AvMed, which promotes long-term patient-physician relationships in its PR, seems to make a habit of making such relationships impossible.
I’ve been an AvMed Advantage plan “member” since 2010.
Before signing on with AvMed I had an agreeable Primary Care Provider, a/k/a “PCP.” He’s an internal medicine specialist (“Specialize; you’ll do half the work and get twice the money” a cutter from my Air Force days told me) – in truth, he’s a General Practitioner (GP) and, I think, a darn good one.
BUT, in 2010 he wasn’t on AvMed’s physician’s list. I found a new, AvMed-listed PCP and went for a visit. I immediately disliked the new PCP, but I was “stuck.”
The I discovered that at the beginning of 2011, my old PCP was now on AvMed’s list so I quickly returned to his office. The medical staff is good; the office staff is not. But never mind.
The other day I receive notice that effective 1 January 2014, AvMed delisted my PCP.
This is not the first time AvMed has played the delisting/listing game.
I have high sugar and developing cataracts. A PCP of several years back told me to see an ophthalmologist to check for signs of diabetes. The result was negative – no signs of the disease. Since, I have had annual or twice-a-year visits with an ophthalmologist.
I had a good one listed by AvMed. Then he wasn’t. But a partner was, so I stayed with the same practice, but with a different doctor. Same office. Same techs and office staff. Different doctor.
Then AvMed delisted the second doctor. I was forced to find a new ophthalmologist and have my records forwarded – at my expense – to the new doctor. The new ophthalmologist is “OK,” but when the old practice advised me that AvMed had relisted my original ophthalmologist – and his partner – I planned to return to that practice come January 1, 2014.
AvMed has provided decent coverage and I have has two hospital stays under its Medicare Advantage plan. All-in-all, I was pleased with AvMed. (I’d had AvMed’s regular policy many years ago as an employee benefit; based on that I selected AvMed as my Medicare Advantage provider years later.)
The delisting of my PCP has a ripple effect on my health care.
I need to find a plan that lists both my PCP and the specialists and hospital I have used since 2011.
This turns out to be borderline impossible.
Last year, when my ophthalmologist was delisted, I tried to find out why. No success.
When I went looking for a replacement ophthalmologist, several told me that AvMed would have its physician’s list cast into concrete only in the following calendar year.
I’m not sure the other plan providers are any better.
One I just checked failed to list the hospital where I have a history, yet listed physicians who have privileges there.
In the end, I may start looking at Medicare Supplement plans that let me have access to any physician or facility that accepts Medicare. Unlike Advantage programs, however, the Supplement programs come at a cost over and above the Medicare Plan B premium.
Of course there always is “Original Medicare” with a Plan D (Rx) extra cost supplement. At least with “Original Medicare,” the patient doesn’t have to play “Find a new plan or provider” every couple of years.
I’m sure AvMed management (thinks it) has a reason for dropping my PCP, but it doesn’t win the plan any friends and it doesn’t promote long-term patient-provider relationships, and that (patient-provider relationships), in the end, is the true “bottom line.”
