How to Get Needed Care With Your Medicare Advantage Plan
Getting in to see a doctor should be easy. But the healthcare system can be challenging to navigate. Have you ever wondered whether you should call your doctor or go to urgent care? Or wished you had your own personal nurse on speed dial?
When you’re in need of care, you may not think to turn to your Medicare Advantage plan. However, it can be a good resource. Some plans include benefits that help you get services, support and answers—when you need them most.
What Is Needed Care?
The term “needed care” refers to the routine and urgent medical services you need to protect your health. It includes annual wellness checkups and preventive screenings, as well as sick visits, tests and treatments.
In addition to the type of care you need, you’ll need to consider the timing to receive those services.
How Long Should You Wait for a Doctor Appointment?
For a routine physical or wellness visit, it’s typical for offices to schedule appointments up to six weeks out. At certain times, especially around the first of the year, you may have to wait longer. That’s why it’s always a good idea to book your appointments early.
On the other hand, if you’re feeling ill or something is “giving you trouble,” you’ll need to be seen sooner.
What Should You Do If You Need Immediate Care?
When it comes to immediate care, you have a few options:
- Your doctor’s office: Medical offices set aside appointment times for sick visits. Make sure you’re specific when you call so the staff knows how soon to work you into the schedule.
- An urgent care center: If your doctor’s office schedule is full or you need care after hours, urgent care is your best bet. (Note: In a medical emergency, call 911 or go to your nearest emergency room.)
How Medicare Advantage Plans Can Help You Get Needed Care
Compared to Original Medicare, Medicare Advantage (Part C) plans often provide extra benefits. When comparing your options, look for those that help smooth your path to care, such as:
Coverage for Urgent Care Visits
All Medicare Advantage plans must cover urgent care visits. But the out-of-pocket costs to use those services vary widely. Many SCAN Medicare Advantage plans have no copays for urgent care services.
Also, consider which urgent care center you should go to. Your doctor’s office works with certain centers. It’s best to use these centers whenever possible for better coverage and easy access to medical records. Ask your doctor which ones they work with before you get sick, that way you’ll be one step ahead.
Nurse Lines
Nurse lines are great when you need advice quickly. Maybe you want to know the side effects of a new medication or have a cough that won’t go away. A nurse line can answer your questions and guide your next steps.
Not all medical groups offer an after-hours medical advice line. That’s where your Medicare Advantage plan can provide extra support. For example, SCAN’s Nurse Advice Line lets you speak with a registered nurse 24 hours a day—at no charge.
24/7 Telehealth
Telehealth visits are convenient. But just like in-person appointments, they’re not always available or offered after hours.
Your Medicare Advantage plan may provide more flexible telehealth options. For example, 24/7 telehealth means you can speak to a doctor or nurse practitioner whenever urgent issues come up. For many people, it’s a better option than going to an urgent care location.
Depending on how comfortable you are with technology, you may want to have a phone visit rather than a video visit. SCAN’s telehealth benefit lets you speak to a doctor or nurse practitioner using the option that works best for you.
Behavioral Telehealth
Telehealth benefits may also include mental healthcare. Many people depend on these services to cope with anxiety, depression, stress and other issues. Look for a plan that meets your needs, whether that’s care from a psychiatrist, psychologist or therapist. SCAN’s behavioral telehealth benefit covers all these options.
Behavioral telehealth differs from medical telehealth because it requires a video visit. Behavioral health providers offer the best care when they can connect with you face-to-face.
Online Tools
Your Medicare Advantage plan may also offer other tools to help you get needed care. For example, SCAN provides a checklist called a Health Check Record in each member’s online account. This document helps you stay up to date with your preventive screenings.
A SCAN online member account also allows you to view your plan materials and manage many of your benefits. Together with your doctor’s patient portal, they provide a full picture of your coverage and care.
Member Support
Your doctor’s office is your first stop for care and to schedule appointments. If you’re not getting the care you need in a timely manner, your Medicare Advantage plan should step in to help. Look for a plan that puts members first with robust support.
At SCAN, our award-winning Member Services team is available for any issues that come up. And with our HEALTHtech benefit, you have experts standing by to make sure you’re able to take advantage of benefits like virtual visits with your doctors.
Getting Needed Care With SCAN
SCAN offers a wide range of Medicare Advantage plans with exceptional coverage and supplemental benefits. Our plans are designed to help you get the care you need, when you need it. Use our online search tool to explore and compare options or contact us at 1-800-547-0887.
