Some things to consider if you KNOW you are going to need orthopedic care in 2025.
1) Some Medicare Advantage plans typically require prior authorization and not only for which provider you can use, but for which types of treatment you can receive from said doctor.
2) Ask about approval periods. Certain services require prior approval which can delay care and cause logistical headaches.
3) You can only change your plan during the specific enrollment periods so if you are unhappy, don’t expect to make a change until next year. 4) Some Medicare Advantage plans offer additional services, such as physical therapy or wellness programs, which could be beneficial for orthopedic care.
5) Medicare Advantage may have lower premiums but can have higher copayments or deductibles for orthopedic services compared to traditional Medicare, which could result in higher overall costs for some patients.
Summary: In Dr. Gobezie’s experience, traditional Medicare generally offers more straightforward access to a broader range of specialists and treatments without referral requirements. But each person’s situation is different. You should carefully review options, considering your specific orthopedic needs, preferred providers, and financial situation. Speaking with an insurance specialist is certainly recommended.
Disclaimer: The views expressed and opinions belong to Dr. Gobezie. The opinions expressed here belong solely to Dr. Gobezie and do not reflect the views of Cleveland Orthopedic & Spine Institute