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The upcoming elections was the topic of conversation during a lunch last week. In other words, a happy, hopeful conversation. Lenny (name changed) joined the conversation. He appeared to be on a mission. He noted that even though I’m a (semi) retired agent, would I still answer a couple of questions? I, of course, offered to help. Afterall, how much time do we need to spend talking about the vile ad from Ramaswamy?
Lenny’s mother is freaking out. She received a letter from the Cleveland Clinic that stated that she needed to find a new insurance policy. Her doctors and the Cleveland Clinic facilities will no longer be covered providers by XYZ Major Insurance Company.
Before we go any further, I should disclose that Lenny is not a client and I didn’t even know that his elderly mother lived in Greater Cleveland. It is reasonable to assume that Lenny’s mom is on a Medicare Advantage plan. And if she is, this is not new and it is not a huge problem. In fact, this happens almost every year.
I will get back to Lenny and his mom in a moment. First, let’s talk about TV. I’m certain that sometime in the last year you noticed a message scrolling along the bottom of your TV screen. The message said that You are going to lose access to this channel and your favorite shows. Your cable provider isn’t going to renew your local station. Call your cable provider today. It is a negotiation ploy. The local stations want more money. The cable companies hate spending money. The stations try to scare you into calling and pressuring the cable company. The antagonists eventually compromise, you pay more (you were always going to pay more), and your access to local stations remains unchanged.
Medicare Advantage policies utilize networks of doctors and facilities. There is a constant push and pull between the medical providers and the insurers. It is important to remember that money is the primary focus of our health care system. This is just a payment system, an organized method of determining how medical providers are compensated. Every year or so the Cleveland Clinic has a fight with Anthem Blue Cross, or UnitedHealth Care, or Medical Mutual, or some other major insurer. The Clinic mails out scary letters to their Medicare Advantage customers, sorry, patients. The letters may even suggest who to contact to get new insurance. Do these fear tactics work? I don’t know. It depends on the goal. If the goal is to upset senior citizens, they are certainly succeeding. I can’t say that CCF gets better payouts because of these tactics, but I know that the contracts always get renewed.
What should Lenny’s mother do? My first question is whether she is really satisfied with her docs. If she is ambivalent, I suggest that she look for doctors and facilities that don’t treat her like a bargaining chip. If she really is happy at CCF, she can probably stay with her current plan. This will all be resolved soon. I suggest that Lenny and his mom should talk with their agent to make sure that the current insurer is still the best fit for her based on her current doctors and medications.
The most important thing is to stay in control and to not succumb to fear tactics.
Dave
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