The annual enrollment window for eligible individuals to select a Medicare Advantage or Prescription Drug Plan began Oct. 15 and runs through Dec. 7. Whether you’re choosing a plan for yourself or a loved one, it’s important to take the time to assess your health needs and budget to ensure you choose a plan that’s right for you. To help you understand and evaluate your options, Vaishali Patel, Pennsylvania Medicare President, from Humana, has provided answers to the most common questions she receives about Medicare Advantage.
I’ve been hearing a lot about Medicare Advantage. What is it?
Medicare Advantage plans, managed by private insurance companies, provide health insurance for Medicare eligible individuals 65 and older or those who are eligible because of a qualifying disability. They help cover hospital bills and doctors’ visits, just like Original Medicare, but many also cover prescription drugs and often include extra benefits like routine dental, vision or hearing coverage. Medicare Advantage ensures your covered medical costs, including doctor visits and necessary emergency care, will never go above a maximum out-of-pocket amount, which you know beforehand.
If I already have a Medicare Advantage plan I like, do I need to do anything during open enrollment to keep my coverage?
If you are happy with your plan and it’s still available, you don’t have to do anything – it will continue into 2025. Keep in mind, though, that plan benefits and costs can change annually, so I always recommend reviewing the information you receive from your insurance carrier to be sure you get the coverage you want and that meets your needs. At Humana, we adjust our plans every year to ensure we’re offering affordable care and the benefits our members say matter most to them.
With Medicare Advantage, am I limited to the carrier’s network of providers if I want to avoid out-of-network charges?
This varies, as each type of Medicare Advantage plan has different network rules. Some have limited networks and require referrals to see a specialist, while others allow you to see out-of-network providers with no referrals for specialists. I recommend checking to see if your preferred doctors are part of the network and understanding costs for both in-network and out-of-network providers to be sure you select a plan that fits both your budget and lifestyle.
I love to travel. If I travel out of state, will I be covered through Medicare Advantage?
There is sometimes a misconception that you can’t travel with Medicare Advantage. If travel is a priority for you, then that’s something you need to look at when comparing plans. The type of plan and your carrier’s network will determine your coverage when you leave home. At Humana, we’ve designed some Medicare Advantage plans for people who travel and want the convenience of seeking care no matter where they are. With these PPO plans, you can visit any in-network doctor who agrees to treat you coast to coast, and it will cost the same as when you’re at home.
Taking the time now to assess your plan can help you avoid any headaches in the long run. Review your options by Dec. 7 to be sure you have the plan that is right for you. To learn more about Medicare eligibility and how it works, visit Humana.com/MedicareBasics. If you have additional questions or need assistance selecting a plan, you can reach out to a licensed insurance agent. Your health and peace of mind are worth the time spent making informed decisions.
Vaishali Patel leads Humana’s Medicare operations for 11 states in the Northeast region, including Pennsylvania.
Disclaimer: Humana is a Medicare Advantage HMO and PPO organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Y0040_GCHMGV5EN_M