With original Medicare, there’s no network to worry about

Dear Toni: In September I turn 65, and I am unemployed. I have been on COBRA since retiring in May after I had a heart attack, and I don’t know what to do about enrolling in Medicare. The cardiologist informed me last week that the only thing that will improve my health is having heart surgery.

What health network does Medicare use? I’m confused about which Medicare option to enroll in because I cannot lose my cardiologist. Should I enroll in Medicare’s network with a supplement, go with a Medicare Advantage plan HMO or PPO, or stay with my current COBRA plan until it ends in about 15 months? — Kenneth, Tulsa, Oklahoma

Dear Kenneth: The good news is, original Medicare has no network of hospitals, doctors or providers.

Medical facilities, doctors and providers who accept Medicare are available nationwide. When you are traveling throughout the U.S. and need medical care, you are covered.

You asked about enrolling in a Medicare Advantage plan. I recently got a frantic phone call from a woman who was trying to help her father, who had been diagnosed with pancreatic cancer.

He had chosen a Medicare Advantage HMO when he turned 65. But the cancer facility he is using is not in his plan’s network. Now he must wait until Medicare’s annual enrollment period (Oct. 15-Dec. 7) to change back to original Medicare. Additionally, to qualify for a Medicare supplement, he must answer underwriting questions. This will not be an easy process, and he can be turned down.

It won’t be hard for you, Kenneth, since you are turning 65 in September, when your Medicare open enrollment period begins.

The best time to purchase a Medicare supplement is during the Medigap open enrollment period the first month you are 65 or older and enrolled in Medicare Part B.

During this special period, you may enroll in a Medicare supplement without having to answer even one health question.

After that six-month window, you would have to submit an underwritten application answering health questions for a Medicare supplement to be approved.

When trying to decide which Medicare plan is best for you, either original Medicare with a supplement or Medicare Advantage plan, always discuss your choices with a medical professional who knows your specific health situation.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.