Choosing the right Medicare plan is one of the most important healthcare decisions you’ll make. While Medicare Advantage plans can look attractive with their lower monthly premiums and bundled drug coverage, they also come with restrictions that may affect your ability to get care right here at home in Hereford.

At Hereford Regional Medical Center, we want every resident to understand how coverage choices affect access to trusted local providers.

Why Medicare Advantage Looks Attractive

For many, Medicare Advantage plans can seem like a great deal:

  • Lower monthly premiums
  • Prescription drug coverage built in
  • Extra perks like vision or dental in some cases

But behind those benefits are restrictions that can cause problems.

The Hidden Risks for Patients

Limited Networks

Traditional Medicare lets you see almost any doctor, almost anywhere in the country. Medicare Advantage, however, restricts your care to a set network of providers.

  • Only 46% of doctors who accept traditional Medicare are included in some Medicare Advantage networks.
  • If your doctor in Hereford isn’t part of the plan’s network, you may have to drive to Amarillo or even farther for routine care.
  • Travel also becomes a problem if you get sick while visiting family or traveling — because care outside of your network often isn’t covered.

Prior Authorization and Coverage Denials

Even if your doctor is in the network, Medicare Advantage plans can still limit what care you receive.

  • 99% of Medicare Advantage plans require prior authorization for services that traditional Medicare covers automatically.
  • This means your doctor may need to get permission before you can access things like physical therapy, oxygen equipment, or even short-term hospital stays.
  • Each plan uses its own rules for approving care — sometimes resulting in delays or outright denials for services that traditional Medicare covers without question.

Local Impact

Here in Hereford, that could mean saying goodbye to the trusted doctors and nurses you’ve known for years or facing delays in care you need now.

“We see patients every year who are surprised to learn their Medicare Advantage plan doesn’t cover care at our hospital,” said Candice R. Smith, MSN, RHCNOC, CCRN, RACR, CEO of Deaf Smith County Hospital District. “It’s important to understand what you’re signing up for before you make the switch, so you don’t lose access to care close to home.”

How to Make the Best Choice for You

Medicare Advantage isn’t automatically the wrong choice, but it is very different from traditional Medicare. The most important step is to get the facts and talk with your doctor before deciding.

At Hereford Regional Medical Center, we’re here to help you understand your options so you can make the best choice for your health and your future.

👉 If you’re considering Medicare Advantage, bring your questions to your next appointment or call us at 806-364-7512. We’ll walk through how your decision could affect your ability to get care close to home.

Learn more on our Medicare webpage: https://dschd.org/medicare/