Some villagers have received letters that their doctors no longer are part of the AARP Medicare Complete plan offered by United Healthcare and suggesting that they transfer to doctors in the new Villages Health System.
The letters came at the beginning of the Medicare open enrollment period, which runs from Oct. 15 through Dec. 7.
One patient posted on the Talk of the Villages web site that he was told his doctor at the Institute of Cardiovascular Excellence of Ocala will no longer be accepted by the plan
“I don’t know about the rest of you, but I don’t like an insurance company and The Villages telling me who my doctor is or will be,” the man said. He asked that his name not be used.
A spokeswoman for the Institute of Cardiovascular Excellence confirmed that the company has been dropped by the Medicare Complete program.
But the United Healthcare’s dropping of physicians is not limited to The Villages. The company has fired thousands of doctors in Florida, Connecticut and possibly other states. Among the providers dropped are the H. Lee Moffitt Cancer Center of Tampa as well as orthopedic, heart and ear-nose-throat specialists in southwest Florida.
Mike Mansour, United Healthcare’s liaison with the Villages Health System, did not respond to a message left Thursday at his office. But a United Healthcare spokesman told a television reporter that the company is building a network of providers that will provide the most quality and collaboration for patients. He also said the company will help members find new doctors.
Insurance companies often drop doctors for a variety of causes including quality or billing issues. Doctors also drop insurance companies, especially if they are dissatisfied with the amount of payment for services.
Joe Flynn, an independent insurance specialist, said people who have health maintenance organization (HMO) coverage like Medicare Complete must find new doctors. Those with United Healthcare’s preferred provider coverage (PPO) can continue to use their doctors if they pay higher out-of-network costs. He also said doctors dropped by United Healthcare have appeal rights.
Flynn said suggesting that patients leave their existing doctors for the Villages Health System hurts those doctors who have established practices here.
“They were enticed to set up practices in The Villages by the developer and now the developer, through ownership of the (health system), is competing against them,” he said, adding that the doctors signed non-compete clauses and now can’t get into the Villages Health System. “This seems to be an awful lot of smoke and you can’t an answer.”
He said it’s also difficult to discover the actual ownership of the Villages Health System, but some people are working to track it down.
