My husband had Kaiser forever and continued with Kaiser Medicare Advantage plan when he turned 65. It was a no brainer as we were both used to the system.
We moved out of state and for the first year, 2017, he selected a United Health Medicare Advantage HMO plan because our close friends had it and they said it worked well for them. He tried out for a year and it just did not work for him - saw his PCP only once and all subsequent visits were with a PA who was not very good. He had no issues with the specialist selection.
We researched and he moved to Aetna Medicare Select PPO in 2018. Prior to the switch we checked their system and all his specialists were in their PPO network. Everything worked well until... December 2018. All of a sudden there is not a single orthopedist in our geographical area. There is one 78 miles away and the rest in the next state over, 4 hours away. What!? We checked our other specialists and 2/3rd of them are no longer in their system. Like orthopedist, several other specialist areas had zero provider. In disbelief, he called to speak to an Aetna agent and they confirmed that there are no specialists in many areas of specialization. They said we could use out of network providers and pay 40% of the share of cost. Wait a minute, if he is with traditional Medicare, his share of cost is only 20%.
Thanks to @simpsontruckdriver whom I consulted with there is a special enrollment change period of Jan to Mar where my husband is allowed to make one plan change. The other PPO plan in our area is sold by Humana. We checked the doctor network and it was very good. Simpsontruckdriver is not licensed to sell where we are and this morning a change was made to switch to Humana Medicare PPO in February.
I am now 100% sold on going with a Medigap plan. Aetna literally pulled the rug from under my husband without any notice. While it is legal for them to make changes to their PPO network it certainly was not ethical with the extensive changes that were made. We had gotten 2 of our friends to enroll in the same Aetna Medicare Select PPO plan last year and we just gave them a heads up and that their doctors are no longer in the network. They will be making the same calls to Aetna about their doctor network to confirm our information and then a second call to Humana to make the change.
Buyer beware.
We moved out of state and for the first year, 2017, he selected a United Health Medicare Advantage HMO plan because our close friends had it and they said it worked well for them. He tried out for a year and it just did not work for him - saw his PCP only once and all subsequent visits were with a PA who was not very good. He had no issues with the specialist selection.
We researched and he moved to Aetna Medicare Select PPO in 2018. Prior to the switch we checked their system and all his specialists were in their PPO network. Everything worked well until... December 2018. All of a sudden there is not a single orthopedist in our geographical area. There is one 78 miles away and the rest in the next state over, 4 hours away. What!? We checked our other specialists and 2/3rd of them are no longer in their system. Like orthopedist, several other specialist areas had zero provider. In disbelief, he called to speak to an Aetna agent and they confirmed that there are no specialists in many areas of specialization. They said we could use out of network providers and pay 40% of the share of cost. Wait a minute, if he is with traditional Medicare, his share of cost is only 20%.
Thanks to @simpsontruckdriver whom I consulted with there is a special enrollment change period of Jan to Mar where my husband is allowed to make one plan change. The other PPO plan in our area is sold by Humana. We checked the doctor network and it was very good. Simpsontruckdriver is not licensed to sell where we are and this morning a change was made to switch to Humana Medicare PPO in February.
I am now 100% sold on going with a Medigap plan. Aetna literally pulled the rug from under my husband without any notice. While it is legal for them to make changes to their PPO network it certainly was not ethical with the extensive changes that were made. We had gotten 2 of our friends to enroll in the same Aetna Medicare Select PPO plan last year and we just gave them a heads up and that their doctors are no longer in the network. They will be making the same calls to Aetna about their doctor network to confirm our information and then a second call to Humana to make the change.
Buyer beware.
