Can I show my Original Medicare Card instead of my Medicare Advantage card, if my provider doesn't take my advantage insurance?
Answered by 8 licensed agents
Answered by Lt Col Tim Brown on May 22, 2025
Broker Licensed in TN, AL, CO & 10 other states
Answered by Gary Church on May 22, 2025
Broker Licensed in Ca, AZ, NV & TX
When You’re on a Medicare Advantage Plan (Part C):
Your Medicare Advantage plan takes the place of Original Medicare for your medical and hospital coverage.
You must show your Medicare Advantage card when receiving care, not your red, white, and blue Medicare card.
Original Medicare will not pay for your services while you're enrolled in a Medicare Advantage plan.
If a Provider Doesn’t Accept Your Advantage Plan:
You cannot use your Original Medicare benefits to bypass the Advantage plan’s network or billing rules.
You would either need to:
Pay out of pocket, or Find a provider who is in-network or accepts your Advantage plan, or
Switch plans during an eligible enrollment period (like the Annual Enrollment Period or Special Enrollment Period if applicable).
Bottom line: If you have Medicare Advantage, that plan is your primary coverage. Your red, white, and blue card no longer applies unless you disenroll from the Advantage plan and return to Original Medicare.
Answered by Joshua Ruiz on May 22, 2025
Broker Licensed in NC, AL, AZ & 17 other states
Elaboration:
Medicare Advantage and Original Medicare:
Medicare Advantage is an alternative to Original Medicare, offering coverage through private insurance companies.
Using the Correct Card:
When you have a Medicare Advantage plan, you use the card provided by your plan to access covered services, not your Original Medicare card.
Provider Networks:
Medicare Advantage plans often have a network of providers, and you typically need to use those providers to get services.
Switches to Original Medicare:
If your provider doesn't accept your Medicare Advantage plan, you may need to switch back to Original Medicare or find another provider.
Enrollment Periods:
You can switch back to Original Medicare during specific enrollment periods, such as the Annual Enrollment Period (October 15 to December 7) and the Medicare Advantage Open Enrollment Period (January 1 to March 31).
Answered by Fred Manas on May 22, 2025
Agent Licensed in NY, CT, DC & 7 other states
If a provider is out of network and you don't have out of network coverage. You will be responsible for the entire bill.
Answered by Marcie Barnes on May 22, 2025
Agent Licensed in TX, AK, AL & 48 other states
Answered by Linda Davies on May 22, 2025
Agent Licensed in IL
However, if you’re enrolled in a Medicare Advantage plan, you generally need to use that plan’s network and follow its rules to get coverage under that plan. If your provider isn’t in your Advantage plan’s network, you may have to pay more or the full cost if you use your Advantage card there.
Showing your Original Medicare card can help you get services covered outside your Advantage network, but it means you’re using Original Medicare benefits, not your Advantage plan benefits. It’s a good idea to check with your provider and your plan before your visit to understand what costs you might be responsible for.
Answered by Alaina Hunt on May 22, 2025
Agent Licensed in KS & MO
Answered by Tony Merwin on May 22, 2025
Agent Licensed in TX, AR, AZ & 28 other states
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