Why Does Medicare Supplemental Have a Limited Network?
How can my supplemental insurance (Empire Plan Blue Cross/Blue Shield) only cover me in certain states? I have Medicare and this supplemental. Medicare is wonderful insurance, but can’t say the same about my supplemental. We have to travel to FL, AZ or any of the few states where they offer participating physicians. I pay the same as everyone else, but I can’t use my supplemental insurance. Can they do this under the ACA?
Answer
Medicare is a public Government run health plan, Advantage and other supplemental is run by private insurers. Given this your coverage is only as good as your insurer and the network they offer. Sometimes an HMO will have a limited range of coverage. The good thing about supplemental is you can swap it out for another plan during one the corresponding enrollment periods.
There is no regulation against private insurers offering limited networks on supplemental coverage beyond it being necessary for essential care to be within a certain distance. We will research this more, if you want more Medicare information CMS.gov has it all right here.
Rate and Comment on the Answer
This site uses Akismet to reduce spam. Learn how your comment data is processed.
Answer Rating:
Thank you. I will definitely check out the coverage during the swap period.