Reno Medicare Advantage
One of Washoe County’s most popular Reno Medicare Advantage companies is Prominence Health Plan. Prominence has recently decided to change a policy within their Advantage plan. It now allows members to see a specialist without a referral from their Primary Care Provider or PCP. This is good news for current members since they will have some more freedom when using the plan.
If you are not familiar with Medicare Advantage policies, they are one of two additional policies for Medicare. They can help cover services that original Medicare parts A and B do not. The other option is a Medicare Supplement Reno policy. Reno Medicare Advantage policies are more restricted than supplement policies. Although, they are very affordable since most do not have a premium. Prior to the recent announcement, the advantage policy functioned more like an HMO plan. HMO policies require referrals to see specialists and are more restricted. With this change, the policy now has more freedom like a PPO plan. PPO plans are almost always more expensive than HMOs. This is because the policyholder can be more liberal with their use of the plan. Sitting down with a health insurance broker can help find the correct policy for you.
Prominence initially made the change earlier this year to require a referral from a PCP but has now flipped back.
Members will no longer have to go see their doctor to determine if a visit to a specialist is medically necessary. In addition, Prominence is reprocessing all the claims that were denied this year due to not having a referral. If you are a current Prominence Reno Medicare Advantage member and were denied a claim, for this reason, you should contact their claims department immediately for reimbursement.
Please call our office at 775-828-1216 if you have any questions or would like to enroll in a health insurance policy. Our brokers assist individuals and families, employer groups, and Medicare Advantage and Supplement plans.