Wed, Nov 6, 2019

Making Sure Your Plan Meets Your Needs

Your health care needs are a key factor in any Medicare decision, from your current health status, ongoing conditions or to your desire to keep a favorite doctor.

Many Americans have trusted doctors who have taken care of them for years, and they’d like to keep going to them once they are covered by Medicare. If that sounds like you, the first thing you might want to do before making any coverage decision is to ask your doctors if they accept Original Medicare or if they participate in any Medicare Advantage plans in your area.

According to the Kaiser Family Foundation, 93 percent of primary care physicians accept Original Medicare, so the odds are good that your current physician does. Under Original Medicare or with a Medicare Supplement, you don’t need a referral to see a specialist, as long as the specialist accepts Medicare.

On the other hand, Medicare Advantage plans have specific networks of medical providers. Some plans let you go to a doctor outside the network, but generally you’ll pay more out of pocket to see those providers. Many Medicare Advantage plans require a referral from a primary doctor to see a specialist.

What about copays?

Unlike Medicare Supplements, if you have an Advantage Plan of any kind, and your health conditions require you to see doctors often or face frequent hospitalizations, you will face numerous and often expensive copays for each visit and each hospitalization. 

Even though the appearance of very “low or zero premiums” may look attractive, be aware that Advantage Plans are only  “free “ if you don’t use them. So if your health is compromised, a Medicare Supplement may be the better choice for you. Yes, you’ll pay higher premiums with a Supplement, but the peace of mind that you are covered with no copays ever is priceless. And even if you’re in good health now, you never know what can happen so why take that chance – especially with your health. 

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