Alliant Dermatology forced TO TERMINATE UHC The Villages and AARP Med.Advantage
 

For those of you on The Villages UHC Healthcare 1 and 2 and AARP Medicare Advantage plans, UHC is terminating their participation effective Sept 1,2018. What this means to you is that you can no longer see Dr Casper, Dr Bolton or any of the other drs in this practice with the exception of UHC The Villages Medicare plan 2 (the $81 per month plan). You will be out of network and will pay a $30 copay.
There is a petition in each of the offices to sign to try and stay in the system. If you are a patient of this practice, I encourage you to drop by any of their 3 locations and sign the petition!

OK, that explains it, we have AARP UHC supplemental plans, as we had previous problems the villages Supplemental plans not being accepted by some of our specialists. Good luck with the petitions.

Your statement is confusing to me. Are you then not affected by Alliant's action because you have a supplemental plan rather than an advantage plan?



My husband has an AARP supplemental, and we use Dr. Casper. Will our insurance still be accepted by Alliant?

Sorry to be confusing. If you have Medicare and AARP supplement, you are ok. It only effects the AARP Medicare Advantage plan.

It's only some advantage plans. The info is on Alliant's web page here:

Alliant Dermatology and Skin Cancer Center - We are a premier Dermatology office led by board certified Dermatologist, David J. Casper, MD

The details are in a letter here:

http://cloud2.snappages.com/245674c0...une%202018.pdf

Looks to me like The Villages Health, Advantage Plan is affected. It's not Dr. Caspar and his group BUT Medicare who is doing it. In the PDF it's explained and patients are told who they may make an appeal to.

Correct. As well as the AARP Medicare Advantage plan. If one has the UHC The Villages plan 2, they may still use Dr Casper but at the out of network cost of $30. Plan 1 does not have an out of network benefit

I'm not sure which one we have but we have a co-pay for specialists....so perhaps we're "good". Still going to check on this though.

Why would a Plan drop one practice and retain another? Does it have anything to do with the number and types of claims? This practice expanded aggressively over the last few years and as a patient of dermatologists for close to 30 years, I notice the number of surgeries has increased greatly. For close to 20 years, I had a single surgery and for the last 8-10 years, I had at least 2 or 3 MOHS surgeries every year.

Medicare, itself dropped these is how I read it and not the plan itself or the doctors (clinic). Insurance is about making money and not about the care of patients which is VERY unfortunate.

...

If you have the plan that you pay $81 a month for you will pay a copay of $30.

Grace, Even though asking patients to sign a petition probably won't do a thing, I see no harm in doing it, especially when their very lively hood is threatened. They work hard to build a patient base only to have it ripped away from them. Of course, that's what can happen when you agree to play with the devil.

…///

“Staying solvent,” you say. Of course, but, actually, staying highly profitable is what drives the game plan in any publicly traded stock.

Yesterday, June 8, United Healthcare stock (UNH) closed at $250.68, near its 52-week high of $251.50. The stock’s 52-week low was $176.42. (What does the percentage math on that say.)

Also, United Healthcare has raised its stockholder dividend with a 20% increase and has announced a new 100 million shares buyback program. Gee. Where did allllll that cash come from.

Before I am accused of being some kind of commie pinko who does not like the stock market, let me say that I like it fine. I am in it — though not with healthcare stocks.

Publicly traded healthcare stocks have the interests of the stockholders and CEOs way ahead of patients and their doctors.

I can own toothpaste. I can own tech. I can own utilities.

But I do not want to own a piece of another person’s life, potentially their actual life.

:BigApplause:...:BigApplause:...:BigApplause:


Buying back stock, to increase stock price and therefore bonuses...is what a lot (most?) of publicly traded companies are doing with their 'new found money.'

Yeah, sure, a few have given $1,000 one-time bonuses to employees to try and avoid criticism, but smart folks know the real goal of paying less taxes...is for upper management to increase their own compensation.

And denying as many medical claims as possible, is also how health insurance companies increase their profits...and stock price. :mad:

Wow we all have our own prejudice
 

The goal of any corporation is to make money for the stock holders. You mention toothpaste, tech and utilities. Same exact thing-THE GOAL IS TO MAKE MONEY FOR THE STOCK HOLDERS. You declare you do not own united healthcare for,"ethical," reasons. .I refuse to buy any of the tobacco stocks. I think if bother were to check, if you have a pension, owns a fund, an ETF, you might well find that YOU
OWN stock in many companies that you would not buy due to your morals.

RE: Medicare changes.
We will ALL be screaming. Our current debt is stated as 20 TRILLION DOLLARS. Of that 20 TRILLION DOLLARS, a sum that WE/I simply can't comprehend, SOCIAL SECURITY hold just over 40% of that and their is no payback period or stated interest. That BILL will be paid as government pays all it's bills-INFLATION, combined with SERVICE CUT BACKS.
To pay this bill you simply can't cut the small stuff and pay it. You need to cut the SACRED EXPENSES-the BIG ONES.
MILITARY,EDUCATION AND WELFARE-INCLUDING SOCIAL SECURITY. No one wants to see it and that includes me.

IN THE END, THROUGHOUT HISTORY, EVERYONE WANTS BUT WANTS SOMEONE ELSE TO PAY FOR IT.

While making money on stocks is always the goal, doing it while knowing that it's being done to the detriment to other citizens health or life, is well..... :ohdear:

And there's a very simple way to change it, which every other developed country on the planet, except us...have figured out. :oops:

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Not sure how that conclusion is reached. UHC dropped Alliant. Medicare didn’t.

It’s UHC—not Medicare—who is the bad guy. This is scary for those with UHC Advantage Insurance that they can arbitrarily drop a provider with seemingly no responsibility to their (UHC) customers.

I wish Casper had posted the letter from UHC.

Please correct me if I’m wrong.

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OK...TO save folks time and effort and a strain on PMs and the Moderator, I have deleted all my posts.

Does anyone find it curious with The Villages Health rapidly expanding their specialty practice that their privately negotiated " approved " UHC " insurance plan is no longer available to what might be a rival specialty practice ? I think I read everything correctly and stand to be told I did not. Might be our cardiologists are next to get the notice. I've always been reminded whenever I post on the subject of the Villages Health that it is a business and thus must act accordingly when it comes to producing a profit. I also know the easiest way to produce a profit is to establish a monopoly and that a geographic monopoly works perfectly well for that purpose.

The specialists in TV Health do NOT restrict insurance providers for patients over 65. They take essentially all insurances, most importantly Medicare. So, your "rival specialty practice" example is meaningless.

This is not the same for TV Health primary care physicians, as we all know.

I can state this from first-hand experience.

Thanks for that information, champion6. That is very good to know.

The vendetta rages on
 

Speaking of insurance coverage:

I hope everyone makes sure to read the very recent news about how the protection for pre-existing conditions is being actively targeted. They are cranking up the heat — “they” who hold the power and will never have to worry about their own healthcare.

Then there are us regular Americans, the majority of whom like the idea of pre-existing conditions protection —

— although I am constantly confused by those who continue to rail against the thing that has allowed them or their spouse or their adult child to be insured. I just don’t get it. I want to say, “Hellooooo, let me draw you a picture of where you actually are in this thing.” —

— But I never bother to say that. I just think about how Pogo was right.

A lot of news on how pre-existing conditions protections are still, and even more so, in peril came out yesterday.

If those protections get thrown out, here is what will follow:

Anyone who gets downsized and has a pre-existing condition could find themselves with no access to healthcare.

Also, anyone who can remain insured but has a pre-existing condition could be carved out for higher premiums.

Or people could be sold policies that are basically useless if they get really sick.

Sound familiar?

Even if you are among those feeling smugly swaddled in Medicare or employer plans, I hope you will take the time to read the recent articles on the current crank-up of the war on pre-existing conditions protections.

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I get your logic. I really hope you’re wrong.

It applies DIRECTLY to the thread and health care in general.

It is not aimed at anyone.

It is in the news each day and applies to ALL, or at least most of who post on this forum.

It is not a discussion of politics but a discussion of the happening that will affect ALL HEALTH CARE.

EVERYONE SHOULD KNOW what is happening relative to Health Care no matter the political party or leaning.

That and the floundering Social Security (we need to dip into the back up fund for the first time since the 1980's....the mortality prediction on not only Social Security but also Medicaire.

These are subjects that YOU may find political for whatever reason but the politicians have control and with our HUGE deficit those who live in The Villages, who have any conscience should be discussing these issues daily.

Perhaps you have the wealth to not worry at all, but most of us have children or grandchildren and our own health care costs to worry about

Uncle.

Why would you not want to be involved in a discussion of such a subject.....?

One that is extremely vital in our community.

May not clear the weeds or get you a better restaurant, but my guess is that in a retirement community, HEALTH CARE and HEALTH COST are talked about quite a bit and should be.

My final comment is that this could have all been fixed years ago if your elected officials had chosen to do so. Also, the the loss of the trust fund doesn't mean benefits will stop (there is always the general fund) but it will mean that your elected officials may actually need to address it but they will wait, as always, until it becomes a crisis. As I remember, none of these programs were meant to take our individual responsibility away, but were meant to supplement and cover those that needed it. We have, as a society, seem to have changed that to mean we should all be taken care of regardless of financial situation and taken care of the way we want to be taken care of, not how we should be taken care of. We get what we allow.

I think Uncle is probably a good choice you made, Gracie. It may be could be construed as political, but I really think it's more pertinent to our lifestyle then it is to our political leaning. We all have to be concerned about the future funding of our medicare and social security.



I used to be concerned that we were drawing off our children's earnings for that. I'm still concerned, but also worry about current reductions that might apply.


From your previous posts, I know you have some kind of supplementary health care that allows you not to have to take an advantage plan. We do too, but many in TV do not.



I have a friend who has several skin cancer issues that have always been taken care of by Dr. Casper. This is probably for four years. She has an advantage plan that will now force her to try to find another dermatologist.


I wonder why Alliance is doing this, and if they're planning to putt out of The Villages. I certainly hope not.

First, MY elected officials are the same as YOURS.

Second, I, with great respect, suggest you do some reading on this country's financials straites, how they just got worse and how we stack up with the rest of the world regarding healthcare who we simply demean but they have worked it out somehow by suggesting that their citizens were worthy no matter what it took

I do find it curious that when I come for treatment in The Villages, the likelihood of MOHS sutgeries is much greater than when I am in NY which is most of the time. I used to go to Dr TRAN until I changed insurance plans and had up to 7 biopsies each time, resulting in many MOHS surgeries. In that short time with Allient I had 3 MOHS and when I got back to NY I had no biopsies and no surgeries in my last two visits. The NY doctor is still in the Plan while Tran and Allient are not in the Plan. Could there be a correlation? Perhaps it is the medical practices doing all the damage and not insurance companies or politicians that it is suggested don’t care about grandkids. Until anyone knows why this practice was dropped, everything posted is pure speculation

The topic of this thread is the specific change in dermatology providers by United Health Care. If you wish to start a new thread about health care plans/policies in general, please do so. Further off topic posts will be deleted.

Thank you.

Moderator

Yes the quotes are accurate (and I thought well known), but irrelevant to the fact that The Villages Health plan has reduced the availability of dermatologists in the network that they accept. This should be concerning to those on that Advantage plan (which we used to be).

I know that. My post references the possibility other practices might no longer to be able to bill the Villages Health " plan. It would force the individuals that opted for their " Advantage Plan " to only use Villages Health for all their care including all specialty care if they want to " stay local ".

Is it your feeling that Dr. Tran does unnecessary MOHS surgeries?
I'm curious because I just had a MOHS surgery with Dr. Tran for squamous cell carcinoma.
I'm Canadian so it was a self pay.

I think your point is well taken. I don’t know whether the large number of non melanoma surgeries are “unnecessary” or if the docs are just very conservative. I wish I knew. No doubt some of it is necessary. Maybe not all.