NORTH NAPLES — United Healthcare is dropping hundreds of doctors from its Medicare Advantage plans in Southwest Florida, local physician medical societies say.
“I know I have well over 100 doctors who have already gotten their letters (of termination),” said Ann Wilke, executive director of the Lee County Medical Society.
Many of the doctors have appealed being dropped from the network for United Healthcare’s Medicare Advantage plan and they have been denied, she said.
In Collier County, the medical society is polling its members to get a count, executive director April Donahue said.
“Anecdotally, we cannot yet track 100,” she said. “Everybody has been appealing.”
The effective date is Jan. 1 for doctors affected to no longer be part of the network.
Medicare Advantage plans are operated by private insurers under contract with the federal government for elders 65 and older. Medicare Advantage plans must offer the same benefits as traditional Medicare and most offer some additional services.
In Collier and Lee counties, United Healthcare’s Medicare Advantage has a combined 14,000 patients, company spokeswoman Elizabeth Calzadilla-Fiallo said.
“Our focus is on offering broad access to physicians who in our view can provide quality, affordable care for more of the people enrolled in our plans,” she said in a statement. “We believe this will ultimately provide better outcomes for our members. We will continue to offer broad choices to care with more than 7,700 primary-care physicians and 11,500 specialists in Florida participating in our Medicare Advantage plan network in 2014.”
There are 77,000 Medicare beneficiaries in Collier and 106,000 in Lee County, according to federal data.
Wilke, of the Lee medical society, said how patients enrolled in United Healthcare’s Medicare Advantage plan will fare is a big concern, especially if they are no longer able to see some specialists they have been using for years.
In order to continue seeing those doctors, they have to switch to another Medicare Advantage plan or to traditional Medicare, she added.
“These are confused elderly people and they don’t know what to do,” she said. “It will resolve itself but it has put an awful lot of anxiety on patients and their physicians.”
Medicare open enrollment is now through Dec. 7 for plan changes effective Jan. 1.
Worse, she said, is that doctors aren’t being told why they are being dropped.
Donahue said she’s trying to put together a list of the doctors and she knows that hospital-employed physicians aren’t affected, while it seems like smaller group practices are being targeted.
“We are guessing it is cost-cutting,” she said. “We cannot discern anything else because some of the top-rated physicians have been removed, some specialists to our area have been removed.”
Patients are receiving letters about removed doctors, but the medical society is telling physician members to let patients know so they can decide what to do, Donahue said.
Florida isn’t the only state where United Healthcare is cutting doctors from its Medicare Advantage network. In Connecticut, more than 2,200 doctors were cut statewide. The insurer also has cut doctors in Rhode Island.
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United Healthcare Medicare Advantage members can call the customer service number on the back of their identification care for more information.