When joining an Advantage plan, make sure you will be able to see the healthcare providers that you prefer–that they are in the plan network and taking new patients.
Reviewing the list of in-network providers can be a challenge. Providers are not listed on the Medicare Plan Finder, and a recent study by the Kaiser Family Foundation found that the information available from plan providers can be difficult to review, out of date, and frequently contain inaccurate information.
“Seniors have to contact the plan, go to their websites, or request a directory–and they come in all shapes and sizes,” says Neuman. “It can be very difficult to do simple comparisons across plans.”
The foundation’s review also found shortcomings in the quality of providers in some Medicare Advantage provider networks. One out of every five plans did not include a regional academic medical center–institutions which usually offer the highest quality care and top specialists. And only 40 percent of Advantage provider networks included top-quality cancer centers, as indicated by membership in the National Cancer Institute’s network.
Author and Medicare expert Philip Moeller recommends asking your doctors which Advantage plans they are in or can recommend. “I always recommend going to the care providers you know,” says Moeller, author of Medicare, Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs (Simon & Schuster, October 2016). “Have your annual notice of change handy so that you can review your options with them.”
Comparing Medicare Advantage options
The best online tool for shopping plans is the Medicare Plan Finder at the Medicare website. It eliminates much of the guesswork in navigating plan choices; it allows you to plug in your Medicare number and drugs (you’ll need each drug’s name and dosage). The tool then displays a list of possible plans likely to meet your needs; their estimated cost, premiums, and deductibles; which drugs are covered; and customer-satisfaction ratings. The finder also will give you advice about drug utilization and restrictions.
The Medicare Rights Center maintains a free telephone hotline (1-800-333-4114) that can walk beneficiaries through differences between traditional Medicare and Advantage plans, and help with selecting drug and Advantage plans.
Federally funded State Health Insurance Assistance Programs can also provide this kind of free assistance. (find your local SHIP here).
Talking to individual-plan sponsors by phone can help get your questions answered, but do your actual enrollment over the phone with Medicare (1-800-MEDICARE) or online in order to create an official record of your selection. That’s crucial if you later find any errors in your enrollment and need to backtrack with Medicare.
Each year, Medicare beneficiaries receive “Medicare and You,” a very useful, comprehensive handbook on the program that is published by the Centers for Medicare and Medicaid.
Pages: 1 2