Sue Wills was upset when the letter arrived in early October.
Wills of York County said she never expected her main health care provider, Tidewater Physicians Multispecialty Group, to drop her as a patient.
“I’ve probably been going to them for 30 years,” Wills said.
An employee with the city of Newport News for 34 years, Wills retired in 2020 at age 62 as the planning coordinator for the police department. Once she turned 65 years old, Wills — along with about 1,380 retirees, according to the city — were enrolled in the city’s Humana Medicare Advantage plan.
The letter said that, effective Jan. 1, TPMG will no longer be part of Humana’s Medicare Advantage plan. That leaves Wills and the other retirees under the health insurance provider to either change their primary care and specialist doctors to physicians in another medical group or subscribe to another insurer before annual enrollment ends on Dec. 7.
That’s upsetting for Wills’ husband, Terry Grinnalds, who is under her insurance and a prostate cancer survivor. Grinnalds still sees his urologist, gastrointestinal specialist, pulmonary specialist and other physicians in TPMG.
“He’s going to lose all of them,” Wills said. “We just hate to have to turn around and take 30 years of somebody knowing your medical history, your personality, how you live and what you need and don’t need and, all of the sudden, you’ve got to find somebody else.”
With a nationwide physician shortage and the uncertainty of which practices are taking new patients, Wills said it’s challenging. On top of that, she said they should not be used as pawns.
“The reason they are turning my family away at the door is because their contract negotiations with Humana have failed,” Wills said.
The couple — along with roughly 40 other retirees — attended an informational session in early November that the city provides every year around open enrollment.
“They did address the elephant in the room first thing,” Wills said, “but said right now everything was still up in the air.”
Historically, Kimberly Bracy, city communications and media relations manager, said carriers and providers renew their contracts with minimal disruption for the city’s retirees.
“We are confident the involved parties will reach an agreement that meets the needs of our retirees and organization,” Bracy said.
TPMG also expressed similar sentiments in an email dated Nov. 12.
“The TPMG leadership team is currently engaged in discussions with Humana to reach a resolution that benefits our patients,” said Terri Reedy, TPMG marketing director.
Lisa Dimond, corporate communications lead for Humana, said the insurer strives to provide access to high-quality health care for their plan members while minimizing out-of-pocket costs.
“We are currently in good-faith discussion with Tidewater Physicians Multispecialty Group and are optimistic we will reach an agreement very soon,” Dimond said in a Nov. 21 email .
But Coleman Young, an insurance agent with National Life and Ameritas, said he used to sell Medicare Advantage plans for various companies and he wants retirees to be aware of something. The Portsmouth resident reached out to The Virginian-Pilot’s tip line to share a webinar by Ed Weir, retired district manager for the Social Security Administration, that warns about the elimination of close to 2 million Medicare Advantage plans (Medicare Part C) across the country at the end of December.
Why? It appears that the health insurance companies spent too much money on the programs last year and are cutting back, Young said.
“I don’t think a lot of people know about it,” Young said. “And, obviously, the health insurance companies haven’t advertised that they’re eliminating programs.”
Sandra J. Pennecke, 757-652-5836, sandra.pennecke@pilotonline.com
