Many Medicare Advantage plans are HMO's, meaning you are required to stay within a network of doctors to receive coverage. Some plans are HMO Point of Service plans. This means that if you go to a doctor outside of the service are you may still be able to get coverage if you need it provided the doctor agrees to accept the HMO's terms of service and the procedure is approved by the carrier. Usually if there is a network doctor in the area that can handle that condition the plan will make you go to the network doctor.
Medicare POS (point of service) plans have limited networks and if you want full coverage (without penalty) you should choose a par provider. Some POS plans require a referral which should minimize or eliminate any non-par penalties.
Usually in a medical emergency situations the carrier will waive non-par penalties. Keep in mind you can still be balance billed by providers not in the POS network.
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Usually in a medical emergency situations the carrier will waive non-par penalties. Keep in mind you can still be balance billed by providers not in the POS network.