You have the option to receive care from another physician within the plan by changing your primary care physician designation. Unlike traditional Medicare, it is not necessary to have a three day prior hospital stay before being admitted to a Medicare-approved skilled nursing facility. Limitations You must get all of your medical care and services from the plan, except emergency care or urgently needed care, unless otherwise provided by the plan. You may be disenrolled from the plan if you are living out of the service area for over 12 months, unless your plan offers the extended travel benefit. You must receive a referral from your primary care physician to receive care from another provider or that care will not be covered.
Appeals can be slow.
Disenrollment from a Medicare managed care plan can cause problems. Preexisting conditions may prevent you from obtaining traditional Medicare supplement insurance. A waiting period may be required for preexisting conditions. You may have to begin a new doctor relationship because your current doctor may not be in the plan or may drop the plan. A particular plan doctor may not be taking new patients.