Medicare annual open enrollment season begins on October 7 and millions of people will be deciding between traditional Medicare and Medicare Advantage. People who want easy access to the care they need take far less of a gamble with their lives and health if they opt for traditional Medicare. People who opt for a Medicare Advantage plan because it has lower upfront costs than traditional Medicare do not have the information they need to choose a plan that will meet their needs.
Lara Goulson, an insurance agent, explains that two zero-premium Medicare Advantage plans can be very different in a piece for medicalresearch.com. She argues that people need to focus on the maximum they will spend out of pocket for in-network care when selecting a Medicare Advantage plan. And, while that number varies widely among plans, it’s not clear how much it helps to know the answer to that question.
Here are two key things you need to know about the Medicare Advantage plan you opt for:
- How robust is its network of physicians and hospitals? Put differently, if you develop a costly and complex condition, will you be able to get care from the providers you want to use? Or, will they be out of network or not taking new patients?
- How many obstacles will the Medicare Advantage insurer impose in the form of prior authorizations before you can get your care? Will you face delays or, worse still, inappropriate care denials that can endanger your life?
If the answer to either of these two questions makes you wonder whether your Medicare Advantage plan will cover the care you need from the doctors and hospitals you trust, the out-of-pocket cap will matter little. That said, it’s not possible to find good answers to either of these questions.
For these reasons, enrolling in a Medicare Advantage plan could mean gambling with your health and maybe even your life. You could save money, but sadly with Medicare Advantage people too often get what they pay for.
Here’s more from Just Care:
- The many disadvantages of Medicare Advantage
- The wrong choice of Medicare Advantage plan could kill you
- Medicare Advantage inappropriate denials of care abound
- Don’t-judge-a-Medicare-Advantage-plan-by-its-stars
