top of page
Medicare Advantage can add approvals, networks, and referrals
Medicare Advantage plans must cover everything Original Medicare covers, but they often add network rules, prior authorization, and sometimes referral requirements. These rules can affect where you can go for tests, specialists, rehab, home health, and certain procedures.
Why it Matters
Even when a service is “covered,” plan rules can change the timing, location, and out-of-pocket costs.
Action Steps
Confirm the provider/facility is in-network.
Ask: “Do you require prior authorization for this service?”
Ask: “Do I need a referral to see this specialist?”
bottom of page