Have you heard the NEWS? This hospital group is no longer taking that insurance company. Oh no, what do I do now? First things first, stop panicking. I know, I know, you saw on your local news broadcast that your insurance company (the company, not your plan) is no longer contracting with XYZ hospital and I am sure they made statements that were VERY emotional in nature designed to get you into a tizzy. I mean, I can't remember a news broadcast in recent history (if ever) that was calming, and happy, and made you feel safe and secure. They make blanket statements without any details that are designed to get you all worked up to get whatever flavor of the month response that they want from you. They want you to take some sort of emotional action which will create more stories for them to sell to the masses (just this girl's opinion).
Contract Disputes Happen All the Time
Lately we've gotten calls and emails about insurance companies no longer contracting with major hospitals and providers. Given that many of our clients receive lifesaving treatments within these hospital systems, this news has created fear, anxiety, and panic. Here's the thing— this isn't the first time we've heard these news reports here in Arizona. Insurance companies, hospital systems, and provider groups bicker over, er um, "negotiate" their contracts periodically and sometimes they don't agree. Like a married couple, sometimes they separate for a time to work out their issues before getting back together. Every once in a while, a split can last for a very long time or forever but when their members (individual members or businesses) start leaving and they start feeling the hit in their pocketbook, they have a tendency to work things out.
In most recent contract disputes we've seen, the split (hopefully temporary) doesn't impact Medicare Advantage Plans offered in the area nor does it impact most Medigap Supplement members. The only non-employer, non-retiree, Medicare group it typically affects is members with network-based Medigap plans like "Select" or "Senior Preferred" plans— very few people purchase those types of plans. It doesn't even impact ACA / Individual plan members most of the time. These changes mostly affect commercial group plans and corporate health services (self-insured) plans. Not the way the "news" made it sound, right?
What This Means for Your Medicare Coverage
Please remember, Medigap Supplements do not have networks and are not impacted by contract squabbles— unless you purchase a "Select" plan or a "Senior Preferred" plan. As a client of ours, I highly doubt you would have one of those plans. If you have a Medicare Advantage plan and mid-year they drop an entire hospital system and their providers, Medicare will typically provide a special election period which will allow you to change plans.
If in doubt, give us a call at 602-281-3898, send us an email, but don't panic until you get the facts. Facts are hard to find in the "news" these days. Let us give you peace of mind or help you work through the next steps should you be impacted by any of these types of changes. We are always here to keep your news fact-based and to make your Medicare journey 123Easy.
By American Retirement Advisors
American Retirement Advisors helps retirees and pre-retirees navigate Medicare, estate planning, and retirement income — so you can enjoy the retirement you've earned.
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Easy Eddie's Take
This is absolutely right about not panicking when you see these scary headlines. Let's take a look at this together. Most people are surprised when they learn that Original Medicare (Parts A and B) combined with a Medigap supplement gives you the most protection from these contract disputes. Since Medigap supplements work with any doctor or hospital that accepts Medicare, you're not tied to specific networks that can change.
A lot of people ask me, "What's the difference between Medicare Advantage and Medigap when it comes to provider networks?" Here's the key: Medicare Advantage plans do have networks, so if your plan drops a hospital system, you might need to switch during the next Annual Open Enrollment Period (October 15 to December 7) or during a Special Enrollment Period if Medicare grants one. With a Medigap supplement, you can see any Medicare-accepting provider without worrying about network changes.
If you're currently in a Medicare Advantage plan and worried about provider stability, the good news is you can switch to Original Medicare plus a Medigap supplement during Open Enrollment. Just remember that after your initial enrollment period, you might face medical underwriting for Medigap plans in most states. A little preparation today can make a big difference tomorrow.