Cancer patients in Texas may need new doctors after insurance changes

Seniors undergoing cancer treatment in Texas may have to find a new doctor after Blue Cross Blue Shield of Texas decided to stop offering a Medicare Advantage plan at MD Anderson Cancer Center.

This means that all doctors working at the Houston cancer center will no longer be in network for seniors using Medicare Part C Advantage plans or Medicaid managed services.

The change takes effect Friday, prompting many to seek a new doctor and treatment.

“Medicare Advantage plans are increasingly playing a tough game with prestige medical centers as they try to balance cost control with patient care,” said Michael Ryan, financial expert and founder of michaelryanmoney.com. News.

But the changes in Texas have not been without consequences, he added.

“MD Anderson is not just another hospital,” Ryan said. “This is one of the leading cancer centers in the world.”

The changes could affect both seniors who rely on Medicare for health insurance and low-income Texans who receive Medicaid.

Newsweek MD Anderson and Blue Cross Blue Shield were contacted via email for comment.

According to Houston Public Media, MD Anderson learned earlier this year that their doctors would no longer be online.

Although MD Anderson continues to accept Medicare and Medicaid, only some portions of the insurance will be in-network.

This includes Medicare Part A, which covers many elements of your hospital stay, as well as Medicare Part B, which provides coverage for doctor visits, tests, and preventive treatments.

MD Anderson has previously stated that they will work with patients to help them find another healthcare provider during treatment.

“While Dr. Anderson welcomes the opportunity to remain in the BCBS Medicare Advantage and Texas Managed Medicaid network, our goal is to ensure continuity of care for those undergoing active treatment,” MD Anderson said in a statement.

“The facility remains in contact with affected patients and is working with Blue Cross Blue Shield to coordinate care for patients enrolled in BCBS Texas Medicare Advantage and Texas Managed Medicaid plans.”

This isn’t the first time Blue Cross Blue Shield of Texas has faced problems with its Medicare Advantage plans. Baylor Scott and White, another Texas provider, also nearly ended its in-network agreement with a major insurer but was able to reach a new agreement just before the Oct. 1 deadline.

Alex Bean, a financial literacy professor at the University of Tennessee at Martin, said many health insurance providers have cut coverage in the marketplaces due to rising costs and an inability to turn a profit.

“In this situation, it is difficult to say whether that is the case because there has not been much information provided outside of the agreement between the provider and MD Anderson, which expires immediately,” Bean said. News.

“The good news for those who receive provider benefits is that they will be assisted in switching to another Medicare Advantage program that Dr. Anderson accepts for coverage. only this market, but others too.”

Chris Fong, a Medicare specialist and CEO of Smile Insurance Group, said that while insurance companies are trying to save money by lowering the cost of services and adding steps such as prior authorization or referrals, medical centers are also experiencing inflation on medications and doctors salaries.

“Unfortunately, patients are some of the hardest hit by these contract negotiations,” Fong said. News. “The advice we give our clients is to look at how they would like their healthcare to work. If they prefer flexibility in choosing doctors and health care providers with fewer restrictions, they should consider traditional Medicare with a supplement and prescription plan.”

Ryan said insurance companies are increasingly using “narrowing the net” as a cost-control strategy.

“They’re betting that by cutting out expensive providers, they can offer lower premiums,” Ryan said, adding that they don’t always take into account the human costs.

As for the affected seniors, Ryan said they have options, but time is of the essence.

“Sometimes a Medicare Supplement (Medigap) plan offers more flexibility than Advantage plans, especially for specialty care. Yes, it may cost more per month, but access to any Medicare provider can be worth it,” Ryan said.