Seniors receiving cancer treatment in Texas will need to find a new doctor after Blue Cross Blue Shield of Texas decides to end Medicare Advantage plans at MD Anderson Cancer Center There may be.
This means all doctors working at the Houston cancer center will no longer be part of the network for seniors who rely on Medicare Part C Advantage plans and managed Medicaid services.
The changes will take effect on Friday and will leave many people looking for new doctors and treatment options.
“Medicare Advantage plans are increasingly taking a hard line with prestigious medical centers to balance cost control and patient care,” Michael Ryan, financial expert and founder of michaelryanmoney.com, told Newsweek. spoke.
But the changes in Texas are not without consequences, he added.
“MD Anderson is more than just a hospital,” Ryan said. “This is one of the world’s leading cancer centers.”
Both seniors who rely on Medicare for health insurance and low-income Texans who receive Medicaid could be affected by this change.
Newsweek reached out to MD Anderson and Blue Cross Blue Shield for comment via email.
According to Houston Public Media, MD Anderson learned earlier this year that its doctors would no longer be part of the network.
MD Anderson will continue to accept Medicare and Medicaid, but only some insurance will be offered in-network.
This includes Medicare Part A, which covers many elements of hospitalization, and Medicare Part B, which covers doctor visits, tests, and preventive care.
MD Anderson previously said it would work with patients to find another health care provider during their treatment.
“While MD Anderson welcomes the opportunity to remain in-network with BCBS Medicare Advantage and Texas Managed Medicaid services, our goal is to ensure continuity of care for those currently receiving treatment. ” MD Anderson said in a statement.
“Our facility is in contact with affected patients and is working with Blue Cross Blue Shield to coordinate care for patients enrolled in BCBS Texas Medicare Advantage and Texas Managed Medicaid plans.”
This isn’t the first time Blue Cross Blue Shield of Texas has run into problems with its Medicare Advantage plans. Another provider in Texas, Baylor Scott & White, also came close to terminating its in-network contract with a major insurance company, but entered into a new one just before the Oct. 1 deadline. I was able to do that.
Alex Bean, a financial literacy lecturer at the University of Tennessee at Martin, said many health insurance companies have dropped coverage in the market due to rising costs and declining profits.
“In this situation, it’s hard to say whether that’s the case, because not much information has been provided other than that the agreement between the provider and MD Anderson is immediately terminated,” Bean told Newsweek. told.
“The good news for those receiving benefits from a health care provider is that they will be assisted in transitioning to another Medicare Advantage program that MD Anderson accepts for coverage. This raises greater questions about the solvency of Medicare Advantage programs offered through providers in this market, as well as others. ”
Chris Fong, a Medicare expert and CEO of Smile Insurance Group, believes that insurers can reduce the cost of services and save money by adding steps such as prior authorization and referrals. While trying to save money, medical centers also face inflation in medicines and doctors, he said. Salary.
“Unfortunately, some of the patients will be the most affected through contract negotiations,” Fung told Newsweek. “The advice we give our customers is to think about how they want to run their own medical care. If they want the flexibility to choose a doctor or health care provider with fewer restrictions, they should consider a supplement and prescription plan. You should consider traditional Medicare.”
Ryan said insurers are increasingly using “network shrinkage” as a cost control strategy.
“They’re betting they can offer lower premiums by cutting out expensive providers,” Ryan said, adding that they don’t always consider the human cost.
For affected seniors, Ryan said there are options, but timing is key.
“Medicare Supplement plans (Medigap) may offer more flexibility than Advantage plans, especially for specialty care. Yes, they may have higher monthly costs, but they provide access to any Medicare provider. It might be worth it to be able to do it,” Ryan said.
Stock image of a cancer patient and the Texas flag. Cancer patients at Houston’s MD Anderson Cancer Center may have to find new treatments after the hospital’s insurance changes. Stock image of a cancer patient and the Texas flag. Cancer patients at Houston’s MD Anderson Cancer Center may have to find new treatments after the hospital’s insurance changes. Lidofranz/Thorsten Asmus/Getty Images
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