What Medicare’s provider network looks like

Recently retired Kelli asks Toni Says about moving from employer coverage to Medicare while managing health problems.

Dear Toni: I retired at 70, and my Medicare Part B starts soon. I will no longer have employer health insurance, although COBRA is one option available to me. Because of my health issues, I chose to retire. My cardiologist told me last week that the only thing that will improve my condition is heart surgery.

I want to understand what Medicare’s health network is so I can be sure all of my doctors are included. I’m uncertain about which Medicare option to choose, and I cannot afford to lose my cardiologist.

Should I sign up for Medicare with a supplement, select a Medicare Advantage plan, or remain on my current COBRA coverage until it expires in about 18 months? — Kellie, Dallas

Dear Kellie: Since you are retired and will have Medicare coverage starting soon, I have good news: original Medicare does not use a network of hospitals, doctors, or other providers. You remain in control of your Medicare decisions.

You do not need to worry about finding in-network providers because almost all doctors accept Medicare, and the program is available nationwide. Your Medicare coverage is about to begin, and because you are entering the Medigap open enrollment period, your health conditions should not be a barrier. For the next six months, you can buy a Medicare supplement policy without answering underwriting questions.

This is the ideal time to purchase a Medicare supplement. The six-month window begins on the first day of the month in which you first enroll in Medicare Part B, which applies in your case after retiring at 70.

My advice is not to enroll in COBRA, because once you have been in Medicare for six months, you will be outside the supplement open enrollment period and would then have to answer health questions.

If you later want to move from original Medicare with a supplement to a Medicare Advantage plan, the annual Oct. 15-Dec. 7 open enrollment period is the time to make that change.

Toni King writes about Medicare and health insurance issues. If you have a question, email [email protected] or call 832-519-8664.