Does Original Medicare Have a Network?
Hi Toni,
I am turning 65 this August and I have no idea what I should do. I have coronary heart disease. I am currently on a COBRA policy from my former employer. Right now, all of my medical bills are being paid because I have met my deductible. Well, now I’m concerned about how I should handle Medicare enrollment because my heart specialist says that one of my options to improve my health is having a transplant. Should I enroll in Original Medicare and get a supplement, enroll in an advantage plan, or stay with my COBRA plan until it ends?
Jeremy, from Tulsa, OK
Hello Jeremy,
I have great news for you and the Toni Says® readers because there is NO network of hospitals, doctors, or any medical provider for Original Medicare.
I repeat…NO NETWORK!
Not having to worry about finding a network provider or facility is hard to understand for those leaving employer benefits.
Your medical provider must be willing to bill Medicare. How easy is that? There are medical facilities, doctors, and providers available nationwide. This means if you are traveling throughout the US and need medical care you are covered.
Read Next: Medicare Now Covers Shingles Vaccines at NO COST!
Recently, I had a phone call from a frantic daughter, who was trying to help her father who had been diagnosed with pancreatic cancer and he had chosen a Medicare Advantage HMO when he turned 65. Now her father must wait until Medicare’s Annual Enrollment Period in the fall to make a change back to Original Medicare because the cancer facility he is using is not in that Advantage plan’s HMO network.
Her father is locked in to his 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 August, there is an 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 Medicare Supplement/Medigap open enrollment period lasts for a 6-month period beginning the first day of the month in which you are 65 or older and have just enrolled in Medicare Part B for the first time.
During this Medicare open enrollment period, you may enroll in a Medicare Supplement and not have to answer “ONE” health question to be accepted by a Medicare Supplement insurance plan. If you decide to not keep your COBRA plan and enroll in a Medicare Supplement, you do not have to worry about your medical care being taken care of because you are in your 6-month Medicare Supplement/Medigap Open Enrollment Period.
You should be aware that after the 6-month window, you will have to submit a completed underwritten application answering health questions for a Medicare Supplement to be approved.
I have been advised by healthcare professionals that some of the newest healthcare procedures are not readily approved by Medicare Advantage plans. These procedures are generally approved with Original Medicare as well as clinical trial prescription drugs that can be rather costly.
Jeremy, talk to your medical professional who knows your health situation when you are trying to make your Medicare plan choice. For information about specific Medicare options, email info@tonisays.com or call 832-519-8664 to have your Medicare questions answered.
Medicare Survival Guide Advanced Edition
Order Medicare Survival Guide Advanced
What You Don’t Know Will Hurt You!
Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.
In Toni King’s Medicare Survival Guide Advanced: Basics and Beyond, Toni gives you the critical steps you need to enroll in Medicare properly. Toni shares various situations that she has experienced with her many clients during Medicare consultations, and gives you the information and tools you need to enroll on time to avoid the “famous” Medicare Part B and D penalties.
Medicare Survival Guide Advanced helps you understand Medicare step by step…
Learn How to Enroll the Correct Way
• Still Working Past 65
• Turning 65
• VA Benefits
• Laid-off or Retiring
What Medicare Option Is Best for You
• Medicare Supplement vs. Advantage
• Losing Retirement Benefits
How to Avoid
• The Donut Hole
• Part B Penalties
• Part D IRMAA Penalties
If you are enrolling in Medicare and are confused by the commercials and telemarketers, or from the information that well-meaning friends or family members give, let Toni guide you through the maze of Medicare. Order TODAY!
What You Need To Know About Medicare Lifetime Reserve Days
What to Do About Medicare and Social Security When You Move
Leaving Employer’s Benefits Past 65 is Puzzling!
Recommended Vaccines for Seniors Over 65
When Does Medicare Coverage Start?
Isn’t Medicare Part A Free?
Popular Articles About Medicare
Originally published March 29, 2023
Author(s):
