Provider Networks and Travel

As we review coverage considerations for your clients, we need to add another piece to the puzzle — providers.

Providers are the doctors, hospitals, and other health care facilities that provide care to patients.

Since certain plans have more limited access to providers within their network, providers are also an important consideration when assessing a plan.

So, what should you be looking for as you review this topic with your clients?

First, you may want to identify what their access to providers looks like.

Does your client live in a more rural location with only one doctor in town?

Or do they live in a provider-rich suburban area with three hospitals within 30 minutes?

For those with more limited access, they might opt for something like a Medicare Supplement, where they won’t have further limitations on providers they’d like to use.

Similarly, those who travel often, whether they are snowbirds or just have family out of state, might find plans with provider flexibility to be a better fit so they have ample access to care, no matter where they are in the U.S.

The second consideration — does your client have preferred providers?

Do they have a doctor they’ve seen for 15 years and have a strong relationship?

Is there a hospital they want to have access to?

As you focus on their preferred providers, you may be able to find many Medicare Advantage plans that include their preferred providers in-network.

Generally, Medicare Supplement offers broad provider access and Medicare Advantage plans work with a network and may have more limited access.

However, keep in mind the different options available.

For example, preferred provider organizations (PPOs) and Medicare Medical Savings Accounts both offer a higher degree of network flexibility, even though they are Medicare Advantage plans.

Let’s add another piece to the puzzle and look at your client’s other coverage in the next lesson.

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