid TexasProgresive Aug 2020 #21
It was Bush that came up with this so it needs improvement just like the Prescription Demsrule86 Aug 2020 #26
A Medicare Advantage plan IS private insurance. LiberalBrooke Aug 2020 #22
It is part of a government program for insurance...not a private sector plan. Demsrule86 Aug 2020 #25
It is private for profit insurance partially Voltaire2 Aug 2020 #28
No, with them you sign over your government benefits to a private company. LiberalBrooke Aug 2020 #31
That is exactly why I keep traditional Medicare. LiberalBrooke Aug 2020 #9
The one we had for the last 2 years was very inclusive. TexasProgresive Aug 2020 #13
also is it true that if you have Medicare Advantage you can't go back to regular Medicare? Demsrule86 Aug 2020 #16
Not true. You can choose a new plan every year LiberalBrooke Aug 2020 #18
Good to know thanks...didn't sound right. Demsrule86 Aug 2020 #19
Stupid promise, You can't keep your doctor, they are a person, they retire and die, too! Brainfodder Aug 2020 #8
As a child I was treated by the same GP who assisted at the births of my Dad, uncle and aunts. TexasProgresive Aug 2020 #10
With Medicare you get to keep your own doctor. IllinoisBirdWatcher Aug 2020 #11
Depends on whether you are on standard Medicare or Medicare Advantage. On Advantage, they can chang SharonAnn Aug 2020 #15
I get assigned to a different primary care Doctor every couple of years or so. Always have. Midnight Writer Aug 2020 #12
I have Advantage thru Humana. I can't complain. leftyladyfrommo Aug 2020 #23
I like my primary care physician. I've had the same one for over 15 years. MineralMan Aug 2020 #24
I checked as well. All our docs were on the list. then in July our PCPs and eye doctor were dumped. TexasProgresive Aug 2020 #29
"Keep your own doctor" has always been a red herring... Wounded Bear Aug 2020 #27
The "keep your own doctor" thing is ridiculous anyway as it would apply to Medicare For All. Vinca Aug 2020 #30
I see this all the time Horse with no Name Aug 2020 #32

El Supremo

(20,365 posts)
1. You are talking about Medicare Advantage not standard Medicare.
Wed Aug 5, 2020, 06:13 PM
Aug 2020

Medicare Advantage was created to take away the "socialization" of Medicare and put money into private insurers pockets.

You shouldn't have done it even if dentistry and vision are included.

TexasProgresive

(12,157 posts)
3. It's way cheaper than the suplement plan we had
Wed Aug 5, 2020, 06:28 PM
Aug 2020

with deductibles, copays etc. The Advantage plan we had for 2 years allowed us to keep all our doctors.

Andy823

(11,495 posts)
20. Exactly!
Wed Aug 5, 2020, 09:29 PM
Aug 2020

The lady that helped me when I started getting medicare took me through the whole process of making that choice. I had been getting flyers in the mail about Medicare Advantage and thought it sound really good. She explained that if I had to go to a specialist in say Seattle I would be leaving my area, and it would not pay for a lot of the things that might come up.

I took her advice and I have never had a problem with my Regular Medicare, or with my supplemental policy when it comes to paying for my care.

I can also go to say Seattle for care if I need it, and not have to worry about getting a bill for things they don't cover. I have had the same Dr. since 2015.

 

mr_lebowski

(33,643 posts)
2. Every single year (at LEAST) every single person on every single insurance plan
Wed Aug 5, 2020, 06:14 PM
Aug 2020

in the whole country ... whether it's employer-based or private via ACA exchange or Medicare advantage ... is at risk of 'losing their doctor'.

Aside from those paying for their doctors with cash out of pocket, there is a 0% certainty of 'keeping your doctor(s)' basically for anyone, anywhere in the USA.

I'm sorry that this has happened to you, I don't mean to sound like I'm downplaying the seriousness of it, but I'm addressing just how right you are about what a joke it is for anyone to claim private insurance provides any actual certainty of one 'keeping their doctor'. It doesn't.

TexasProgresive

(12,157 posts)
4. I know, just needed to vent.
Wed Aug 5, 2020, 06:29 PM
Aug 2020

We have relatives in Europe. They cannot understand why we are so stupid about this and a load of other stuff.

DBoon

(22,383 posts)
5. Every time I change employers I get a new insurance policy
Wed Aug 5, 2020, 06:46 PM
Aug 2020

and inevitably have to change physicians, because they don't take the new policy.

Sometimes physicians just decide they will no longer take certain types of insurance and leave their patients out to dry.

Demsrule86

(68,620 posts)
26. It was Bush that came up with this so it needs improvement just like the Prescription
Thu Aug 6, 2020, 10:53 AM
Aug 2020

program...GOP types can't do anything right.

LiberalBrooke

(527 posts)
22. A Medicare Advantage plan IS private insurance.
Thu Aug 6, 2020, 09:15 AM
Aug 2020

You essentially give your Medicare benefits to a private insurance company. That company is paid by Medicare to provide your care. The advantage plans are cheaper because the company can limit your care and they hope to make money by doing so. Advantage plans market heavily to get you on them with lower prices and a few benefits thrown in. Be very careful, they are not doing so out of the goodness of their hearts.

LiberalBrooke

(527 posts)
31. No, with them you sign over your government benefits to a private company.
Thu Aug 6, 2020, 01:47 PM
Aug 2020

You no longer are covered by government Medicare when you sign up for Medicare Advantage. The government actually pays the private company your benefits to cover you.

LiberalBrooke

(527 posts)
9. That is exactly why I keep traditional Medicare.
Wed Aug 5, 2020, 07:00 PM
Aug 2020

My choice of doctors is very broad. Each Medicare Advantage plan I am offered has a narrower base of providers. Plus, even that small network can and does change at the whim of the insurance company. There is a reason they are cheaper. If you can make it work financially, stay with traditional Medicare. The insurance companies offering advantage plans make money by providing less care

TexasProgresive

(12,157 posts)
13. The one we had for the last 2 years was very inclusive.
Wed Aug 5, 2020, 07:36 PM
Aug 2020

This one started out that way. In July we got word from some of our doctors that we were out.

Demsrule86

(68,620 posts)
16. also is it true that if you have Medicare Advantage you can't go back to regular Medicare?
Wed Aug 5, 2020, 07:55 PM
Aug 2020

I an not going to choose an Advantage plan...not old enough anyway.

LiberalBrooke

(527 posts)
18. Not true. You can choose a new plan every year
Wed Aug 5, 2020, 08:31 PM
Aug 2020

during their open enrollment period. You do have to stay with your choice for the year however

Brainfodder

(6,423 posts)
8. Stupid promise, You can't keep your doctor, they are a person, they retire and die, too!
Wed Aug 5, 2020, 06:56 PM
Aug 2020

DUH!

If that attached to one doctor, you might need to see another one?



TexasProgresive

(12,157 posts)
10. As a child I was treated by the same GP who assisted at the births of my Dad, uncle and aunts.
Wed Aug 5, 2020, 07:03 PM
Aug 2020

He was a great doctor who had a twice a week clinic in the poorer part of Houston. Both our doctors are in their early 40s and healthy. Sure they could die or move away. That is not the point- a company is deciding who our doctors can or cannot be. The relatives in Germany don't have this problem or the ones in Ireland.

IllinoisBirdWatcher

(2,315 posts)
11. With Medicare you get to keep your own doctor.
Wed Aug 5, 2020, 07:14 PM
Aug 2020

I've kept every one of my doctors when I went on Medicare eight years ago. And honestly, it has been the best insurance I've ever had.

I don't think we can get to Medicare for All in the near future. But there could (and should) be a public option for everyone.

Midnight Writer

(21,771 posts)
12. I get assigned to a different primary care Doctor every couple of years or so. Always have.
Wed Aug 5, 2020, 07:32 PM
Aug 2020

I have never had a Doctor long enough that he/she would recognize me on the street.

leftyladyfrommo

(18,869 posts)
23. I have Advantage thru Humana. I can't complain.
Thu Aug 6, 2020, 09:22 AM
Aug 2020

They covered all but $180 for my $26,000 hospital stay in December. $90 was for 2 specialists and $90 for ER.

I have a friend wIth Medigap and her's covers everything but it costs more per month.

MineralMan

(146,320 posts)
24. I like my primary care physician. I've had the same one for over 15 years.
Thu Aug 6, 2020, 09:34 AM
Aug 2020

When I chose a Medicare Advantage plan, I checked to make sure he was on their list.

That said, he works at a multi-specialty clinic operated by a particular health care provider that also has hospitals and diagnostic imaging centers. He works at that clinic.

He could be moved to a difference clinic in that group, far away from where I live. He could quit. He could die. If any of those things happen, I will have to choose another PCP.

I like my PCP, but if necessary, I will find another one. Anyone can lose their PCP for many different reasons.

During the Medicare open enrollment period, you can change your plan. I check every year to make sure my plan includes the healthcare group my PCP works for and that he is on the list of doctors I can choose. If your former employer won't pay for the Advantage plan you choose, you can pay for it yourself. They're not expensive.

TexasProgresive

(12,157 posts)
29. I checked as well. All our docs were on the list. then in July our PCPs and eye doctor were dumped.
Thu Aug 6, 2020, 12:43 PM
Aug 2020

& months OK and then BOOM!

Wounded Bear

(58,676 posts)
27. "Keep your own doctor" has always been a red herring...
Thu Aug 6, 2020, 11:06 AM
Aug 2020

Hell, even on most employer based plans you often get forced into "preferred provider" networks.

Then if your employer changes plans, which they often do when renewal time comes up, you're forced to go with the new plan.

Employer based healthcare doesn't have that much personal choice involved.

Vinca

(50,299 posts)
30. The "keep your own doctor" thing is ridiculous anyway as it would apply to Medicare For All.
Thu Aug 6, 2020, 01:17 PM
Aug 2020

If there were limited options for doctors and hospitals to get paid - Medicare or cash - they would all take Medicare and it wouldn't be a problem.

Horse with no Name

(33,956 posts)
32. I see this all the time
Thu Aug 6, 2020, 01:49 PM
Aug 2020

Oh we did your brain surgery?
Sorry. We can’t see you because we don’t accept your insurance.
It’s a horrible conversation.
Traditional Medicare is the golden ticket.
Best to stick with if you possibly can.

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