Why Some Doctors Accept Medicare But Won't Accept UHC Medicare Advantage PPO

[JC]

Well I am back. This time my wife goes to the ER and ER determines she needs surgery. A surgeon is called and the surgery is performed. She stays in the hospital overnight and released the next day. The insurance used at the hospital is United Healthcare Medicare Solutions PPO. In the discharge instructions, it says call surgeon for a followup appointment for a week after surgery. Called for an appointment and they refused because they don't accept United Healthcare. I guess I will just make an appointment and promise to pay cash.

ER is always covered as in network including any hospitization that arises from an ER visit. However follow up visits your back to dealing with whether they are in or out of network.

Bottom line is they dont want you to worry about where your going in an emergency so they cover all ER visits as in network

 

[JC]

Well I am back. This time my wife goes to the ER and ER determines she needs surgery. A surgeon is called and the surgery is performed. She stays in the hospital overnight and released the next day. The insurance used at the hospital is United Healthcare Medicare Solutions PPO. In the discharge instructions, it says call surgeon for a followup appointment for a week after surgery. Called for an appointment and they refused because they don't accept United Healthcare. I guess I will just make an appointment and promise to pay cash.

ER is always covered as in network including any hospitization that arises from an ER visit. However follow up visits your back to dealing with whether they are in or out of network.

Bottom line is they dont want you to worry about where your going in an emergency so they cover all ER visits as in network

 

[gooch]

One possibility is to find a surgeon who is in the network to do the followup. I don't how the two surgeons would feel about that kind of an arrangement

 

[Iwilltellyouwhy]

UHC manages your Medicare for Medicare. Medicare pays UHC for doing that. Since that happens doctors and hospitals get less from an Advantage plan than they do from Medicare alone. This is what I was told by a major University hospital who told me they would take Medicare but not my UHC Medicare Advantage PPO plan.