General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsOne 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!
El Supremo
(20,365 posts)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)with deductibles, copays etc. The Advantage plan we had for 2 years allowed us to keep all our doctors.
Andy823
(11,495 posts)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)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)We have relatives in Europe. They cannot understand why we are so stupid about this and a load of other stuff.
SharonAnn
(13,777 posts)DBoon
(22,383 posts)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)TexasProgresive
(12,157 posts)Demsrule86
(68,620 posts)Nothing is perfect.
TexasProgresive
(12,157 posts)Medicare and private insurance
Demsrule86
(68,620 posts)program...GOP types can't do anything right.
LiberalBrooke
(527 posts)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.
Demsrule86
(68,620 posts)Voltaire2
(13,095 posts)funded by Medicare.
LiberalBrooke
(527 posts)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)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)This one started out that way. In July we got word from some of our doctors that we were out.
Demsrule86
(68,620 posts)I an not going to choose an Advantage plan...not old enough anyway.
LiberalBrooke
(527 posts)during their open enrollment period. You do have to stay with your choice for the year however
Demsrule86
(68,620 posts)Brainfodder
(6,423 posts)DUH!
If that attached to one doctor, you might need to see another one?
TexasProgresive
(12,157 posts)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)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.
SharonAnn
(13,777 posts)Midnight Writer
(21,771 posts)I have never had a Doctor long enough that he/she would recognize me on the street.
leftyladyfrommo
(18,869 posts)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)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)& months OK and then BOOM!
Wounded Bear
(58,676 posts)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)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)Oh we did your brain surgery?
Sorry. We cant see you because we dont accept your insurance.
Its a horrible conversation.
Traditional Medicare is the golden ticket.
Best to stick with if you possibly can.