Know the Risks Before Choosing a Medicare Advantage Plan

Open enrollment for Medicare patients is upon us. It is important for those eligible community members to examine their coverage plans before the December 7 deadline. The choice is what is commonly referred to as “traditional” Medicare and Medicare Advantage. While the name may imply a perceived added benefit, it is important to note that Medicare Advantage comes with risks, and may not always be the better choice for patients or their healthcare providers.

When Medicare Advantage is chosen, patients give up their traditional Medicare benefits for an option that is increasingly denying many patient claims. We continue to see patients that are not able to receive timely care due to the obstacles with the Medicare Advantage plan. We have experienced delays or denials for admission to care facilities (nursing homes, rehabilitation centers, etc.). Many of our physicians have noted delays in prior authorizations for care as well.

• Advantage plans could result in delay in care to nursing homes
• Advantage plans could result in delay in care for testing
• Advantage plans could deny your claims to providers
• Advantage plans may not be in your local area
• Advantage plans could change your formulary for your medications

There is another solution, and it is not the “Advantage” you see advertised. Choosing traditional Medicare over Medicare Advantage can lead to better outcomes for patients and healthcare providers. Consumer Reports' analysis of Medicare options says more people in rural areas are changing and electing to turn back to traditional Medicare because of the issues highlighted.

While many factors may influence your plan choice, please consider the impact on your access to healthcare and on local community healthcare organizations when making your decision. Evaluating coverage each year can be difficult and time-consuming for patients and their family. Resources for comparing plans are available through the Ohio Department of Insurance at insurance.ohio.gov/medicare.

The open enrollment period is also a great time to select a primary care provider or make a specialty appointment. You can call 855-446-5937 or visit Insurances Accepted on holzer.org to learn about plans accepted. We are working hard to bring you the care you need, and to ensure your care is covered by your Medicare plan.

Source: Origin of article credits to Myron Lewis, CEO, Blanchard Valley Health System as it appeared in the Courier: Know Medicare Advantage risks before picking a plan | The Courier Myron Lewis guest column: Nov. 14.