I Have Cancer – Does Original Medicare Have a Network of Specialists?
Medicare expert, Toni King explains how to find doctors and medical facilities when you’re enrolled in Original Medicare – it’s easier than you may think!
Hi Toni,
Turning 65 this October and have no idea what I should I should do because I have lung cancer. Currently, I am on a COBRA policy from my old employer, with all my medical bills paid, since I have met my deductible.
Advertisement.I receive my care from MD Anderson and am currently receiving chemotherapy. My radiation treatments start in November.
Do I enroll in Original Medicare’s Network with a Medicare supplement, go with a Medicare Advantage Network plan, or stay with my current COBRA plan until it ends in about 15 months? If you could help me sort through this, I would appreciate it.
Jeremy, from Spring TX
Hello Jeremy,
I have great news for you because there is NO network of hospitals, doctors, or medical providers for Original/Traditional Medicare.
I repeat – NO NETWORK with Original Medicare!
Your medical provider must be willing to bill Medicare. There are medical facilities, doctors, and providers available nationwide. This means, that if you are traveling throughout the US and need medical care, you are covered.
Recently, I had a phone call from a frantic daughter, trying to help her father who had been diagnosed with pancreatic cancer. He had chosen a Medicare Advantage HMO when he turned 65. Now her father must wait until Medicare’s annual enrollment in the fall to make a change back to Original Medicare because MD Anderson is not in that Medicare Advantage plan’s network.
Her father is locked into his Medicare Advantage plan and must wait until October 15th –December 7th to make any changes back to Original Medicare for the following year.
Not you, Jeremy – because you are turning 65 in October, there is a special enrollment time called Medicare Supplement/Medigap Open Enrollment period.
As I have said before, this is the best time for someone to purchase a Medicare Supplement, because the open enrollment period lasts for 6 months, beginning the first day of the month in which you are 65 – or you are older and have just enrolled in Part B for the first time.
Enrolling in Medicare Part B for the first time is the key, because during this open enrollment period you may enroll in a Medicare Supplement and not have to answer ONE health question to be approved by any Medicare Supplement.
Related: I Have Cancer and I’m on Medicaid – Should I Apply for Social Security Disability?
Jeremy, if you decide not to keep your COBRA plan and apply for a Medicare Supplement, you do not have to worry about your medical care being taken care of. After the 6-month window has passed, however, then you would have to submit a complete underwritten application for a Medicare Supplement.
I have been advised by healthcare professionals that some of the newest healthcare and cancer procedures are not readily approved by Medicare Advantage plans. They must fight every day to get the care they desperately need when they have a Medicare Advantage plan. These types of procedures are approved with Original/Traditional Medicare as well as clinical trial prescription drugs that can be costly.
Toni Says: Talk to a medical professional who knows your health situation when you are trying to make your Medicare plan choice.
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Originally published August 26, 2022
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