Brokers are directing people towards Medicare Advantage Plans. You may come in having changed to an advantage plan without even knowing it or understanding what you've gotten yourself into.
We get a lot of Medicare questions. Here is how the conversation might go:
Patient: I have Medicare
ALTA: Do you have Medicare Part B or an advantage plan?
Patient: What's the difference?
Here's the difference:
Medicare Advantage plans are an alternative to Medicare Part B. You have one or the other, not both. With an advantage plan, you get your Medicare benefits through the plan, instead of through the federally administered Medicare program.
ALTA: Unfortunately we can't work with your Advantage plan.
Patient: But it's Medicare.
Here's why we can't work with your plan:
Medicare Advantage plans have more restricted networks. For example, some Medicare Advantage plans, like HMOs, use a provider network. You can only use providers that are contracted with your Medicare Adv
antage plan. Other plans
may use a PPO that lets you see both in-and out-of-network providers, but you may pay higher co-payments and coinsurance when using out-of-ne
One more consideration: How much do you use PT?
If you have an injury and need a lot of PT - for example, 10 visits in a month, you could pay more out of pocket than you would with Medicare Part B and a supplement. Run the numbers and see what works best for you. As always, we are happy to answer questions.
If you sign up for an advantage plan and are unhappy, you can switch back to Medicare Part B between January 1st and February 14th.