Opuscula Being ignored Does not win My business

IT IS THE FINAL DAYS OF THE Medicare Advantage plan sweepstakes.

I have a plan that automatically will roll over to the insurer’s 2020 plan, so I’m covered.

But there is a plan that offers more of that I want and, as a bonus, savings, too.

I have the preferred plan's Evidence of Coverage (EOC) and its Formulary (drug list) from the internet.

I lack the company’s list of providers: PCPs, specialists, hospitals, urgent care facilities, etc.

My PCP’s web site shows he accepts this company. The insurer’s site confirms it works with my PCP.

The preferred hospital likewise lists the company on its web site; however, the insurer’s site omits the hospital. Since my primary specialist is a hospital employee, if the insurer doesn’t have a contract with the hospital, then I can’t be referred to that specialist.

My PCP, who CAN refer me to the hospital and specialist under my current plan may NOT be able to refer me — assuming the hospital has a contract with the insurer — due to this company’s “capitation.”

I DID WHAT any sensible person would do: I sent an email to the insurer asking “What is the location of the Providers’ List for (plan ID)?”

I prefer email since I will have a written record of the exchange.

The email was sent on December 1.

Today is December 3.

I still am waiting for a response.

The deadline to make a decision is, for me, Friday, December 6.

Medicare Advantage selection deadline

If the insurer cannot respond to my simple query “What is the URL (web site) for the 2020 Providers’ List for (plan name)” then I have no confidence the company will respond to me if I have a concern with the plan and its benefits.

I COULD have called and talked with a sales person, but then I would lack a written record, and frankly, I have concerns about information from sales people, many of whom are engaged just for the “season.” In any event, all I want is a URL, an internet address to which I may point my browser.

Granted, provider and drug lists are “subject to change” throughout the contract (calendar) year, but its been my experience that most insurers make changes near the end of the contract period. Only the EOC is cast into concrete.

I can get EOCs, Formularies, and Providers’ Lists online for most plans. It is becoming more difficult — why this is so is beyond me — and based on a comparison spreadsheet, I make a decision that is best for me. I do this exercise every year between October 15 and November 30. (I also compare auto and home insurance when renewals come due.)

IF the insurer provided me with a URL to a PDF or other searchable file, I would check with my PCP if, under this insurer, he can refer me to my necessary specialist. “Capitation” — limiting PCPs to a sub-list of the Providers’ List — is the standard for most Advantage insurers today as a way to boost profits.

Bottom line: Ignoring potential customers is a sure-fire way to gain customers … for a competitor.

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