Medicare "Pick-a-Plan" time again
It's a frustrating time of year for geezers - that's anyone of Medicare age.
It's the annual time to "Pick A Plan."
I have a pretty good plan. I like my Primary Care Physician (PCP), a fellow by the name of Eduardo Perez-Stable. He's a Family Practitioner which, as a geezer, I translate to be "general practitioner" or "GP." I've got a lot of respect for GPs and this one in particular.
(When I was in the Air Force, back when Orville and Wilber were testing the winds at Kitty Hawk, NC, a surgeon told me that if I ever went into medicine - I was a corpsman then - I should specialize because, he said, you work half as hard and make twice the money. The guy was a gas passer and cutter and only slightly crazy, but that's why most GPs became Family Practitioners or Internal Medicine specialists.)
Anyway, I had my PCP before I had my Medicare Advantage program. When I joined The Plan, he wasn't a provider and I was forced to find a new PCP. Shortly thereafter I discovered that he had signed on with my Advantage plan and I immediately went back to his office.
Now, when it comes time to renew with The Plan I make certain that Eduardo Perez-Stable still is on the PCP list; if he's not, I'll go elsewhere.
The first year I was with this plan I had a really good ophthalmologist.
But he got dropped.
However he had a partner who the plan deemed acceptable.
Effective January 1, the partner no longer will be a plan provider, so I have to find a new ophthalmologist. Since I have borderline diabetes and since I am developing cataracts, it's in my best interest to keep the same physician over the long term.
But apparently that is not a concern of the Medicare Advantage provider.
I also am dealing with a cutter and that is "double jeopardy."
The cutter (surgeon) was on the provider list, but he and his partner changed practice affiliations, basically from one hospital to another. My plan has him on its provider list through the end of the year - but after that? When I called the plan's Help line I was told the cutter was terminating his relationship with the plan. The cutter's office manager denies this.
With Medicare Advantage, anything costing more than $9.95 (I'm being facetious) requires pre-approval, "authorization." It took about 3 weeks to get a CAT scan authorized. Question is, was the delay due to the plan or was it due to the cutter's office manager dragging her heels. She told me last Friday she would start the pre-surgery authorization process that afternoon; now, Tuesday, it still hasn't gone to the insurance company, I'm beginning to suspect the problem is with the cutter's office staff.
Less-than-efficient medical office staffs seem a constant in south Florida.
Approvals or not, the surgery - which is not an option - will result in a long-term relationship with the cutter; not just a few weeks or months, but annual checks. I would hope he and the Medicare Advantage provider can put the patient first - that's me, by the way - and engage in their own long-term relationship.
Of course there are other cutters who can read my records. I've moved around the country and transferred medical records from one doctor to another, but now I'm "situated" and have no plans to relocate.
I've got a good PCP - he actually listens (which is why he's always running late) - and I will sign up for any plan that includes him.
But I don't like hunting up new specialists every year.
To be fair, I don't know if my second local ophthalmologist quit the plan or the plan quit him.
The plan I'm on is pretty good - I compare plans annually - but I really would like a continuing relationship with my specialists. Apparently that is not a luxury I will enjoy.
