Wednesday, October 2, 2013

United Healthcare Medicare Advantage drops several providers in SW Florida

LEE COUNTY, Fla.- WINK News has learned United Healthcare's Medicare Advantage plan has dropped several major Southwest Florida doctor groups for 2014.
Some of them include Orthopedic Specialists of Southwest Florida, Ear, Nose and Throat Specialists of Florida, Florida Heart Associates and Associates in Dermatology.
United Healthcare released a statement that says, "With the many changes happening in health care, we are building a network of health care providers we can work with more closely to have the most positive impact on the health of our members. Current plan members are being informed in writing about changes before they need to make decisions about their 2014 coverage."
At Orthopedic Spedicalists, director of business services Tiffany Drake says they found out about the change on July 31 in a letter from United, and began sending letters to the 1500 patients impacted in September. "Currently their co-pay is $30 which is going to $50 in January, it would be $70 for out of network."

She adds, "patients who continue to have United Medicare (Advantage) may change providers so we would lose some patients, we're hoping not too many, but that is one of the possibilities that may happen. Many of them are elderly, many of them are chronically ill and have multiple physicians that are affected by this decision so now they're in the middle of treatment for something and having to find a different doctor or change plans or pay more."
Drake says, "we have submitted an appeal to United Healthcare. This is something we weren't anticipating and wish we had some control over but we really don't."
Dr. Phillip Andrews at Ear, Nose and Throat Specialists of Florida says, "I was blown away, we've been taking care of those people forever." He says the patient-doctor relationship is very important, and he's worried about what will happen to his patients when his office is dropped. "I don't have any idea who's going to take care of them if we can't, it's a total mystery."
He wonders whether pressure from the federal government is forceing United to make the changes. "It's all about the dollar. It's not about taking care of people."
Both his practice and Orthopedic Specialists have not heard back about their appeals to United. Several patients have also filed grievences with the healthcare company.
Open enrollment for Medicare Advantage begins October 15. Healthcare providers are encouraging all patients to review their plans and what coverage is important to them.

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