Question: I need help spotting what to watch out for regarding these Medicare Advantage plans. How do I navigate this process?
Four things to watch for with Medicare Advantage
- Make sure the health care professionals you see are in your Medicare Advantage network.
- Be clear on what the plan should cover.
- Does your plan require pre-authorization or other rules to get treatment covered?
- Watch your bills from your health care providers and Medicare Advantage plan.
Answer: Recent news has highlighted some of the challenges with Medicare Advantage plans.
First off, if you’re joining Medicare for the first time, we recommend you follow a proven process we cover at www.themedicarecoach.com to ensure that Medicare Advantage is best for you. The advertisements often don’t fully share the details and costs of Advantage plans, which leads to regret.
The advertisements often don’t fully share the details and costs of Advantage plans, which leads to regret.
If you or a loved one are on a Medicare Advantage plan, there are a few things to look out for to ensure you’re getting the best care without breaking the bank.
Four things to watch for with Medicare Advantage
#1: Make sure the health care professionals you see are in your Medicare Advantage network. Not doing so can result in uncovered services that can become very expensive.
#2: Be clear on what the plan should cover. Medicare covers many services that are “medically necessary,” as clearly stated on Medicare’s website. If you have a service or referral denied and you think it is medically necessary, we recommend you do more research to see if there is a way to get it approved.
#3: Does your plan require pre-authorization or other rules to get treatment covered? Medicare Advantage plans often have a lot of fine print you need to follow to get services covered. We recommend you get very familiar with these rules when you first join an Advantage plan and every year during Medicare’s Annual Enrollment Period when the plan can change networks and rules.
#4: Watch your bills from your health care providers and Medicare Advantage plan. Look into charges not being approved by Medicare Advantage if they were “medically necessary” and by a doctor covered under the plan’s network.
