There outta' be a law....Medicare plans
 

Just recently my PCP cancelled my appointments because it was decided that patients with my particular Medicare Advantage Plan are no longer being accepted, unless I pay "out of pocket" cost. (For personal and financial reasons I decided not to pay "out of pocket"). This information was not given to me until I called the office one week before my appointment.
I understand a doctor's decision to do this, however, I was not informed by my insurance people, Medicare, or my doctor's office. If I did not happen to call the office I would have shown up for an appointment that no longer existed.
I know I am not the only person this has happened to, so, my question is: "Why can't the doctor's office inform patients when the decision is made to drop those patients who have a particular insurance plan?"
I was told that the responsibility to do this falls on the insurance company. But the insurance company may have tens of thousands of people on their books, leaving the possibility of overlooking someone.
The way I see it, if a doctor can confirm every appointment by texting, why couldn't a simple "FYI" text be sent to patients when their appointments are cancelled because of an insurance decision? (There are some states that require a doctor's office to inform patients with a 60 day notice before any existing appointments are cancelled.)
I know there are a few MD's, as well as insurance folks, on this forum, and I thank them and anyone else who may reply.

Typically, it would be the insurance company who dropped the doctor from their plan. I can understand them not notifying you because they would have no way to know if you had an appointment with that doctor. I think the doctor should have notified you, but a 60 day notice seems unrealistic. They do confirm appointments, but that is usually a few days before the appointment.

What is your particular Medicare Advantage Plan?

But you're not on Medicare, you're under a Advantage plan.
I'm I correct on that?

An advantage plan is Medicare Part C. It replaces and covers most things that Part B (doctor visits and surgery) and Part D (drugs) cover. Part A is hospitalization.

three thoughts....

every insurance company handles things just a little bit different....which makes the work in the medical office more complex... the insurance companies haven't gotten together and agreed upon a standard process....take a guess at how many different insurance companies the office staff has to deal with (add to that the shortage of help)

But standardization within the business world is no surprise...heck, even the hot dog makers and the folks that bake the hot dog buns can't seem to get together and standardize the quantities in their respective packages...how difficult would that be right?

for a practical reason, medical school rarely includes an extensive amount of business courses (that's why many doctors have an office manager)

lastly, yes, a bummer that you were not informed of their decision to no longer accept the coverage you had....but, you still had an appointment on the calendar....the only thing that changed was the method of payment they would accept....you could have paid out of pocket, submitted the claim to your current insurance and switched to one that the doctor accepts

I thank you for your reply, but, as I stated previously, my doctor cancelled my appointments, meaning, I no longer had those appointments. WITHOUT any notification from anyone.
Also, as I previously stated, for personal and financial reasons, I decided NOT to pay out of pocket.

Yes

OP, very sorry this happened to you, and this is one (of many) reasons that we choose to stay with Medicare and supplemental plan. We were on advantage plan for a short period when Villages Health decided to stop grandfathering of supplemental plans. We had some problems and were able to get back to supplemental WITHOUT the underwriting requirement. We will never go back to an advantage plan.

How do Medicare Advantage Plans work? | Medicare

A Medicare Advantage is another way to get your Medicare Part A and Part B coverage. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are offered by Medicare-approved private companies that must follow rules set by Medicare. If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare.

Your appointment was not canceled you were given the opportunity to pay outside the insurance coverage

Not the responsibility of the physicians office.

Medicare advantage plans suck. Only decent if you are healthy. Healthcare is not free. you will be paying somewhere down the line even though they advertise No Premium. Go with traditional medicare. and with the right supplement you have no co-pays, no deductibles, no referrals and it is accepted anywhere in the US. Advantage plans are NOT accepted everywhere.

I have had advantage plans since I turned 65, 14 years ago and have had several surgeries, lots of different medications and appointments with specialists and have paid hardly anything but a small co-pay ($20-35), and no more than a couple hundred for any of the surgeries Advantage plans work very well from my experience.

I find myself in a similar situation. I had Tricare as my primary insurance, which was accepted by Villages Health. Now at 65, my primary becomes Medicare with tricare as a supplement and I am looking for a new doctor because Medicare is not accepted by Villages Health.
I knew this would happen and therefore can't complain, but I do wish I didn't have to change.