Doctor Choice Can Be Limited with Medicare Advantage

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Medicare Advantage are plans with private companies that contract with Medicare to deliver services. Some of these plans work great, but many of them have limited lists of approved providers, which can make finding a doctor difficult for some patients.

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Doctor Choice Can Be Limited with Medicare Advantage


26 thoughts on “Doctor Choice Can Be Limited with Medicare Advantage

  1. My Medicare advantage is managed by “Clover,” They are a part of CareOne. If I had known that,I wouldn’t have signed up with them. They cover limited areas but have treated us very well

  2. In Barcelona, while on a six week stay, Susan had an upper respiratory infection. Then, she had sciatica from walking 5k a day and doing stairs. Two trips to the Dr. One Dr. home visit. One ambulance trip to the major teaching hospital in Barcelona to see the head of Orthopedics, a bunch of Meds (none of them opiates) Total cost; $1,600. What do you think that would have cost in Newark, NJ, USA where we live? What’s wrong with us?

    • With a Medicare Supplement, Susan would pay little to zero out of pocket for medical care here in the United States.

      Medicare Supplements also provide worldwide coverage.

  3. I travel an hour to take my boyfriend to his radiation/ chemotherapy therapy its the closest cancer center to us and 3 hours to his colorectal specialist then back it gets exhausting

  4. As a Canadian, I didn’t understand much of what he says. I wonder if most Americans understood.

    I gave him a thumbs up, though.

  5. I work as a Community Health Worker. Trying to help clients select an advantage plan and find a doctor who will take them is an absolute nightmare. I am a relatively well educated, intelligent individual. This is part of my job, and I cannot figure it out, it is ridiculous.

    What you said about Google being more accurate than the MAP databases is absolutely correct. Those databases are garbage and have served to do nothing but waste the time of me and my clients.

    It is too difficult. Far too difficult for people who actually need to actually utilize the supposed opportunities that MAPs provide.

  6. Before I was on Medicare my employer’s insurance was with Blue Cross Blue Shield, with my primary care physician of more than 8 years. The first year that I was on Medicare I signed up for an Advantage plan with BCBSTX, assuming that my PCP was on that plan. She was not. I went the first year on Medicare having to pay for my appointments with my PCP at her standard rate. Fortunately I only needed to see her once that year and the cost was only $50.
    Before I signed up for Medicare for the second time I checked with her to make sure that I got an advantage plan that she was on. Interestingly she did not even know. I had to ask her Health Texas Provider Network for the list of which options they were associated with.
    Of course now I check with them every October to make sure I get on the right plan.

  7. I’m a year and a half from signing up for Medicare. My current intent is to take Medicare Classic. My logic is that I would like to be able to travel the country a bit and would prefer to avoid the bureaucratic nightmare of dealing with an insurance company should I need or want treatment away from home.

    • Martha, you definitely have time to do your homework! Not every Medicare option is right for everyone but you will want to consider a Supplement and Part D Rx plan when the time approaches.

      Hint, Plans G and N are both great options! Hope that helps.

    • @Martha K I work for a Medicare Part C sales company, and I can back that. Med Supps are taken by any doctor who takes Medicare, but they do have a premium usually attached. Something to be aware of.

  8. This is EXACTLY why you should only trust a licensed and qualified insurance broker (not an agent who works for only one company!). Not all $0 premium plans are created equally and not every Medicare Advantage plan is good for everyone. Also, not every geographical area has good MA and MAPD options.

    If you are new to Medicare or someone you care about is approaching Medicare, please talk to an expert.

  9. “as with everything in healthcare, it’s really hard to make an informed decision” This is pretty much the bottom line of it.

    • Not every nation with universal healthcare has single payer. Universal coverage =/= single payer. Also, a government option =/= single payer, necessarily.

  10. Please pardon me for not buying Kaiser study. I’m a kaiser member and they’re a narrow network imo. Finding specialist is almost impossible for anything that is not cancer or heart disease.

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