Informed Consent: Key To Preventing Big Medicare Advantage Mistakes

As Diane Omdahl highlights in her recent article, the lack of a formal “informed-consent” process means many find themselves blindsided by network limitations, prior-authorization delays, or surprise charges. Drawing on real-world examples—such as a retiree suddenly billed after discovering his doctors were out-of-network, or a patient hit with a six-figure charge post-surgery because services weren’t properly authorized—Omdahl argues that beneficiaries must be fully educated about three key risk areas: the provider network, the prior-authorization requirements, and the cost-sharing structure (including high in- and out-of-network maximums).

The actionable takeaway is clear: treat the selection of a Medicare Advantage plan with the same diligence you apply to retirement choices. Before enrolling, examine the plan’s evidence of coverage and ask: “Do I understand what happens if my doctor leaves the network mid-year? How will prior-authorization impact access to care? What are my real worst-case cost scenarios?” Even plans marketed as “zero-premium” can carry substantial coinsurance and deductibles up to thousands of dollars. By embedding these risk-checks into your process you help ensure health-care coverage decisions don’t inadvertently increase financial vulnerability in retirement.

In short: having the right coverage isn’t enough—you must understand it. Remember that health-care path and investment path are intertwined.

Read the full article here.