The President’s Message is published in the MHA Weekly News Report, a member-only publication of the Montana Hospital Association. To subscribe, click here.

The annual Medicare open enrollment period opened last week and runs through December 7.

The plan a patient picks now will decide where they can get care starting January 1, and many don’t realize how much is riding on it. For a lot of Montanans, the biggest question is whether to choose a Medicare Advantage plan or stay with Original Medicare, and that’s where things get complicated.

Medicare Advantage has been frustrating for both patients and providers. For providers, it means waiting on prior authorizations, fighting claim denials and getting paid less than traditional Medicare. That’s hard on any clinic or hospital, and harder on rural ones running on thin margins. For patients, the problems often show up when they’re sick or hurt: a procedure needs approval they didn’t know about, their specialist or hospital is out of network, or a rehab stay gets cut short. Too many Montanans learn what their plan won’t cover only when they need care. We’ll keep pushing for fair pay, faster approvals and real oversight of these plans.

Our patients also deserve straight answers before they pick a plan. Many don’t know that if their doctor or hospital leaves a plan’s network mid-year, they usually don’t get a special chance to switch. Open enrollment is the time to check.

To help, we’ve put together a Medicare Advantage fact sheet—both a generic version, and one you can add your own name and contact information to. It covers how Original Medicare and Medicare Advantage differ, what a plan may require before patients get care, hidden risks, and steps to take before making a decision. Please consider putting it at your front desk, in discharge folders, at senior centers and in local newsletters.

Thank you for all you do to keep care close to home.