When you turn 65, choosing the right Medicare coverage is one of the most important decisions you’ll make. The challenge is that none of us can predict the future. While we all hope to stay healthy, the reality is that as we age, the likelihood of needing more frequent or specialized care increases.
At Hereford Regional Medical Center, we’ve seen how these decisions play out for our neighbors. Choosing between Traditional Medicare and Medicare Advantage isn’t just about today, it’s about protecting your future self.
Here are three important things to consider before making your choice:
- Prior Authorization Can Delay or Deny Care
On paper, Medicare Advantage plans cover everything Traditional Medicare does, and sometimes they even advertise extras like dental or vision benefits. But there’s a catch.
- Limits on visits and care settings: Medicare Advantage can cap how many therapy or home health visits are covered.
- Prior authorization: Nearly every plan requires your doctor to ask the insurance company for approval before you receive treatment, even if it’s something your doctor knows you need.
This process can take days or weeks, delaying care when time matters most. And sometimes, the approval never comes.
- Local Access Matters
Traditional Medicare allows you to see almost any doctor or hospital nationwide, including those here at Hereford Regional Medical Center. Medicare Advantage plans, on the other hand, lock you into their own networks.
- If your doctor in Hereford isn’t in-network, you may have to drive to Amarillo, Lubbock, or farther for care.
- These networks can change every year. A provider you rely on today could be out of network next year, forcing you to start over with someone new.
For those managing chronic conditions like diabetes, heart disease, or COPD, that disruption in continuity of care can be more than inconvenient, it can be harmful.
- MediGap Protection Can Be Lost
One of the biggest advantages of starting with Traditional Medicare is the ability to buy a MediGap (supplemental) policy.
- MediGap helps pay out-of-pocket costs like deductibles and copays.
- If you sign up for MediGap when you first become Medicare-eligible, you’re guaranteed coverage regardless of your health status.
But here’s the problem: if you start with Medicare Advantage and later try to switch back to Traditional Medicare, you may no longer qualify for affordable MediGap coverage. If you’ve developed a chronic condition, insurers can charge you more or deny coverage altogether.
Think About Tomorrow, Not Just Today
No one wants to imagine themselves sick or needing extensive care, but the chances increase as we age. While Medicare Advantage may look appealing with lower premiums and bundled extras, the reality is that it often comes with hidden restrictions, limited local access, and fewer long-term protections.
At Hereford Regional Medical Center, we want our community to have the information needed to make the best possible decision. Medicare Advantage isn’t always the wrong choice, but for many rural seniors, Traditional Medicare provides the freedom and security that matters most long-term.
👉 If you’re weighing your options, talk with your Hereford provider or call us at 806-364-7512.
We’re here to help you understand how your coverage choice will impact your care — today and in the years ahead.
Click here for additional Medicare resources: https://dschd.org/medicare/
