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Creighton doctors say no to private Medicare plans
(Omaha World-Herald (NE) (KRT) Via Thomson Dialog NewsEdge) Oct. 14--Patients who see Creighton doctors and who have made the switch to Medicare Advantage plans may need to start shopping, either for a new plan or a new doctor.
Creighton Medical Associates sent out letters to 22,000 Medicare-eligible patients notifying them that -- as of Dec. 1 -- its doctors will accept only traditional Medicare and MediGap policies.
That means the group, the academic faculty practice for Creighton University, won't take private fee-for-service Medicare plans, private fee-for-service plans or a variety of Medicare Advantage plans that people in Nebraska and Iowa have purchased from private companies in the past year.
Robert Glow, Creighton Medical Associates' chief executive officer, said the group has never signed up to accept any of the plans. The letters -- dated Oct. 6 -- were intended to clarify the group's long-standing practice of not accepting them.
Doctors have been advising patients about the practice, he said. But confusion remained, so the group's board of directors asked his office to formally notify patients. The group also notified companies that provide the plans that it won't accept them.
"We felt we needed to come out and be very specific about our position," Glow said.
Alegent Health made a similar announcement in March after some patients sought treatment with the understanding -- perhaps based on incorrect assurances from plans or confusing information on the Medicare Web site -- that coverage extended to its doctors.
This year, several companies provided new Medicare Advantage plans -- a private alternative to government-backed Medicare that includes private fee-for-service (PFFS), health maintenance organization (HMO) and paid provider organization (PPO) plans.
The plans were offered as one option for seniors who wanted a health plan combined with the drug benefits of the new Medicare prescription drug program. As of February, about 11,000 Nebraskans and nearly 15,000 Iowans had signed up for such plans, according to Medicare tallies.
Glow said he did not know how many Creighton patients had signed up for the plans.
But the doctors group has a process in place to help those patients work through the issue, he said. Providers will not turn patients away, particularly in emergencies, if they arrive needing medical care.
"We're not abandoning the patient," he said.
Nontheless, the group has gotten calls from patients trying to sort out what the letters mean as well as from those who are dissatisfied with their doctors' position.
But the group's doctors, Glow said, believe that their patients will get the best care under traditional Medicare.
"We will work with the patients," he said. "We certainly want to take care of them; they're important to us."
An Omaha-based senior advocacy group also has gotten "literally hundreds" of calls about the letters, said Aimee McKim, executive director for Volunteers Assisting Seniors.
Other Senior Health Insurance Information Program-affiliated offices in Lincoln and Norfolk, Neb., also have received calls, she said.
Most of the calls are from people who don't understand the letter, she said. But the majority of the callers have traditional Medicare and a Medicare supplement and won't be affected by Creighton's policy.
The good news, she said, is that people who signed up for the plans within the last year can change back to traditional Medicare and a Medicare Part D prescription drug plan at any time during the first year, and get their supplements back. The change would take effect at the first of the next month.
Among the PFFS plans Creighton will not accept are Cigna Healthcare for Seniors, Humana Gold Choice, Medicare Masterpiece Plan, Quality Health Plans Inc., Secure HorizonsSecurity Choice Classic, Sterling Option 1, UMWA (United Minor Workers), Unicare and United HealthCare Medicare Complete Essential. The private Medicare PPO, POS and HMO plans include Medicare Blue PPO (all products), United HealthCare Medicare Complete Choice POS and United HealthCare Medicare Complete HMO.
Federal Medicare officials were expected to announce the Medicare Advantage plans that will be available this year yet this month.
Copyright (c) 2006, Omaha World-Herald, Neb.
Distributed by McClatchy-Tribune Business News.
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