I’m shopping around for a new Medicare Advantage plan and am having a tough time finding one with all my doctors in-network. In your book, you refer to this as one of Medicare’s Frustrating Flaws. Is there an easier way of finding which Medicare insurance companies have my doctors in their Medicare Advantage network?
Thanks for the question and of course, for buying my book!
The Medicare Website is Great for Enrollment
If you’re planning to buy a new Medicare Part D Prescription Drug Plan (PDP) on Medicare.gov, it’s the most accessible DIY enrollment tool. Overall, entering your ZIP code, adding your prescriptions, and searching for preferred pharmacies is pretty straightforward on Medicare.gov. If a stand-alone Medicare PDP is all you’re shopping for, the Medicare website is more convenient than a Medicare insurance agent or Medicare insurance company website. Medicare lets you enter your prescriptions into their Plan Finder tool, and you can add up to five of your preferred pharmacies. They even have a convenient map tool you can use. If you want to find a pharmacy, you would do this as the last step in the shopping process. I cover that entire process in chapter nine of my book.
Medicare.gov Isn’t Great for Finding Your Doctors
If you’re trying to look up doctors and hospitals for Medicare Advantage plans on Medicare.gov, it is frustrating! That’s because you can’t do it. Medicare.gov doesn’t allow you to search for Medicare Advantage Providers. I call this a “Frustrating Flaw” in my book, and in my opinion, it’s a massive gap in the usability of the entire shopping experience on Medicare.gov.
And, if you’re looking at Medicare Advantage plans on Medicare.gov, you cannot look up any providers. It’s not like looking up pharmacies. You have zero ability to enter your doctors and preferred hospitals on Medicare.gov and then sort by those doctors to find the Medicare Advantage plan that covers them all. This is a huge miss and a major flaw of the Medicare.gov website.
How To Find Your Medicare Healthcare Providers
One of the free checklists I offer as a thank-you for signing up for the Prepare for Medicare newsletter is the Buying a Medicare Advantage checklist. The first thing I recommend checking is that your doctors and preferred hospital are in the insurance company’s provider network. You should do this even if you’ve seen your healthcare professional recently, especially for doctors you don’t often see. It’s best to call their offices to double-check.
Doctors and hospitals enter and leave Medicare Advantage plan networks, especially at the end of the year. Suppose your preferred doctors, hospitals, outpatient facilities, or other healthcare providers aren’t in the Medicare Advantage plan network or are considering buying. My advice is to find a plan that has all of them in the network. It will take some work, but it will be worth it.
To look up Medicare Advantage providers, you have essentially three options. The first is to narrow down your preferred Medicare Advantage plans on Medicare.gov, then research network providers on the Medicare insurance company websites. The second step you can take is to call your doctor’s office and ask for a list of Medicare Advantage insurance companies. Be specific; confirm they’re in the Medicare Advantage network, not just in a network for other types of insurance plans from the same company. If those two options aren’t what you’re looking for, you can call an online Hybrid insurance agency or use a local Medicare insurance agent for help. If you choose this option, the checklists on my website PrepareforMedicare.com will come in handy and save you some time.
You can also find a shortlist of major Medicare insurance companies and Hybrid online insurance agencies in the Helpful Links section of the Prepare for Medicare website!
Christine, I hope this helped!
I love answering Medicare questions. Send me yours at firstname.lastname@example.org and I’ll pick a few for a future video or blog post!
Until next time – To your wealth, wisdom and wellness!
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Author Bio Matt Feret is the author of the Prepare for Medicare book series and launched prepareformedicare.com to help people get objective answers to questions about Medicare. Matt is also the host of The Matt Feret Show. He has held leadership roles at numerous Fortune 500 Medicare health insurers in sales, marketing, operations, product development, and strategy for over two decades.