Out-of-network access should be allowed in Scripps Medicare Advantage split, expert says

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Out-of-network access should be allowed in Scripps Medicare Advantage split, expert says
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Research by the Health Insurance Counseling & Advocacy Program indicates that those with preferred-provider organization plans can still go to clinic and coastal doctor groups, but will pay more.

The recent decision by Scripps Health to stop its clinic and coastal medical groups from participating in Medicare Advantage plans created uncertainty for thousands of seniors. But there might be one bit of good news.

PPO plans allow a sort of middle ground, allowing beneficiaries to stay within a plan's contracted network of providers and pay lower fees for the bulk of their needs but preserve the option to visit a much wider range of care givers if the need arises. While HICAP does not make recommendations, it does work to lay out all of the available options with as much accuracy as possible.

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