Does Medicare Advantage really provide an advantage?
If your Medicare Advantage Plan has denied or delayed care, if you find yourself out of network, if you aren’t happy with your choice for any reason, you have options.
Use this site to guide you through important information and speak with your doctor or provider so you get the Medicare coverage that is right for you.
“My hospital sponsors a Medicare Advantage plan that has some perks I like. My doctor said it may be a good choice for me.”
Original Medicare
(Administered by the U.S. Government Centers for Medicare and Medicaid Services)
Nearly all providers participate in Original Medicare. Prior authorization for services is rarely required and your doctor decides the care you need. Insurance brokers will not try to sell you Original Medicare.
Medicare Advantage Sponsored by Private Insurance Companies
Offers plans that vary widely regarding benefits, costs and has a “network” of doctors and hospitals that accept your particular plan. Insurance brokers sell these plans and advertise them widely. The plan requires preapproval requirements for many specialized services (i.e., advanced imaging, certain procedures). You can either choose Original Medicare or Medicare Advantage – not both.
Medicare Advantage Sponsored by Hospitals
The sponsoring hospital ensures you receive the care you need and reduces additional costs and coordination for that care. You can either choose Original Medicare or Medicare Advantage – not both.
Medicare vs Medicare Advantage
Did You Know?
Original Medicare allows you to visit any doctor or hospital in the U.S. that takes Medicare and typically makes it easier to access higher level, specialty care such as hospital care, skilled nursing or rehabilitation. Visit Medicare.gov for more info.
Hospital-sponsored Medicare Advantage plans typically have a more concentrated network focused primarily on the hospital’s providers and can potentially facilitate better communication and coordination between different specialists within the hospital system. Check out the Resources page for more information about Oklahoma Hospitals that sponsor Medicare Advantage plans
Private Insurance Company-sponsored Medicare Advantage plans cover only care inside their network and usually require prior authorization and referrals, even for some outpatient services. Medicare Advantage creates a network of providers, restricting which providers you can see in a non-emergency situation, and may deny specialty services such as rehabilitation and nursing home care based on plan requirements for authorization and approval.
Medicare Advantage Open Enrollment runs Jan. 1-March 31, 2025
If you are currently enrolled in Medicare Advantage, this is your opportunity to switch back to Original Medicare or enroll in a different advantage plan. Use this site to learn more about Medicare Advantage and Original Medicare.
Click here to learn more or visit Medicare.gov.