I don’t need to tell you Medicare’s open enrollment period is happening now through December 7. The airwaves are just lousy with Medicare Advantage commercials, and no one escapes the pitches of charming celebrities and insurance marketers.

It is less obvious to beneficiaries that these campaigns are designed to sell Medicare Advantage Plans, not necessarily inform or educate. That, of course, falls to providers and suppliers like you, faithful reader. I know savvy suppliers will accept that reality, and I want to arm you with two education points that are critically important, but easy to overlook.

Next Episode: Thursday, June 20, 2024

Medicare Advantage Plan Types Matter

To wow patients with supplemental benefits, lower costs, and other perks, marketers often direct prospective beneficiaries to HMO plans over PPO plans. All HMOs operate closed networks that may or may not include beneficiaries’ existing doctors and suppliers. Patients may make decisions about plans based on what marketers tell them, but that is not always reliable intel.

Case in point.

Several of my family and friends – including my own mother – have asked insurance marketers to verify their existing doctors and suppliers were covered under a hyped plan. The explicit – if inaccurate – answer was “Yes, your doctor is in network.” In my mom’s case, the proposed plan was an HMO based in Louisiana … and none of her rural South Carolina healthcare providers were in network.

It is critical that beneficiaries verify participating healthcare practitioners for themselves before enrolling in a new plan. You can help your patients by proactively publishing the insurance plans your company accepts. There may be a lower cost plan with more benefits that better suits your patient. Help them look for it by starting from a list of the ones you do business with.

Changing Insurance is More Difficult Than Signing Up for a New Plan

The marketer and new insurance company are satisfied when patients sign up for their plans. They may be more than willing to leave the prickly details to someone else, and it may fall to you to explain that changing insurance may require a:

  1. New office visit with the physician, even if the existing physician is in network with the new plan.
  2. Restart of rental benefits, including deductibles and co-payments.
  3. Supplier or doctor change.

By educating your current patients now, even as they are inundated with Joe Namath commercials, you can help them make good decisions based on all the facts. I bet that is exactly what they have already come to expect from working with you.