Business Insight presented by Arlington Dermatology What is the problem with Medicare? We receive many phone calls as well as requests in person to clarify Medicare issues. Our practice has a very large population of patients 65+ and many of them have been coming for years. They always assume we are in their 'network' of doctors, and we are happy to be a part of most insurances existing in Illinois. Medicare Part A is a hospital plan carried out by the US government for all who sign up at the age of 65. Medicare Part B is a similar plan, also run by the US government, but for outpatient services and doctors. Doctors must agree to accept assignments from Medicare, and it is a careful and long process, however, once you become a part of it, you do not need to do much, except to keep your license valid and be in good standing. Our doctors have been a part of Medicare Part B for many years. Years ago, private insurance companies were allowed to offer their services to seniors as, so called, Medicare Advantage. Some call it Medicare Part C. It is not US government plan and not a part of Medicare Part A or B. Private insurances had an opportunity to design their own plans, usually offering some additional services like dental, but putting multiple limitations on the plans, including network of doctors, referrals, pre-certifications, and similar. Many sales agents working for private insurances told patients that they are getting the same plan as Medicare Part B. This was not true. They did it to sell the plans and make money. Patients often realized that when they visited the doctors and found out they could not be seen. Arlington Dermatology participates in many Medicare Advantage plans. Simply, being a part of Aetna commercial insurance, we extended our agreements to Aetna Medicare Advantage. This is just an example that was also true with many other private insurances. This year, some significant changes started happening. Several private insurance companies decided that they no longer want to offer the plans under Medicare Advantage. The reasons behind it were mostly financial. It is difficult to make money of older patients because they do get sick more often. Patients were facing very difficult decisions: they had to change their plans under Medicare Advantage because their plans were no longer offered. They were approached by the same agents who now were selling them 'substitute' plans, that were supposed to be identical. They were not. In many cases, patients ended up on plans that were brand new, their doctors were not a part of their networks, and services offered did not match the previous plans. We have seen several patients who were super upset that they cannot see us anymore. Unfortunately, it is far beyond our decisions. We could not and have not anticipated all the changes occurring in healthcare and Medicare Advantage was never our favorite recommendation for patients. Unfortunately, changes cannot be made at this time. Patients must wait for the open enrollment period by the end of the year and seek assistance from trusted individuals and not sales personnel. Medicare Part A and B run by the US government has no problems accepting patients during the open enrollment and those problems of discontinued plans do not apply to them. Please, contact us for more information. While we cannot enroll you in any plans, we can certainly help you understand the concepts and problems associated with the process. Michael Bukhalo, MD Arlington Dermatology 5301 Keystone Court Rolling Meadows, IL 60008 Tel. 847 392 5440 | www.arlingtondermatology.net Business Insight presented by Arlington Dermatology What is the problem with Medicare ? We receive many phone calls as well as requests in person to clarify Medicare issues . Our practice has a very large population of patients 65+ and many of them have been coming for years . They always assume we are in their ' network ' of doctors , and we are happy to be a part of most insurances existing in Illinois . Medicare Part A is a hospital plan carried out by the US government for all who sign up at the age of 65. Medicare Part B is a similar plan , also run by the US government , but for outpatient services and doctors . Doctors must agree to accept assignments from Medicare , and it is a careful and long process , however , once you become a part of it , you do not need to do much , except to keep your license valid and be in good standing . Our doctors have been a part of Medicare Part B for many years . Years ago , private insurance companies were allowed to offer their services to seniors as , so called , Medicare Advantage . Some call it Medicare Part C. It is not US government plan and not a part of Medicare Part A or B. Private insurances had an opportunity to design their own plans , usually offering some additional services like dental , but putting multiple limitations on the plans , including network of doctors , referrals , pre - certifications , and similar . Many sales agents working for private insurances told patients that they are getting the same plan as Medicare Part B. This was not true . They did it to sell the plans and make money . Patients often realized that when they visited the doctors and found out they could not be seen . Arlington Dermatology participates in many Medicare Advantage plans . Simply , being a part of Aetna commercial insurance , we extended our agreements to Aetna Medicare Advantage . This is just an example that was also true with many other private insurances . This year , some significant changes started happening . Several private insurance companies decided that they no longer want to offer the plans under Medicare Advantage . The reasons behind it were mostly financial . It is difficult to make money of older patients because they do get sick more often . Patients were facing very difficult decisions : they had to change their plans under Medicare Advantage because their plans were no longer offered . They were approached by the same agents who now were selling them ' substitute ' plans , that were supposed to be identical . They were not . In many cases , patients ended up on plans that were brand new , their doctors were not a part of their networks , and services offered did not match the previous plans . We have seen several patients who were super upset that they cannot see us anymore . Unfortunately , it is far beyond our decisions . We could not and have not anticipated all the changes occurring in healthcare and Medicare Advantage was never our favorite recommendation for patients . Unfortunately , changes cannot be made at this time . Patients must wait for the open enrollment period by the end of the year and seek assistance from trusted individuals and not sales personnel . Medicare Part A and B run by the US government has no problems accepting patients during the open enrollment and those problems of discontinued plans do not apply to them . Please , contact us for more information . While we cannot enroll you in any plans , we can certainly help you understand the concepts and problems associated with the process . Michael Bukhalo , MD Arlington Dermatology 5301 Keystone Court Rolling Meadows , IL 60008 Tel . 847 392 5440 | www.arlingtondermatology.net