4 Common Medicare Advantage Plans You Can Choose From

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Plethora Of FAQ People Have About Medicare Advantage Plans

Can I use my doctors at any hospital or facility? Are they in the network?

Will doctors/provides I’d like to see accept new patients with the plan?

Will the plan cover any providers not in-network?

What hospitals, specialists, skilled nursing facilities, etc. are listed in the network?

What is the plan’s service area?

Will coverage for care be covered if outside the coverage area?

Can I choose my own Primary Care Provider?

Will there need to be prior approval for hospitalization from the plan?

Will referrals be necessary to see a PCP?

What kinds of costs will I be expected to pay such as deductibles, premiums and copayments?

Is there a yearly maximum out-of-pocket expense?

Will the plan cover prescription medications outpatient?

Is there any coverage restrictions on my plan?

Am I able to use any pharmacy I want?

Will the plan cover prescription drugs if I’m traveling?

How much will I pay for name brand and generic drugs?

Will my plan work in conjunction with the current coverage I have?

Will I lose the retiree or job-based coverage insurance if I sign up with the plan?

How To Find A Medicare Advantage Plan Accepting Physician

There are several ways to find a doctor who is in your chosen Medicare Advantage plan, including:

  • Look at the website of your plan and call customer service to find those doctors.
  • Call the doctor’s office to find out if your Medicare Advantage plan is accepted. You can also look at the plan’s website to see if the doctor is listed.
  • Use the Find Medicare Doctors Tool to locate doctors who accept your kind of plan.

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Unless it’s an emergency, out-of-network providers do not have to treat PPO plan members. Before you visit an out-of-network doctor or service, it would be wise to reach out to get a pre-service organization determination beforehand. Reach out to your plan’s customer service or look at the Evidence of Coverage to learn more about out-of-network services.

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