Don’t assume your doctor still accepts Medicare Advantage

  • Verify that your doctors and hospitals still participate in your Medicare Advantage plan
  • Some major U.S. health systems have canceled or plan to cancel their contracts with Medicare Advantage
  • Calling the doctor’s office directly is the best way to check if they are in-network
  • Canceling Medicare Advantage contracts can have serious consequences for health systems and patients
  • Low payments and administrative hassles are reasons health systems terminate their relationship with Medicare Advantage
  • Consider switching back to original Medicare if you want to avoid prior authorization requests and restrictions on providers
  • Switching plans during the annual Medicare Advantage open enrollment period is another option

Medicare Advantage enrollees should verify that their doctors and hospitals still participate in their plan. Some major U.S. health systems have canceled or plan to cancel their contracts with Medicare Advantage, so it’s important to check your plan’s provider network every year. Calling the doctor’s office directly is the best way to ensure they are in-network. Canceling Medicare Advantage contracts can have serious consequences for both health systems and patients. Health systems may lose patients and revenue, while patients may lose access to trusted providers and face disruptions to their care. The reasons for terminating these contracts include low payments and administrative hassles. Medicare Advantage plans often require prior authorization for prescriptions and procedures, which can cause delays and rejections of care. Switching back to original Medicare is an option for those who want to avoid prior authorization requests and restrictions on providers. However, it’s important to note that switching to original Medicare may not guarantee the right to buy a Medigap supplement plan outside of the original eligibility period. Another opportunity to switch plans is during the annual Medicare Advantage open enrollment period. By doing the legwork now and verifying your plan’s provider network, you can avoid unpleasant surprises in the new year.

Factuality Level: 7
Factuality Justification: The article provides information about Medicare open enrollment and the importance of verifying doctors and hospitals in the plan. It also mentions examples of health systems canceling their contracts with Medicare Advantage. The information provided is relevant and accurate, without any obvious bias or misleading information. However, the article could have provided more details and specific sources to support the claims made.
Noise Level: 3
Noise Justification: The article provides relevant information about Medicare open enrollment and the importance of verifying doctors and hospitals in the plan. It also highlights the consequences of canceled contracts with Medicare Advantage. However, there is some repetitive information and the article does not provide a deep analysis or actionable insights.
Financial Relevance: No
Financial Markets Impacted: No
Presence Of Extreme Event: No
Nature Of Extreme Event: No
Impact Rating Of The Extreme Event: No
Rating Justification: The article does not pertain to financial topics and does not describe any extreme events.
Private Companies: Scripps Health
Key People: Tricia Neuman (Executive Director for Program on Medicare Policy at KFF)

Reported publicly: www.marketwatch.com