considering medicare advantage

Considering Medicare Advantage

If you are considering Medicare Advantage for your Medicare coverage, here are some things to think about: Most Medicare Advantage plans are HMOs (Health Maintenance Organizations) and have networks of doctors, hospitals, and other providers. [...]

Tucson Medicare Advantage Enrollment

Who were the winners and losers in Tucson Medicare Advantage enrollment from 2016 to 2017? Each year at this time, I look at Medicare Advantage enrollment data provided on the CMS website (Centers for Medicare and Medicaid Services). Below I [...]
unitedhealthcare

UnitedHealthcare and Northwest Healthcare

UnitedHealthcare and Northwest Healthcare are in contract negotiations – and it may not be going well. They have until May 1st to come to an agreement on  their contract and United is sending letters about this to everyone enrolled in [...]
unitedhealthcare logo

UnitedHealthcare Contract Dispute

Uh oh.  A UnitedHealthcare  contract dispute with Northwest Healthcare is going to cause problems for lots of people who live on the northwest side of Tucson. Northwest Healthcare owns Oro Valley Hospital, Northwest Medical Center, and Northwest [...]
medicare advantage disenrollment

Medicare Advantage Disenrollment

For people who are unhappy with their Medicare Advantage plan, there is still a way to get out of it. That is called the Medicare Advantage Disenrollment Period (MADP). The Medicare Advantage Disenrollment Period runs from January 1 – [...]

Observation Status with Medicare Advantage

Observation status with Medicare Advantage can cost you a lot of money. If you go to the hospital, you might start out in the Emergency Room and your co-pay would be $75 – even if they do lots of tests on you over several hours. That’s [...]

Medicare Advantage Networks

Some Medicare Advantage networks are large and some are small.  Some Medicare Advantage networks change often while others rarely lose doctors. About once each month, someone calls me to say they are moving from California to Arizona and they [...]

Medicare Advantage Enrollment in Tucson

Each year at this time I like to look at Medicare Advantage enrollment in Tucson and which plans added members and which ones lost from one year to the next. Tucson (Pima County) has lots of competition in the Medicare Advantage market.  Blue [...]

Aetna to Buy Humana

Have you heard that Medicare Advantage plans have no future?  If that is true, why are the biggest insurance companies buying other insurance companies that focus on Medicare Advantage? An article from the Hartford Courant  says: Aetna to [...]

Centene to Buy Health Net

Centene to Buy HealthNet….unless United steps in and offers more for Health Net. Last week, Centene announced  a $6.8 billion offer to buy Health Net.  The two companies combined would become one of the nation’s largest Medicaid-focused [...]

Medicare Advantage Mergers

The Wall Street Journal has an article on merger mania among big insurance companies, some of which are big players in the Medicare Advantage market. One-third of all Medicare beneficiaries (16 million) are enrolled in a Medicare Advantage plan, [...]

Medicare Advantage Home Visits

I got a call from a client who is very annoyed by phone calls from her Medicare Advantage plan asking her to agree to  a home visit from a company nurse.   Asta asked me if she had to comply with her Medicare Advantage plan’s request [...]

Your Primary Care Physician

I have had several calls recently from people who were moving to Arizona and needed to enroll in a local Medicare Advantage plan. Picking a new plan is not difficult in Arizona – but finding a primary care physician is another matter. Most [...]

Medicare Advantage Networks

Starting in 2016  Medicare Advantage plans will be required to keep up-to-date online directories, or face large fines. The online directories allow the public (and insurance agents) to see which doctors are in a plan’s network and which [...]

Medicare Advantage in Tucson

Who were the Medicare Advantage winners and losers in Tucson, AZ after the Medicare Open Enrollment Period (OEP)?   The 2014 OEP was chaotic for over 10,000 people in Pima County who changed their Advantage plan. Many of them had been notified [...]

Who is enrolling in Medicare Advantage?

An article in Kaiser Health News says: The majority of people who signed up for Medicare Advantage plans in recent years were switching out of the traditional Medicare program, according to a recent study. The findings contradict the popular [...]

New Advantage Plan New Referrals

I got a call Friday evening from a very upset client who said her doctor’s office told her they were having problems with her new Medicare Advantage plan.  The doctor’s staff said they could not get through to the plan to verify [...]

You still have time to do something if your plan has been cancelled.

People affected by a Medicare Advantage plan cancellation who did not take action during the Open Enrollment Period can get a “special election period” (SEP) to make a move. This SEP runs from December 8th to the last day of February, [...]

Medicare Advantage Network Chaos

As a broker, I think there is Medicare Advantage network chaos in Tucson.  My head is spinning trying to remember which doctors are no longer with which plans.  But my clients don’t seem very concerned about their Medicare Advantage [...]
Insulin prices

Insulin Costs in Medicare Advantage

The cost of insulin varies widely from one Medicare Advantage plan to another.  I checked out all the Medicare Advantage plans in Pima County and how they cover insulin and pills for glucose control…. and I was shocked at what I found! One [...]

Tucson Medicare Advantage Cancellations

This will be a hectic Open Enrollment Period (OEP) because there will be several Tucson Medicare Advantage cancellations. Health Net and SCAN are cancelling their Medicare Advantage special needs plans that focus on people with diabetes and [...]

Tucson Medicare Advantage Changes

Big changes are coming to Tucson Medicare Advantage plans in 2015.  People enrolled in Tucson Medicare Advantage plans will be getting the news very soon.   Agents are not supposed to talk about 2015 “benefits” until October [...]

Medicare Advantage in Tucson

46 percent of Medicare beneficiaries are enrolled in Medicare Advantage in Tucson, AZ.  Tucson has a competitive market with 7 companies offering a total of 17 Advantage plans in 2014. But things are going to change in 2015.  Some plans will [...]

Medicare Advantage Network Law Proposed

Medicare Advantage enrollees in Florida and Connecticut have been faced with losing their doctors or local hospital when their Advantage plan cut its network.   Congresswoman Rosa DeLauro of Connecticut is proposing a Medicare Advantage Participant [...]

Hospitals Dropped from Medicare Advantage Networks

Health News Florida has an interesting story about a dispute between Humana’s Medicare Advantage plans and a Miami Hospital and doctor network.  Medicare Advantage plans must control their costs, and when a doctor group or hospital requires [...]

Medicare Advantage Star Ratings: Who cares?

Seniors do not care about the Medicare Advantage and Part D star ratings.  This is the finding of  focus group research carried out by the Kaiser Family Foundation last fall. AIS Health has a good article on the report and a briefing that [...]