MA Regional Ppo
- Thread starter agentjhc
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Guess it depends on the company in your area. In my area we only have 3 PPO's. Fl blue, Humana and UHC. I tell people if they are looking for a plan with a lot of doctors and you're not doing a med supp, You'll probably want one of these. I would never word it as, all doctors usually accept the plan. You're just setting yourself up to get a lot of pissed off clients in the future.
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- #3
The 2 I will deal with are UHC-CIP and Humana In N GA. Guess we can call docs during the meeting and confirm they take it? Of course the doc can stop with little notice, correct?
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I usually just check each website. AARPmedicareplans.com and Humana.com. They are the most up to date. Yes they can leave the network at any time
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- #5
I meant out of network docs, hospitals. Medicare.Gov lists "doctor choice" as "any docs" which seems a little misleading as non network docs can choose not to take it--at least as I understand it.
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That is true. In my experience using the "out of network" option with the PPOs is more of a theory, than a reality.
Also misconception that frustrates seniors, Is they think since they can see doctors out side the network they would be about t see doctors in other states, These seniors are usually very upset when they find out they need to be in the Service are,
There are a couple companies like AARP or Aetna that have out of state cov but it is based on their rules and only on certain plans
There are a couple companies like AARP or Aetna that have out of state cov but it is based on their rules and only on certain plans
You're setting yourself up for a bad situation here. I would never tell my client to use out of network services. I would tell them to find a plan that accepts them in network or to choose a med supp. I let my PPO clients know they do have out of network options but try to avoid it at all cost.
Too many times do I have clients tell me their agent said they can go anywhere with their PPO. Not true.
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- #9
I don't plan on telling them to use OoN docs. I just clarifying my understanding of plans. In one county only 2 choices RPPO. Would prefer they go Med Supp route. One client and his wife only make $24k.
Stolen from the Clover topic:
Medicare doctors must accept Medicare PPOs, but a bit more context may help clarify. According to the Center for Medicare & Medicaid Services, if you’re a member enlisted in a Medicare PPO, Medicare doctors are obligated to offer you services unless the doctor is not accepting new patients and you are a new patient. So, the speaker was right in saying Medicare doctors must accept PPOs—so long as the plan is a Medicare PPO, like all Clover plans are, and the doctor is still accepting new patients, or you were an existing Medicare patient.
Medicare doctors must accept Medicare PPOs, but a bit more context may help clarify. According to the Center for Medicare & Medicaid Services, if you’re a member enlisted in a Medicare PPO, Medicare doctors are obligated to offer you services unless the doctor is not accepting new patients and you are a new patient. So, the speaker was right in saying Medicare doctors must accept PPOs—so long as the plan is a Medicare PPO, like all Clover plans are, and the doctor is still accepting new patients, or you were an existing Medicare patient.
