As you’re making your initial transition into Medicare, you may find that there are two avenues that you can pursue medical coverage. With traditional Medicare, you can purchase a Medicare supplement plan to coincide with your parts A & B and also a Medicare prescription drug plan or Part D policy. Those programs are excellent options for consumers because they offer several key conveniences. With Medicare, although it’s a daunting and complex entity, there are several factors that should make it more convenient and give you piece of mind as a consumer.
Firstly, as you approach Medicare, know it’s national coverage. As you go anywhere in the country any health facilities that accept parts A & B also accept any and all supplement providers. So, as you travel or enjoy your retirement, know that wherever you go coverage is also there to follow you.
Secondly, as I just previously mentioned, these are non-network based plans. Any and all Medicare supplement programs have to be accept by any providers that accept Medicare A & B as a source of primary coverage. So no longer as you pursue medical coverage do you have to ask yourself “will my doctor or hospital accept this” or “are they a party to my network.” Because A & B coverage is your primary source that’s the only factor you have to consider as you pursue doctors and health facilities. All Medicare supplement programs are automatically accepted.
Thirdly, another key factor is that these programs are uniformed and standardized. As you begin to shop for medical coverage, you’ll come to the realization that there are eleven supplement plans. Plans noted from the letters A all the way to the letter N. The coverage that denotes each of these plans is standardized by CMS and the federal government.
What that means is you as a consumer have uniform coverage from carrier to carrier. So regardless of the plan and the carrier that you choose, the coverage that you receive is uniform and the same no matter what. This makes the shopping process much easier and convenient for a consumer because once you determined the plan that fits your health needs, it’s a matter of shopping for the price and the program and the carrier that offers you the most competitive rate.
Now although there are Medicare supplements, which are an excellent and convenient options for consumers, on the other side of the isle you have what’s known as Medicare Advantage. Medicare Advantage plans are denoted by the term of HMP, PPO and sometimes PFFS plans. There are several factors of Medicare Advantage programs that are uniform and standard, but their inconveniences to consumers.
First and foremost, Medicare Advantage plans feature network doctors and hospitals, and how that refers to you as a consumer is that you have to adhere to those doctors and hospitals. Should you stray from the network and hospitals that are provided to you, you could be paying the cost of your medical responsibilities and claims entirely out of your own pocket.
The second key factor is that these plans are not standardized. As you shop Medicare Advantage programs, you’ll notice that each of the plans that are out there are unique and vary in the coverage they offer you. This can make the process of shopping much more convoluted and confusing for a consumer.
Lastly, Medicare Advantage plans also have the inconvenience of prior authorizations. As you utilize your doctors and hospitals for Medical coverage and claims, you would have to have prior authorization not only from your doctor but from your medical insurer that you associate and line yourself with. Should you not have that authorization in place the claims that you file could end up being your own financial responsibility and having you pay out of pocket.
These are the several factors that make Medicare Advantage plans a true disadvantage for Medicare recipients, and there are factors as to why it’s more convenient to you as a Medicare consumer to stay with Original Medicare.
If you ever have questions or concerns relating to these Medicare plans and programs, feel free to contact us at our website.