Middlesex Hospital Not AcceptingAARP Medicare Advantage Plans
If you are of a certain age, a member of AARP, and researching possibilities for Medicare enrollment, you may have received AARP literature on some the many AARP insurance and health care plans. If so, proceed with caution.
AARP Medicare Advantage coverage, available through UnitedHealthCare, is not viable at Middlesex Hospital. At present, Middlesex Hospital doesn’t have a contract to service people who enroll in AARP Medicare Advantage (MA) plans. That means if you are enrolled in an AARP Medicare Advantage plan and happen to land at Middlesex Hospital, you will be treated, but you will need to foot a larger portion of the hospital bill, as reimbursement from the AARP MA plan will be minimal.
Medicare Advantage plans, also known as Medicare Part C, offer comprehensive or "complete care" and focus on preventive care and seem to be offered at lower cost (see * below).
While Middlesex Hospital accepts coverage from all Medicare Supplement plans (a different type of coverage--MediGap), including AARP Medicare Supplement plans, Middlesex accepts only the following Medicare Advantage plans:
ConnectiCare Medicare Advantage plans (www.connecticare.com/medicare)
Blue Cross Medicare Advantage plans (www.anthem.com/medicare)
Medicare is a complex program and bears looking into carefully. Medicare.gov and provider websites noted above are a good place to start.
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*Medicare Advantage (Medicare Part C) plans offer comprehensive coverage that focuses on preventive care. They seem to be offered at lower cost than other coverage and some Medicare Advantage plans offer important coverage at low or no additional or "co-payment" cost: Preventive care, routine annual health exam, routine testing, laboratory procedures, and some annual inoculations, like flu shots, along with other options, such as routine dental and eye-care coverage, gym or health club membership, and the like. Be sure to check Medicare.gov and insurance plan websites for further information. Note that this author is not a health care or Medicare authority, and you need to research any Medicare matters carefully for yourself.
This is another example of how broken our health care financing system is. How are people supposed to know such things? Who could have imagined that our local hospital would not accept coverage from an insurer affiliated with AARP? There must be an insurance regulatory agency whose job is it to make sure situations like this don't exist. A single-payer system or at least a public option would avoid such confusion that for-profit companies seem to generate. I wish someone from Mx Hospital would comment on this matter. Thank you, Caritas, for the post.
ReplyDeleteJohn, while I agree with the general thrust of your comment about the system being broken, I think you are being a bit hypercritical of Mx Hospital.
ReplyDeleteFirst, why do you wish they would comment, but don't seem to put a similar responsibility on AARP as the other party to the situation?
Second, I am fairly certain that the insurance company involved is not in fact affiliated with AARP, but is merely endorsed by them. Huge difference.
And finally, do you really put so much stock in the AARP Seal of Approval?
I don't assume that this is Mx Hospital's fault. Maybe United Health Care does not reimburse sufficiently, or is too difficult to work with. And I don't place a lot of stock in the AARP, but many people do. What is your stake in this issue, Martel? If you know something, please share it?
ReplyDeleteMy point is that this confusion and complication is a symptom of a messed up system that puts an additional burden on people who need medical services. Isn't being sick enough, without having to discover that your local hospital doesn't accept a "name brand" insurance? Again, where are the regulators? Are there any?
I don't have any stake in this matter or any secret knowledge.
ReplyDeleteI do agree with you that the system we now have is incrediby confusing and anxiety-provoking.
As for the regulators, there are 50 of them, one for each state.
I am equally sure that AARP's relationship with United Health Care (and with the Hartford for property and casualty) is much more than just an endorsement. They have their logo all over both insurers' products, and only AARP members are eligible for those particular insurance plans. There must be a financial relationship -- can anyone clarify for the rest of us?
ReplyDeleteFrom AARP's website:
ReplyDeletehttps://www.aarphealthcare.com/myaccount-access
"AARP Health is a collection of health-related products, services and insurance programs made available by AARP. Neither AARP nor its affiliate is the insurer.
AARP contracts with insurers to make coverage available to AARP members. Insurers and providers pay a royalty fee to AARP for use of the AARP intellectual property. Amounts paid are used for the general purposes of AARP and its members.
AARP and its affiliate are not insurance agencies or carriers and do not employ or endorse individual agents, brokers, representatives or advisors.
AARP does not make health plan recommendations for individuals. Insurance products carrying the AARP name are intended to be competitive products and may not be the lowest priced products. You are strongly encouraged to evaluate your needs and compare products."
In other words, AARP makes money for renting out its name to insurance companies.
Information on the ins-and-outs of health care and health insurance coverage need to be readily accessible. Nowhere in AARP literature (or other Medicare Advantage literature) did I find mention of hospital provision.
ReplyDeleteThough I also am in favor of single payer or public option arrangement), in our free-enterprise, for-profit system, companies like AARP and Middlesex Hospital, United Health Care are free to make their own deals. But someone should be obliged (perhaps by law), as a public service, to make sure critical details such as hospital provisions, are available upfront.
Perhaps omission of this information in AARP/UHC literature was an oversight. Would anyone believe that?
This is very upsetting- this Hospital should loose a star or ranking as first because it denies elderly people care via not accepting all forms of medicare and aarp- sad & sickening
ReplyDeleteAnon 12:24, a few thoughts:
ReplyDeleteMx Hospital does accept all forms of Medicare.
AARP-endorsed insurance is not Medicare. It is private insurance. AARP is not the insurance company, they simply rent out their name to the insurance company for a hefty fee (kind of like what Donald Trump does these days).
Maybe AARP should lose a star or ranking for renting out its name to an insurance company that does not have a contract in place with Mx Hospital.
Mr. Hall is correct, however - the system is broken.
Maybe there is another side to the coin here. Maybe UHC is not offering a competitive deal. There are many things that could factor in. Before attacking the hospital "Anon 12:24" maybe it would be worth doing some research if this is an issue of importance to you.
ReplyDeleteJohn, I agree with your thoughts and think it would prove interesting to read a comment from MH. On the other hand, maybe a community group can do some education on this point. I know that as a grown woman and a parent, I have to check out all the providers I use before I elect the coverage I am going to go with. I don't see why every adult shouldn't expect to do the same.
Becky Carroll
Carrol maybe as such a smart grown woman you can be an advocate for my 80 something parents as many elderly do not know how to use the Internet like you or are able to do the research to make detailed reports about coverage. You take for granted that you can make the decision on coverage but many cannot.then again this us Connecticut an an employer can deny you a job based on bad credit - which you wod have if you were unemployed long enough and forced to live on credit, so I am not shocked by your interpretation of this limitation on AARP. Maybe you can be there when my parents need to be re examined to switch health insurers since it's so easy in your eyes.
ReplyDelete