When it comes to decide on a Medicare Advantage plan, you have to make sure that you fully understand the coverage and its limitations. Many people I speak to tell me that they have Medicare Supplement coverage when in fact they have a Medicare Advantage plan. There is a big difference.
Medicare Advantage Plans are network driven health plans. There are 3 types of plans: HMO, PPO and PFFS. The 2 most common ones are HMO’s and PPO’s. HMO require referrals to see specialists. With this type of coverage, your primary care provider(PCP)will “quarterback” your care. Under PPO’s, referrals are not required to see specialists and you are covered both in and out of network. However, out of network will cost more.
Most Medicare Advantage plans include Part D drug coverage along with extra benefits like dental, vision, Silver Sneakers, etc…
When selecting plan you need to make sure that your doctors accept the plan you are applying for. If there are important doctors that you need to see, make sure and double check that they accept the coverage. Don’t just listen to an agent. Call the doctor’s office or check the online directory from the plan. Don’t go by provider directories in print. They are usually outdated by the time the provider directories are printed. Even if you chose PPO coverage and you are covered out-of-network, make sure your doctors accept this coverage. You want to stay in-network as much as possible to keep your costs low.
Other things to remember is to make sure your hospital of choice is in-network and any other health care provider or facility that is important to you accepts the coverage you want to get into.
The other factor to check out is your prescription drug coverage. You need to make sure that your prescriptions are covered affordably under this new coverage. This needs to be evaluated each year you have Medicare Advantage coverage. If you take expensive medicines and are not diligent about evaluating this aspect of your coverage, each year, between October 15th and December 7th, you could make a huge financial mistake and potentially waste a lot of money.
Call me and I can make sure you have the most appropriate coverage that will meet your needs and not break the bank.