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Thursday, 27 October 2016

Without Medicare Advantage Lakeland Residents May Not Be Able To Afford Medical Care

By Joyce Davis


People older than sixty five and many disabled younger people have been benefiting from medical care since 1966, when the federal social insurance program was introduced. Membership is limited, however, to those that worked through their lives and that made contributions to the program and, in some ways, the program is limited. Still, by 2015, the program had more than 55 million members. With Medicare Advantage Lakeland members now enjoy even more benefits.

The program does not offer free medical treatment. It pays approximately half of the cost of treatment and the member is responsible for paying the remainder. Members have to make use of medical practitioners that are approved and registered by the program. In addition, the program will only pay for the treatment of a limited list of conditions and only approved drugs may be supplied.

Basic membership allows members access to the services of Part A and B of the program. Part A is a hospital plan, Part B consists of medical insurance and Part D covers a variety of prescription drugs not available to ordinary members. The Advantage plans are all about access to Part C of the program. This part allows members access to Part D and other and other treatment options that exceed those covered by basic program membership.

Most of the medical insurance companies offer a variety of Part C plans. It is not always easy to compare them objectively with each other. The best course of action is to consult with a medical insurance broker that acts independently and that can provide objective advice based upon the needs and circumstances of the client. These brokers are not paid to sell the plans of a specific company.

It is important to study the rules of the chose Part C plan and to get clarity on issues that are not clear. If the patient is required to obtain prior authorization for seeing a specials, for example, and fails to do so, he may be liable for all the cost. Some plans require members to see only practitioners that are approved by them.

There can be no doubt, however, that Part C plans offer many excellent benefits. For example, by law they have to limit the amount that has to be paid for treatment by the member himself each year. Once that limit is reached the member does not pay a portion of any further treatment. Members receive world class benefits at a very reasonable premium. The fees that may be charged for services rendered are also regulated.

Critics of Part C plans say that there are too many exclusions. They criticize the fact that members may only use practitioners approved by the insurer. This lead to situations where members rarely see the same practitioner with each consultation and this may lead to incomplete medical histories. There are even those that say that government expenditure on medical care for a select few is morally wrong.

The fact remains that quality medical treatment is out of reach for ordinary people and that millions depend upon Part C plans. These plans may not be perfect and they may not cover all medical conditions, but they provide quality care that would otherwise not be affordable. Only the wealthy van afford comprehensive medical insurance that makes provision for every possible condition.




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