Your health care needs are a key factor in any Medicare decision, from your daily pill regimen to your preexisting conditions to your desire to keep a favorite doctor.
Many Americans have trusted doctors who have taken care of them for years, and they’d like to keep going to them once they are covered by Medicare. If that sounds like you, the first thing you might want to do before making any coverage decision is to ask your doctors if they accept Original Medicare and if they participate in any Medicare Advantage plans in your area.
According to the Kaiser Family Foundation, 93 percent of primary care physicians accept Original Medicare, so the odds are good that your current physician does. Under Original Medicare, you don’t need a referral to see a specialist, as long as the specialist accepts Medicare.
On the other hand, Medicare Advantage plans have specific networks of medical providers. Some plans let you go to a doctor outside the network, but generally you’ll pay more out of pocket to see those providers. Many Medicare Advantage plans require a referral from a primary doctor to see a specialist. The government’s Medicare Plan Finder can help you find Medicare Advantage plans in your area, and it also lists the doctors within each plan.
Your preexisting conditions
One of the great things about Medicare is that it covers existing medical conditions, regardless of whether you chose Original Medicare or Medicare Advantage.