While both options offer a variety of benefits, there are several reasons why Original Medicare remains largely preferable. In this article, we will discuss three key reasons to choose Original Medicare.
3 Reasons Why You Should Choose Original Medicare
- Greater Flexibility in Provider Choice
One of the main reasons people opt for Original Medicare is the flexibility it offers in terms of provider choice.
With Original Medicare, beneficiaries can see any doctor or specialist who accepts Medicare patients, without the need for a referral. This means that individuals have the freedom to choose their preferred healthcare providers and can seek care from specialists across the country, as long as they accept Medicare.
On the other hand, Medicare Advantage plans often restrict beneficiaries to a specific network of providers. This can limit the options available for care and may make it difficult for individuals to see their preferred doctors or specialists.
Furthermore, if a beneficiary decides to see a provider outside of their plan’s network, they may face higher out-of-pocket costs or be required to obtain a referral from their primary care physician.
For those who value the ability to choose their own healthcare providers and access care from a wide range of specialists, Original Medicare can offer greater flexibility and choice than Medicare Advantage plans.
- Nationwide Coverage
Original Medicare offers consistent coverage across the United States, making it an ideal choice for individuals who travel frequently or have multiple residences in different states.
Since Medicare is a federal program, its coverage and benefits are uniform across the country, which means that beneficiaries can access care wherever they are without worrying about varying plan rules, restrictions, or costs.
In contrast, Medicare Advantage plans are offered by private insurance companies and their coverage may vary depending on the plan and location.
Some plans may have service areas limited to specific geographic regions, meaning that if a beneficiary moves or travels outside of their plan’s service area, they may not have coverage or may need to switch to a different plan.
This can be inconvenient for those who need consistent access to healthcare services, regardless of their location.
By choosing Original Medicare, beneficiaries can enjoy the peace of mind that comes with knowing their coverage remains consistent, no matter where they are in the United States.
- No Referrals or Pre-Authorizations Needed
Under Original Medicare, comprising Part A (hospital insurance) and Part B (medical insurance), there is no need for referral or pre-authorization thereby ensuring a convenient and seamless healthcare experience.
It should be noted that a referral is a recommendation from a primary care physician (PCP) for a patient to see a specialist or receive specific healthcare services.
In many health insurance plans, including some Medicare Advantage plans, a referral is required before a beneficiary can access specialized care or undergo certain tests and procedures.
Original Medicare, however, does not require beneficiaries to obtain a referral from their PCP before seeing a specialist.
This means that individuals enrolled in Original Medicare can directly schedule appointments with specialists or access specific healthcare services without needing approval from their PCP.
In the same vein, there is no need for pre-authorization or prior authorization. This is a process in which an insurance company must approve a specific medical service, test, or procedure before it is performed.
This process is designed to ensure that the requested service is medically necessary and covered by the insurance plan.
In contrast, Original Medicare does not require pre-authorization for most services. This means that beneficiaries can access medically necessary services without waiting for approval from their insurance provider.
More importantly, there are a few exceptions, such as durable medical equipment and specific outpatient procedures, where pre-authorization may be required.
In general, the vast majority of services covered under Original Medicare do not need prior authorization, making it more convenient for beneficiaries to access the care they need.
Enrolling in the right Medicare plan is fundamental to your healthcare experience and financial wellbeing.
While both Original Medicare and Medicare Advantage have their benefits, there are several compelling reasons to choose Original Medicare.
You can contact us directly via 1-877-855-3484, as well as get our free ebook on Medicare titled “Medicare Made CLEAR,” which contains up-to-date information on all areas of Medicare coverage.
Choose right! Stay healthy!