Mar 22, 2015

Medicare Advantage plans: Is the doctor in? Or out?

Is the doctor in? Is the doctor out? When it comes to your Medicare Advantage Plan, it can be difficult to know for certain, because the "current" list of participating doctors may be out-of-date or incomplete. Doctors listed as being in a plan may have dropped the program, or relocated. Even providers who technically remain in the plan may not be accepting new patients, leaving you little choice among doctors.

If you sign up for a Medicare Advantage plan and find out subsequently that the doctors you thought were available are not, there's nothing you can do. You're stuck for the full year. Fortunately, that's going to change. Starting in 2016, the Centers for Medicare and Medicaid Services will require Medicare Advantage plans to contact their providers every three months and to update their online directories accordingly, in "real time." This will give consumers better data about the plans they are considering joining. It also will allow the federal government to better monitor whether an insurer has sufficient numbers of active providers to properly service its subscribers.

About 16 million Americans are currently enrolled in Medicare Advantage plans.

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