Compare Medicare Provider Options
Provider choices are an important factor in the plan you choose. There are differences among each Medicare plan as to how much flexibility you have in choosing your providers. Typically, as flexibility increases, so does the cost of the plan. You may have to weigh those factors carefully to find the best provider for you.
Determine what health providers you want
Decide what's important to you by answering these questions:
- Do you currently have access to the doctors, specialists and hospitals you need?
- When you join a health plan, would you like to keep seeing your current doctor(s)?
- Does the plan you are interested in offer access to any Medicare-contracted doctor or hospital you choose?
- Is it important to you to be able to see a specialist without a referral?
- Are you more concerned with keeping costs to a minimum or with having a broader choice of providers?
Types of Medicare plan providers
Generally, you have three types of providers to consider when selecting plans.
- Network plans
These plans typically cost less than other plan types, but usually require you to receive care from the contracted doctors and hospitals within the network. Some plans do not require you to get a referral to see a specialist. Check the plan's physician directory to see if your doctor is included in the network.
- Network plans with flexibility
You can go to doctors and hospitals outside the plan network, but you usually pay more. Many plans let you go directly to a specialist without a referral.
- Non-network plans
You can go to any provider throughout the United States that accepts the plan's payment terms and conditions, so you can get care anywhere you travel. Plus, you don't need a referral to see a specialist.
Find out the rules about getting care for each plan you are considering. For network plans, be sure to ask for a list of the doctors and hospitals in each plan's network. Many plans list their provider networks on their website.
In all types of Medicare plans, if you have an emergency or need urgent care, you can go to the nearest doctor or hospital.
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