Medicare 411: Make Informed Choices Regarding Your Healthcare

In light of recent news regarding some Medicare Advantage plans not contracting with local rural entities we wanted to share our information with you.

  • Medicare Part A covers a large portion of hospital charges.  (Traditional Medicare)
  • Medicare Part B  covers outpatient charges like doctor visits or outpatient lab, x-ray, rehab
  • Medicare Part D is your Prescription drug coverage.
  • Medicare Part C is Medicare Advantage.  These are plans run by private insurance companies.

Medicare Advantage plans are not required to contract with providers in your area.  This means in order to receive your care “in-network” you may have to travel out of town or switch physicians.  If you choose to receive care at an “out of network” hospital or clinic your cost responsibility may increase.

Traditional Medicare is accepted everywhere with your full choice of providers, no referrals to specialists required and no “out of network” costs.

It is recommended that you also purchase or acquire a secondary insurance to cover the out of pocket costs if you select Traditional Medicare.  This could include Medicaid if you qualify.

At the current time Blue Mountain Hospital District has a contract with one Medicare Advantage plan:  Pacific Source.  They have been great to work with.

Providence Medicare Advantage and Blue Cross Blue Shield Medicare Advantage have refused our request to pursue a contract.

We have requested contract information from other Medicare Advantage plans but do not have contracts with them at this time.  We will continue to pursue acceptable contracts with other companies to better serve our community.

Please review your plan and decide if you are happy with your choice.

If you were a Summit Medicare Advantage member in 2024, you have until 2/28/25 to choose a new plan.  This includes your prescription drug coverage.

If you chose a Medicare Advantage plan and would like to switch plans or revert back to traditional Medicare the Open Enrollment window is open Jan 01 – March 31.