Once you turn 65 and that thick guide to Medicare lands in your mailbox, you know you're entering a whole new world of healthcare choices. When Medicare open enrollment happens, it's time to think about the coverage you need and where you will obtain healthcare for the coming year.
The federal government website has many resources to assist you, especially if you're new to Medicare. This includes the "Physician Compare" guide for help in finding a doctor in your area. Spend some time to learn about your options, says Dr. Sonia Sehgal, UCI Health geriatrician.
"There are multiple Medicare options and plans: Medicare HMO plans, PPO plans. Seniors need to carefully weigh the benefits and downsides of each," she says. "It can be very complicated."
How to consider costs
Cost, of course, is a significant consideration.
How much money are you willing to spend to expand your options and coverage? One thing that seniors may not think about is the services that are typically not covered by Medicare, Sehgal says. For example, certain Medicare plans don't cover healthcare needs if you're traveling outside of the United States.
"Other special considerations would be whether you need hearing aids, dental care or vision care," she says. "Typically, Medicare doesn't cover those things. But there are some plans that will help offset the cost of those services."
Choosing a physician
Selecting a physician is as important as picking a plan.
If you already have doctors you like, make sure they accept the Medicare coverage you're choosing. If you're choosing a new physician, is that person accepting new patients?
It's smart to select a primary care physician who can connect you to high-quality specialist or hospital care, Sehgal says. Patients who see UCI Health geriatricians or primary care physicians, for example, have access to the large and highly regarded group of UCI Health specialists.
The network also connects them to UC Irvine Medical Center, where they will have access to the latest diagnostic capabilities and treatments, if needed.
"Depending on what primary doctor you choose, that might limit your choice of where you can be hospitalized," she says. "If you have a very special health need that requires a certain kind of specialty care, you want to make sure that discipline is covered by your insurance."
Seeing a geriatrician
At UCI Health, seniors can select a geriatrician as their primary care provider. What will happen during your visit?
"The Senior Health Center is one of Orange County's only such clinics," Sehgal says. "It provides comprehensive and specialty care for older adults. Our focus is on preserving quality of life and function."
She recommends "younger" seniors choose a geriatrician and stay with that doctor "so we can help them age."
Patients who choose a primary care physician in the UCI Health network will enter a coordinated system and can be assured that the primary care physician will oversee all of their care, she adds.
"Our primary care physicians talk to the specialists. We talk to the radiologists," she says. "We have a coordinated and deliberate way of ensuring comprehensive care for our patients to maintain their dignity and wishes."
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