Tag: Humana Medicare Advantage

Finding Medicare Advantage Providers for 2027 Is Easier but Not Flawless

RETIRING        The government has made improvements to the Medicare Plan Finder, a key online tool, in time for open enrollment. It helps seniors compare policies to avoid costly surprises.

Finding the best private Medicare Advantage plan that meets multiple medical needs at the right price and includes trusted doctors and hospitals can be like winning at bingo.

To make it easier to sort through dozens of Advantage plans, the Centers for Medicare & Medicaid Services has upgraded its indispensable Medicare Plan Finder website.

For the first time, beneficiaries and those who help them can type in the name of any licensed health care provider — not just doctors, which was the case last year — and find which Advantage plans they accept.

Medicare Advantage is a private alternative to the government-run traditional Medicare program that offers extra benefits the federal program doesn’t. It also has a cap on out-of-pocket expenses. But it usually requires members to use health care professionals in a plan’s network. Doctors and hospitals can leave the network plan any time, while Advantage members cannot (with rare exceptions). [Continued The New York Times.]

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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage

Bart Klion (Hans Pennink for KFF Health News)

Bart Klion, 95, and his wife, Barbara, faced a tough choice in January: The upstate New York couple learned that this year they could keep either their private, Medicare Advantage insurance plan — or their doctors at Saratoga Hospital.

The Albany Medical Center system, which includes their hospital, is leaving the Klions’ Humana plan — or, depending on which side is talking, the other way around. The breakup threatened to cut the couple’s lifeline to cope with serious chronic health conditions.

Klion refused to pick the lesser of two bad options without a fight.

..With rare exceptions, Advantage members are locked into their plans for the rest of the year — while health providers may leave at any time. …But a few years ago, CMS created an escape hatch by expanding special enrollment periods, or SEPs, which allow for “exceptional circumstances.” Beneficiaries who qualify can request SEPs to change plans or return to original Medicare. [Continued on KFF Health News]…