If you’ve had private health insurance, you’ve probably had to get referrals before seeing certain doctors. These referrals are pre-approvals that you need to get from your primary care physician before seeing a specialist within the same network; we often associate them with certain types of private insurance plans. But now that you’re on Medicare, or are about to enroll, you might be wondering: do you need referrals to see specialists if you’re on Medicare?
Are Referrals Necessary?
The good news is that Original Medicare (Parts A and B) doesn’t require referrals for specialist care. However, if you have Part A or Part B coverage through a Medicare Advantage (Part C) Plan, you might need a referral before seeing a specialist.
In addition, if you have a Medicare Supplement Plan, you will not need a referral to see a specialist: you will be able to go to any doctor, hospital, or other provider in the country who accepts Medicare. This means that Medicare Supplement Plans offer some of the best coverage out there: all you have to pay is your monthly premium and you get all the benefits of Original Medicare, plus a lot of extras. For example, your plan will cover what Original Medicare does not, including the 20% coinsurance that you need to pay when you receive medical treatment.
In addition to the ability to see a specialist without a referral, all Medicare Supplement Plans also offer coverage for at least part of:
Medicare Parts A and B deductibles
Skilled nursing facility costs (after you run out of Medicare-covered days)
Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)
Medicare Part B coinsurance or copayment
Part B excess charges
Part A hospice care coinsurance or copayment
Blood (first 3 pints)
Two Medicare Supplement Plans (Plans K and L) include an out-of-pocket limit. This means that once you have reached a certain amount spent on Medicare-covered services, the plan will cover 100% of Medicare-covered costs for the rest of the year.
As stated, Medicare Part B, which covers the costs of most medical services, only covers 80% of these costs. This will leave you with the remaining 20% to pay out-of-pocket, but a Medicare Supplement Plan can help you pay for the medical expenses that aren’t covered by Medicare Part B. One of these plans can help you save hundreds, or maybe even thousands of dollars each year.
There are 10 different plans to choose from, and depending on which plan you choose, you could get anywhere from 75% coverage of your medical expenses up to 100%. Each plan offers a range of coverage at different price points, and can help save you money and keep you from stressing over medical bills, leaving you with more time and energy to focus on your health.
EZ can compare all 10 Medicare Supplement Plans and find the one that will meet your financial and medical needs. Our agents work with the top-rated insurance companies in the nation, which makes comparing plans easy, quick, and free – our services come at no cost to you because we just want to help you save money so you can focus on your health. To get free instant quotes on plans that cover your doctors, simply enter your zip code in the bar above, or to speak to a local licensed agent, call 888-753-7207.
