Yeah, and those details will bite you in an uncomfortable place.
Notice UHC's caveat. "...and accept the plan." Your research shows
that SMH will not accept the UHC plan in 2024, hence you are SOL.
The IBM UHC Advantage doesn't operate in a vacuum. In this case,
SMH also gets to have a say, and they don't have an agreement with
IBM UHC as I understand from your note.
Tim
Timothy A
Johnson, Tucson, AZ ()
Member of European Train Enthusiasts ()
On 12/4/2023 7:39 AM, Michael Halliday
via groups.io wrote:
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HC wrote to me, warning that my health provider will go out
of network in 2024. They said, in part "Your plan will cover
care from Sarasota Memorial Health Care System (SMH) as an
out-of-network provider, if they are a Medicare-approved
provider and accept the plan. Your share of the cost will be the
same as if they were part of the network."
Sound comforting? Not so. The devil is in the details. SMH told me
they will NOT accept UHC in 2024 - not even out-of-network. So I
must change all my doctors next year, or return to an Aetna
Advantage plan (which IS accepted by SMH), and lose the IBM
subsidy.
I wonder if anyone knows exactly how out-of-network with same
copay even works with UHC. Without a contracted rate, how much
would the provider bill UHC?? Their full rate? I find it hard to
believe that UHC would swallow the difference between full rate
and Medicare "usual & customary" (less my copay).