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Evaluate Your Medicare Options While You Still Can


Blogs > Elder Care and Special Needs Law Blog

Enrollment in Medicare Advantage Plans continues to climb. These managed care plans, otherwise known as Medicare Part C, offer many advantages for healthier seniors. They have minimal co-pays and deductibles, and generally, cover services that traditional Medicare does not.

However, Medicare Advantage plans are run by private insurance companies and they have managed care plans, which means they restrict your choice of providers. This can be especially problematic when you need a specialist. We have also found that our clients who have Medicare Part C have quite limited choices when it comes to picking the rehab facility to go to after a hospitalization. In addition, our experience is that managed care plans tend to cut off rehab stays sooner than the provider would themselves. With Part C, the insurer decides, whereas, with traditional Medicare, the facility makes the initial decision when they think Medicare will no longer cover the patient. For this reason, we often recommend that our clients consider switching back to Medicare Parts A and B when they need long-term care.

Of course, that switch can be made only during certain periods. Open Enrollment has ended. However, this year there is an additional enrollment period that extends until the end of March. During this period, Medicare Advantage Plan participants can switch to another Medicare Advantage Plan, return to original Medicare, or join a Medicare Prescription Drug Plan. Many professionals can help you consider your options, given your specific health situation, for free.

Recently, the federal Centers for Medicare & Medicaid Services (CMS) has proposed changes to the Medicare Advantage program that would increase the number and scope of supplemental benefits available and would open up the option of tailoring benefit packages to patients with certain chronic conditions. At least for now, though, beneficiaries with serious health issues should seriously consider switching to traditional Medicare while they can.

If you have any questions about this post or any other related matters, please email me at ssiegel@norris-law.com.

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