Medicare open enrollment for the 2024 plan year runs from October 15, 2023 - December 7, 2023 for coverage that becomes effective January 1, 2024. If accessing Baptist Health for elective services is important to you, consider selecting an insurance plan or coverage option that includes Baptist Health hospitals, outpatient centers and doctors in its network.
The first decision consumers need to make is selecting between Original Medicare and Medicare Advantage (Medicare coverage provided by private insurance companies).
Accepted by all Baptist Health hospitals, outpatient centers, and physician groups.
Original Medicare is the least restrictive and most widely accepted Medicare option accepted by any hospital or provider in the United States that participates in the Medicare program. Original Medicare:
- Is not administered by an insurance company.
- Does not restrict beneficiaries to a network.
- Does not require a beneficiary to select a primary care physician or seek referrals/authorizations for care.
- May have higher out of pocket costs than a Medicare Advantage plan, so it is important for beneficiaries to evaluate whether to purchase a Medigap supplement to help offset out of pocket expenses.
Baptist Health is part of a variety of Medicare Advantage plans, which may vary by county, as listed below.
Medicare Advantage (sometimes referred to as “Medicare Part C”) is a Medicare plan administered by an insurance company, such as a Medicare HMO or PPO.
- Plans typically involve sticking to a network of providers and may also require referrals or authorizations for elective care before the plan will pay for covered services.
- Although Medicare Advantage plans have to cover the same benefits as the Original Medicare program, some Medicare Advantage plans may offer additional benefits like vision, dental and transportation coverage.
- In Medicare Advantage HMOs, patients will be required to select a primary care provider and will usually be required to get referrals from their primary care provider for specialist and hospital care.
- However, even if Baptist Health is in-network with a Medicare Advantage HMO, primary care providers might have their own preferences when it comes to referring their patients to other in-network providers.
- Medicare Advantage PPOs are typically less restrictive and usually do not require primary care provider referrals for specialist and hospital care. In addition, Medicare Advantage PPO members may have out of network coverage with providers that participate in the Medicare program.
To understand which Medicare Advantage option suits a person best, it's a good idea to contact an advisor.
Baptist Health works with many Medicare Advantage plans, but availability varies by county.
A full list of Baptist Health’s facility and physician insurance participation can be found on our Baptist Health Accepted Insurance Plans page.