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.
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.