10/20/2026
Medicare advantage plans; several people have asked lately which plan can they utilize that is an advantage plan for Partners Family Medicine. We do have different contracts, but I know 100%. You will not go wrong with Aetna PPO Advantage.
Also straight, Medicare A & B works very well
When your researching Advantage plans be sure to ask can I go to that facility and use the Advantage plan for my Medical and my behavioral health visits?
Several plans will offer a kick back of $75-$100 a quarter if you select their plans and I don’t know if that’s the appropriate word kickback but that’s basically a benefit that they offer to a lot of seniors if you select their advantage plan however what is not explained to the senior in-debt is the answer to that question: “ does that advantage plan cover both medical and behavioral health visits?”
This past year we experienced several clients took out certain Advantage plans thinking that it would cover both the medical and their behavioral health visit when in fact it only covered one and not the other so it was very disheartening to the client to learn halfway through the year that one of their visits is not Going to be covered. Then the client will often call the insurance and be told that they cannot change their plan until the enrollment period.
So I encourage everyone to ask that question when you look at taking out an advantage plan for Medicare.
Prime example we are a multi specialty integrated practice. I may have a client that comes to partners for Counseling services. That’s under the behavioral health contract so a certain payer will pay that visit, however if the client wants to also see Partners Clinic for primary care services and that Advantage plan is only going to cover the behavioral health & not cover the medical so you have to ask the question in the beginning. Forget about the kickback forget about the hundred dollars forget about the $75 that people tend to lure you in so that the senior citizen will jump to take out a certain plan. Look at the bigger picture. Does that plan cover both behavioral health and medical for that facility?
Just some advice, not to be misled and make sure that everything is transparent when you select your plan.
There is other Advantage points out there other than Aetna that work well however some of them are customized so they have to be evaluated individually and you can do that. Just simply ask for the information and for example, you can call the business office at the clinic and give them the information and they will let you know if that particular plan can be used for both medical visits and behavioral health visits.
I’ve seen this first hand that’s why I’m sharing this information with you. My mother is 76 and lives with me already. Several plans have been calling her individually on her personal cell phone and discussing with her over the phone about taking out different coverages and they started out by saying you get $100 that you can spend on XYZ… so it’s very easy to bite and jump and grab that plan so for my mom what I’ve told her is do not agree to any plan until you call the facility that you want to use for your primary care or your medical visits and confirm that that facility takes that insurance so that you know you’re covered throughout the year.
Just wanting to give you a little bit of transparent insight to the wonderful world of insurance.
Thank you for reading. I hope this provides some guidance.
