Traditional Medicare May Offer Texans Greater Freedom Than Medicare Advantage

When you turn 65, you have health care choices: Traditional Medicare or Medicare Advantage?

Having the freedom to choose the health care coverage that works best for you only works when you have all the information to make an informed choice. Taking the time to assess your options will help ensure a better health care experience as you age.

One big difference between Traditional Medicare and Medicare Advantage is the availability of health care providers. For many, having the freedom to keep their doctor or choose one based on their needs is an important part of maintaining independence and a feeling of control over their health.

Traditional Medicare works with nearly every hospital and doctor in the country. Medicare Advantage plans’ limit their networks of health care providers by design.

In fact, less than half of the country’s doctors work with any Medicare Advantage plan.

Often, people sign up for Medicare Advantage plans without realizing they will be forced to find another doctor, and doctors and other health care providers are not locally available.

Medicare Advantage plans choose which doctors, therapists, home health care providers, and hospitals they want to work with, and your options for care are limited to their choices. Even if you’ve had the same doctor your entire adult life, if he or she isn’t in your Medicare Advantage plan’s network, you’ll need to pick a different one.

Another point to consider, particularly, for the millions of Americans with chronic conditions, is continuity and consistency of care. When Medicare Advantage plans’ provider networks change year over year, this continuity of care can be threatened.

To be sure you can have the doctor you want:

• Ask insurance brokers or Medicare Advantage sales agents about provider availability in your local community.
• Clarify the availability of specialists, such as home health providers, podiatrists, and those you might depend on most for other specialized care nearby.
• Verify benefits associated with care following an inpatient hospital stay for services such as rehab and therapy.