For the past several years, Medicare has been offering a health care plan called Advantage. It is a health maintenance type Medicare coverage. It has been touted as less expensive, and many seniors and their decision-makers are opting out of traditional Medicare for the savings. Be careful when making this change.
If you were ever in an HMO when you were employed, Medicare Advantage is like those programs. You are assigned to a primary care provider who is the gatekeeper for all of your care. You may not select other physicians that are not on the panel of the program. The primary care physician will send you to a referral for specialty care that is a healthcare provider and also a member of the health maintenance group. You can select another doctor, but if they are outside the network you have purchased, you will have to pay substantial co-payments to see your preferred provider.
The traditional skilled nursing home benefits after a hospital stay are still available, but they may require more aggressive recuperation to maintain the rehabilitation stay. The Advantage Plan is approved by Medicare, but they can make their own plan rules, and they are different than traditional Medicare A and B that you are accustomed to.
However, if money is an issue and you are comfortable using a plan provider, the Advantage Medicare Plans can save substantial healthcare costs. Premiums are less, medication and routine services are far less expensive than in traditional Medicare. The key is to be a smart consumer. Look at all of the options before making a change. If you uncomfortable changing physicians and they aren't in the Advantage plan that you selected, you will have to pay for that benefit of using the physician of your choice. Ask Medicare experts lots of questions about the scheme and its coverage before making a decision. You can always change plans, but usually the option to do that is only available at your annual plan selection time. Please contact me if you have concerns about Medicare and are unsure which plan is best for your specific situation.