Choices 65 is not a standard Medicare health plan. Unlike other Medicare health plans, we are an Open Access (definition) health plan. This means that as a member of Choices 65, you have the flexibility to choose your own Primary Care Physician (PCP) (definition) and specialists from our extensive network of providers. You also have the ability to see specialists without a referral from your PCP.
You may prefer having your medical care coordinated through your PCP. Going to a PCP first offers you the most savings, and it enables your personal physician to help you with coordinating your overall healthcare; for example, what kind of specialist you need to see or what prescription drug interactions to observe. The PCP also provides you with advice on all issues pertaining to overall health and well-being.
In other words, with Choice 1 you benefit from the guidance and expertise of your PCP, a health professional who knows your medical history and lifestyle.
You may prefer to visit a specialist without seeing your PCP first. You may do this on a case-by-case basis. You have the choice to access care when and how you wish. The ability to self-refer is one of the many ways Choices 65 is unique.
With Choice 2, you enjoy the freedom to go directly to a provider within the Choices 65 network.
Choice 1
Within Physician Team
Choice 1 maximizes your savings. Your Primary Care Physician (PCP) can help you coordinate care with doctors and hospitals within your Physician Team. Office visits to your PCP cost just $5, and your visits to specialists within your Physician Team are just $15.
Choice 2
Within Choices 65 Network
Choice 2 provides direct access. You can see any provider in the Choices 65 network without a referral from your PCP for only a $25 copay for each visit.