What No One Tells You About Medicare Coverage — Carol (Vol. 2)

The following is an excerpt from Phillip Moeller’s Get What’s Yours For Medicare: Maximize Your Coverage, Minimize Your Costs, out now on Simon & Schuster. This is the second of a three-part series on Medicare coverage.
The Medicare rules say that private Medicare Advantage insurance plans must cover at least the same things that Original Medicare (Parts A and B) covers. Many people naturally assume this means the two approaches to Medicare are the same.
Big mistake.

Phillip Moeller
(Photo courtesy of Simon & Schuster)

Carol’s husband, Ernesto, had a Medicare Advantage plan in Texas, when he was diagnosed in June 2014 with pancreatic cancer. Little more than six months later, Ernesto would be dead following complications from surgery. During this time, when Carol wanted to spend as much time as possible with her partner, she instead had to fight insurance company rules and respond to unexpected surprises about what his Medicare Advantage plan did not cover.
Even after she learned about some limitations, new ones kept cropping up.

Her problems stemmed from the fact that Medicare Advantage plans restrict coverage to those doctors, hospitals and other caregivers who are in the plan’s provider network. Original Medicare, by contrast, insures covered medical services from any provider who accepts Medicare. When Carol was forced to take over as the main caregiver for her husband, she didn’t know about these restrictions. Even after she learned about so...

Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - October 24, 2016 Category: Consumer Health News Authors: Health – CBS Boston Tags: CBS Small Business Pulse Guest Posts - National Health Only CBS Small Business – National Health Coverage Medicare Pulse Guest Contributors Retirement Source Type: news