Here are four things to know about Medicare Advantage networks.
1. The size, composition, communication and accuracy of Medicare Advantage plan networks poses a significant challenge for policyholders. Network directories posted on insurers’ websites often contain incorrect, confusing or outdated information, according to a recent study by the Henry J. Kaiser Family Foundation. The online indexes can also prove difficult to navigate, making finding appropriate, in-network providers difficult for older patients.
2. About 46 percent of primary care physician, oncologist, ophthalmologist or cardiologist listings on a Medicare Advantage website contained an inaccuracy, according to a report Henry J. Kaiser Family Foundation prepared for CMS in September.
3. Kaiser studied Medicare Advantage plans offered in 2015 to determine what percentage offered broad network plans. Kaiser defined a broad network as including at least 70 percent of the hospitals in a county. Out of 409 plans, about 23 percent had broad networks, 30 percent had medium-large networks, 31 percent had medium-small networks, 14 percent had narrow networks and 2 percent offered ultra-narrow networks.
4. A lack of network transparency and accessibility, inaccurate network directories and a limited number of broad networks can increase the chance of Medicare Advantage beneficiaries unknowingly or inadvertently choosing out-of-network care, resulting in costly and unanticipated bills.
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