[Villages Kahuna]

Lots of people across the country have received notices that their health insurance coverage has either been cancelled or will no longer be accepted by their doctors. I know a couple here in The Villages who received that notice from their doctors with regard to their policies offered by Preferred Care.

Frankly, I don't know whether "Preferred Care" is a company or a type of policy. It's clear that the policy coverage is being discontinued because it is in violation of requirements of the Affordable Care Act. But does anyone know or can explain how those policies are in violation or what terms in those policies are now unacceptable? Have those whose policies been cancelled been told why?

Can anyone fill the rest of us in on what's happening? Please don't answer with a rant against the ACA. Just try to be specific on what content of the Preferred Care policies are in violation of ACA.

[Indydealmaker]

Originally Posted by Villages Kahuna

Lots of people across the country have received notices that their health insurance coverage has either been cancelled or will no longer be accepted by their doctors. I know a couple here in The Villages who received that notice from their doctors with regard to their policies offered by Preferred Care.

Frankly, I don't know whether "Preferred Care" is a company or a type of policy. It's clear that the policy coverage is being discontinued because it is in violation of requirements of the Affordable Care Act. But does anyone know or can explain how those policies are in violation or what terms in those policies are now unacceptable? Have those whose policies been cancelled been told why?

Can anyone fill the rest of us in on what's happening? Please don't answer with a rant against the ACA. Just try to be specific on what content of the Preferred Care policies are in violation of ACA.

I received a similar letter from BlueCross. It gave no other reason than it was necessary to comply with the ACA. I am sure that my current plan did not pay for birth control, abortions, etc. Also my current plan took into consideration my pre-existing conditions and the new plans must be issued ignoring those which simply means more premium. Blue Cross did say that I could be enrolled in a new plan for another $500 per month.

[njbchbum]

my aunt's policy was cancelled because it did not include maternity care and pediatric care and was offered a conforming policy for considerably more $$. when she asked why she had to pay for what she didn't need she was told because it is the law, everyone must pay for the same things - young/old/men/women -

[jerseyvillager]

You got your answer - it's Obamacare.

But remember, according to our leader, "If you like your current insurance you can keep it."

You see how that worked.

[RVRoadie]

Preferred Care Partners offered a Medicare Advantage plan in our area, in addition to throughout South Florida.

Last year they were purchased by United Health Care. It is UCH that terminated the PCP plan, but only in our area.

In my opinion, they did this to support the exclusive deal they made to be the sole Medicare Advantage partner to The Villages Health Care clinics. They only wanted the PCP customers. Unfortunately, the replacement plan comes at a substantially higher cost. In my case I have calculated that additional cost to be about $4,700 over what I paid out in 2013 with PCP.

Since insurance companies are regulated by the State, it is outrageous that they allowed UHC to suppress a competitor in order for them to do an exclusive deal with VHC clinics.

[TicoTexan]

Preferred Care Partners was bought by United HealthCare. The PCP Advantage Plan was cancelled for this area. It is still available in other Florida areas.

United has formed an alliance with The Villages resulting in the United Advantage plan being the only Advantage plan accepted at the various Village Heathcare Centers.

So it appears the demise of PCP was a result of business decisions rather than the ACA.

[ilovetv]

All of insurance industry is a "business decision". But the problem with this subject is, many of us thought we still had laws and state regulatory commissions to protect consumers and smaller businesses against a "monopoly" owning and controlling the marketplace.

"A monopoly exists when a specific person or enterprise is the only supplier of a particular commodity (this contrasts with a monopsony which relates to a single entity's control of a market to purchase a good or service, and with oligopoly which consists of a few entities dominating an industry).

Monopolies are thus characterized by a lack of economic competition to produce the good or service and a lack of viable substitute goods. The verb "monopolize" refers to the process by which a company gains the ability to raise prices or exclude competitors. In economics, a monopoly is a single seller. In law, a monopoly is a business entity that has significant market power, that is, the power to charge high prices......

Monopolies can be established by a government, form naturally, or form by integration.

In many jurisdictions, competition laws restrict monopolies. Holding a dominant position or a monopoly of a market is often not illegal in itself, however certain categories of behavior can be considered abusive and therefore incur legal sanctions when a business is dominant.

A government-granted monopoly or legal monopoly, by contrast, is sanctioned by the state, often to provide an incentive to invest in a risky venture or enrich a domestic interest group. Patents, copyright, and trademarks are sometimes used as examples of government granted monopolies. The government may also reserve the venture for itself, thus forming a government monopoly."

Monopoly - Wikipedia, the free encyclopedia

[Indydealmaker]

Originally Posted by ilovetv

All of insurance industry is a "business decision". But the problem with this subject is, many of us thought we still had laws and state regulatory commissions to protect consumers and smaller businesses against a "monopoly" owning and controlling the marketplace.

"A monopoly exists when a specific person or enterprise is the only supplier of a particular commodity (this contrasts with a monopsony which relates to a single entity's control of a market to purchase a good or service, and with oligopoly which consists of a few entities dominating an industry).

Monopolies are thus characterized by a lack of economic competition to produce the good or service and a lack of viable substitute goods. The verb "monopolize" refers to the process by which a company gains the ability to raise prices or exclude competitors. In economics, a monopoly is a single seller. In law, a monopoly is a business entity that has significant market power, that is, the power to charge high prices......

Monopolies can be established by a government, form naturally, or form by integration.

In many jurisdictions, competition laws restrict monopolies. Holding a dominant position or a monopoly of a market is often not illegal in itself, however certain categories of behavior can be considered abusive and therefore incur legal sanctions when a business is dominant.

A government-granted monopoly or legal monopoly, by contrast, is sanctioned by the state, often to provide an incentive to invest in a risky venture or enrich a domestic interest group. Patents, copyright, and trademarks are sometimes used as examples of government granted monopolies. The government may also reserve the venture for itself, thus forming a government monopoly."

Monopoly - Wikipedia, the free encyclopedia

And...since we are all free to use the Villages Health Care System and pay cash, there is no monopoly.

[Number 6]

Originally Posted by Indydealmaker

And...since we are all free to use the Villages Health Care System and pay cash, there is no monopoly.

And we are free to NOT use Village Health.

[JE Greenwood]

Originally Posted by Indydealmaker

I received a similar letter from BlueCross. It gave no other reason than it was necessary to comply with the ACA. I am sure that my current plan did not pay for birth control, abortions, etc. Also my current plan took into consideration my pre-existing conditions and the new plans must be issued ignoring those which simply means more premium. Blue Cross did say that I could be enrolled in a new plan for another $500 per month.

Yikes! An additional $500 per month?

[fb32162]

This occurs quite often. Insurance companies and doctors discontinue their contracts for a variety of reasons....the Dr may not be serving enough of the insurance company's members, the dr may not be meeting quality scores, the dr may decide the insurance co doesn't pay enough or the company may just be too big a pain to deal with, It also happens when providers in an area sign exclusive contracts. I suspect that may be the case here with the new Villages health care/united contractual agreements.

[Bizdoc]

Sigh. Did you know that 99 % of all natural disasters in the last 1,000 years were caused by ObamaCare? I read it on the internet.

In any given year, lots of insurance companies enter and leave a variety of markets. They may find that they can't sign up enough docs in their network, they can't sign up enough customers, they can't make money or whatever. There is absolutely nothing new about that. Anyone recall when their homeowner's insurance stopped writing policies in FL? (Should we blame Jeb Bush for that?)

I seem to recall people saying that PCP refunded a large portion of the Part B premium. I suspect that they found that business model to be unsustainable. (Unless, of course, their stockholders simply love giving away money).

Of course, in this current politically charged every single change gets reported on national media and analyzed to death.