What are the risk factors in Medicare Advantage plans?

What are the risk factors in Medicare Advantage plans?

Services can import more:

Henry J. Kaiser Family Foundation has found that size generally refers to the services offered, which can be important if you have a rare or complicated condition

While some of the narrow network plans have received good ratings from the Medicare and Medicaid Services Centers for customer care and preventing care, narrow network tends to exclude various hospitals which are specialized in treating various complicated conditions.

More specifically, according to Kaiser, 75% of the narrow networks expelled National Cancer Institute Centers, 49% barred academic medical centers, In addition, 21% did not contain hospitals with accredited cancer programs.

Costs may escalate:

What this all means, if you sign up for a Medicare Advantage plans whose network hospital does not address your condition, you need to go “off the net” at a great personal expense or, even worse, avoid treatment for yourself. That’s why knowing as much as possible about your Medicare Advantage plan, including the size and services offered by the hospital network, is so important to your physical and financial health. If you will go for Medicare Supplement Plans, you will be covered under many different types of medical illnesses.

Improvements needed:

According to Kaiser, CMS needs to review provider directors more often than now, detect and correct errors and omissions. Also, Kaiser believes that CMS have to review requirements of Medicare Advantage and redeem them as needed. Other suggestion includes making it easier for consumers to compare Medicare Advantage plans by requiring all plans to follow a uniform format and to develop a uniform “plan size” network comparison tool.In turn, the CMS says improvements are already underway. In 2017, for example, plans to expand will have to submit the entire network for review by CMS.

It’s in you:

In the meantime, when estimating Medicare Advantage plans, it is necessary that you should ask questions when something are unclear. For example, ask how often the plan you are considering refers to out-of-network patients for care. For additional help, contact the State Health Insurance Assistance Program (SHIPS) for your state. You can perform a Google search or use this helpful guide.

The bottom line:

Medicare Advantage plans can be cost-effective while providing the care you need. If you consider this plan, be sure to do your homework and be aware of CMS changes that will make it easier to compare Medicare Advantage plans. Finally, it is worth noting that if you find your Medicare Plan advantageous to be inappropriate, you can switch to Medicare Supplement Plans.