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  • 30Oct

    United Healthcare is dropping 10 to 15% of its doctors nationwide. This cut will likely include Californian physicians as there are many United Healthcare HMO plans offered throughout the state, though the details are not yet released.

    While United Healthcare (UHC) has sent termination letters to affected doctors notifying them that their contracts will end February 1, 2014, UHC has not informed affected Medicare beneficiaries. In fact, they are not planning to inform them until after the doctor termination process runs its course, which will likely be after Dec 7, the end of the Annual Election Period. This is of great concern because if affected beneficiaries want to switch to another Medicare Advantage plan that their provider contracts with, they must do so during the AEP (Oct 15- Dec 7). If they don’t know about their doctor’s termination, however, they may well miss this window of opportunity to change plans.

    Assuming beneficiaries are notified after the AEP and they want to drop their UHC Medicare Advantage plan, they may still have an opportunity to do so using the Medicare Advantage Disenrollment Period (MADP) which is from January 1 – February 14. In using the MADP, beneficiaries can disenroll from their current MA plan and go back to Original Medicare. They cannot join another MA plan but they do have a coordinating Special Election Period to enroll in a stand-alone Part D plan for their prescription drug coverage.

    Affected beneficiaries also have a guaranteed issue right to buy a Medigap policy. They can choose from plans A, B, C, F (including F with a high deductible), K, L, M, or N from any company that sells one of these plans. (See our Medigap section for more info.) If they find out after February 14, however, they would have to stay in their UHC Medicare Advantage plan and change doctors, unless they have another Special Election Period (SEP). See our section on Medicare Parts C and D SEPs for info. Beneficiaries can also contact their local Health Insurance Counseling and Advocacy Program (HICAP) for free individual counseling and assistance at 1-800-434-0222.

    As there are UHC Medicare Advantage HMOs in many Califorina counties, if you hear about doctors being cut in your area, please let us know at comments@cahealthadvocates.org.

    Two articles on this topic include:

    Posted by Karen Fletcher @ 3:33 pm

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