Does La Grange Hospital Letter Raise Fears?

LA GRANGE, IL – If you have traditional Medicare, you can go to the La Grange hospital for care.

You don't need Medicare Advantage to get service.

A recent letter from the hospital's chain – UChicago Medicine Advent Health – may require clarification.

In the message, the chain informed senior citizens about the Medicare open enrollment period from Oct. 15 to Dec. 7.

"To help find the best Medicare health plan for your needs and make sure you are still able to get care with UChicago Medicine AdventHealth, we have partnered with Chapter, a team of licensed independent Medicare advisors," the chain said in the letter.

Those with traditional Medicare can get care at any hospital that takes Medicare. Virtually, all do, including the La Grange hospital.

According to the Medicare website, those with traditional Medicare "can go to any doctor or hospital that takes Medicare, anywhere in the U.S."

Patch asked the hospital chain about the letter. Its spokeswoman, Julie Busch, said the letter was intended to provide a helpful resource for Medicare patients to ensure they fully understand their coverage options through traditional Medicare or a Medicare Advantage plan.

"The complexity and number of choices now available under Medicare health plans can be overwhelming for a patient," Busch said in an email. "Our partnership with Chapter is designed to provide our patients with a free resource to help them navigate this complexity and help the patient find the best Medicare plan for their unique situation."

If patients choose a Medicare Advantage plan, she said, their coverage is different or restricted depending on whether their healthcare providers are contracted with the Medicare Advantage plans known as "in-network" or "out-of-network."

"UChicago Medicine AdventHealth wants to ensure our patients understand which Medicare Advantage plans we are contracted with and can accept their insurance, allowing our patients to receive their highest level of health care benefits and coverage," Busch said. "We do participate with traditional Medicare and several Medicare Advantage plans."

Hinsdale resident Linda Burke is among those who received the chain's letter. She said it was misleading.

"Briefly, the letter raises fear that if you don't check your Medicare coverage by calling the phone number of 'Chapter' Medicare guides, you might not be able to receive treatment at Hinsdale Hospital," Burke said in an email to Patch. "This, of course, is a lie. Like virtually all hospitals, Hinsdale accepts Medicare with Medigap."

She said Medicare Advantage plans have major drawbacks.

"(The letter) fails to note that Medicare Advantage is run for profit, with very limited provider networks, geographically limited networks, burdensome prior authorizations, and frequent denials of care," Burke said. "None of these facts are mentioned in the letter."

In a statement, Chapter's chief executive, Cobi Blumenfeld-Gant, said his firm assesses all Medicare options – Medicare Supplement, Part D and Medicare Advantage plans.

"We are the only unbiased Medicare advisor in the country: we look at 100% of Medicare options (even those that don't work with Medicare advisors) and our advisors' compensation does not change based on plan enrollment type," he said.

However, Burke said in an interview that Chapter cannot claim to be objective when it allows its name to be used in misleading advertisements for a particular Medicare Advantage brand.

"I am not saying that our real healthcare providers at Hinsdale or LaGrange Hospitals have anything to do with promoting Medicare Advantage. People who actually treat patients are heroes," she said.

She pointed to a statement on Chapter's website: "Chapter Advisory, LLC represents Medicare Advantage HMO, PPO, and PFFS organizations and stand alone prescription drug plans that have a Medicare contract."