#Medicare #MedicareAdvantagePlans #MedicarePartC #HealthCareNetworks
The ads are relentless this time of year, trying to get those on Medicare to sign up for Advantage plans, the so-called Medicare Part C.
These plans can indeed, in many cases, offer more benefits and lower costs.
But, if you want absolute – or as close to absolute as possible – freedom of choice in where you get your care, stick with the Medicare Part A, B and D plans.
These Part C plans, in most cases, are tied to a network of practitioners. In other words, you have to go to someone in that network to get your care covered by your insurance. In many cases, practitioners outside the network will not take you as a patient.
As a patient, you may develop a rare or complicated disease, even if you are relatively healthy today. Sometimes, going to see a specialist that is far from where you live would give you the best chance at recovery or survival. Chances are, that specialist won’t be in the network with which your Part C plan is affiliated. That may preclude you from the best care you can get.
Also, some of the Part C plans also require referral from a gatekeeper, usually a primary care doctor in the network, to see a specialist within the network.
Then, with Part C, there is the risk that large medical providers within the network will have battles with the insurer over reimbursements. When the practitioners hold the insurer hostage, or vice versa, the patients suffer and may lose their health care providers – temporarily or permanently.
These Part C plans are the more profitable products for the health insurers. Those who sell them earn much higher commissions. And, as we all see, they spend a fortune in advertising that might be better spent on patient care. Reports indicate that these plans actually cost the government more than regular Medicare.
All this isn’t to say that everyone should stay away from a Part C. plan. If you are someone who doesn’t often go far from home, and the practitioners you like are in the network, it could work for you. Be advised, however, that in many of these plans, the practitioners can come and go at will, while patients are locked in for the year.
If you do shop your Medicare plans, it might be best to find someone who sells multiple plans and could give you more choices. However, if want the flexibility that Part C plans do not give you, don’t let someone talk you into settling for a Part C plan. As of today, Parts A, B and D are still an option.
Medicare has been a marvelous way for retirees to get health insurance, usually with no questions asked. If you opt for a Part C plan, and it doesn’t work for you after a time, going back to Medicare parts A, B and D may be difficult, more expensive and may not cover pre-existing conditions.
Some of the ads for Medicare Part C often are created to make older people look stubborn, angry and, well, uniformed. Not everyone is like that. Or, others have celebrities doing everything they can to get you to call a certain number to examine plans.
But, it boils down to a simple decision: do you want flexibility in deciding where to get your care? If it doesn’t matter to you, then shop around for the best price, most convenient practitioners or whatever you are looking for.
If you get sick or injured on vacation, the practitioners you need where you are may not be in your network. Make sure you know what will happen to you, financially, if that occurs.
The hard sell for these Part C plans not only turns people off, it should be unnecessary.
Peter
Tag Archives: freedom of choice
WHAT IS REAL CHOICE, OR FREEDOM?
#choice #freedom #FreedomofChoice #limitations #DiversityofThought
Whoever thought that the concept of choice would be so misunderstood?
Freedom is a second concept that seems misconstrued in today’s world.
Those combine for the misconception of the term Freedom of Choice.
Let’s start with choice. A person walks into a store, is confronted with an array of choices, decides and buys.
That simple concept has evolved into a case of having an array of choices in life, none of which is ideal. That means one has to decide on the lesser of evils. Some may feel that way as they, say, walk into a voting booth. Just because no choice is ideal doesn’t mean we should not make a choice. By all means, go to the polls and vote!
We have to evaluate in our minds which choice would be, for lack of a better term, less bad.
In terms of voting, sometimes one must use his or her vote to help prevent the worst of choices from getting elected.
In short, our lives revolve around choices. There may not be such things as the BEST choices, but, chances are, if the majority of one’s choices are BETTER, the better one’s life will turn out.
Freedom is another matter. Often, those who talk a lot about freedom do not want any of us to be free at all. THEY want to be free to make the rules, but they expect us to follow THEIR rules.
As a corollary, complete freedom for EVERY individual would lead to community chaos. Therefore, freedom has, and must have, its limits.
As an example, one may want to paint his or her house bright purple. But, neighbors will find it an eyesore, affecting their property value. Therefore, Mr. or Ms. purple house need some sort of approval to paint.
Most of what we do, and decisions we make, affect others. Therefore, we are not completely free to do as we wish, in many instances. So, we must agree on limitations and abide by those agreements. It’s called compromise, which has become a dirty word among a few.
If absolute freedom and best choices are not available to us in practical terms, what exactly is Freedom of Choice?
Does the concept really exist? How do we reconcile confining choice and limiting freedom into what most would see as a good life?
It involves being free to choose one’s limitations. It involves coexisting in a community in which there are diverse ideas of limiting freedom and choosing better.
To quote a Rolling Stones lyric, “You can’t always get what you want. But, if you try, sometimes you get what you need.”
We live in a world of diverse ideas of freedom and choice. That’s not something to be feared. It’s something to be embraced.
We actually might not only learn from each other, but also might draw from others’ belief systems ideas that will improve our own.
We may not be free to choose everything. But we should be grateful that we are allowed to experience diversity of thought, lifestyle and ideas. We can all be better for that privilege.
Peter