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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 cover the full cost of treatment and drugs, however. Members are responsible for paying approximately have of the cost themselves. In some cases the percentage paid by the member can be even higher. Furthermore, the program does not cover treatment for all medical conditions and a limited list of drugs may be prescribed. Members have to see an approved medical practitioner, even if he is not their first choice.

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 medical insurance companies offer Part C plans. The terms and conditions and the benefits offered by the various plans differ wildly, however, and it may be difficult to compare them. Experts advise that the services of an independent medical insurance broker are obtained. They can assess the needs of the client and recommend the plan that will best suit his needs and unique circumstances.

Members should make very sure that they fully understand the rules of the plan that they have chosen. It is vital to contact the insurance company if there are any questions. Failure to do so can end up being very costly. For example, if the plan requires a member to get approval for referrals to a specialist, they will end up being responsible for all the costs if they did not do so.

Despite the restrictions, Part C plans offer many benefits. They are generally affordable and they may not charge treatment fees that exceed those of the original plan. Another great benefit is that the yearly out of pocket expenses of the member is limited. Once he reaches that limit all further treatment is free of charge. This limit varies from plan to plan and should be an important consideration when choosing a plan.

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.

One thing is certain. Medical care is extremely expensive and often out of reach of those unfortunate people that do not have medical insurance. Part C plans may be limited, but they offer quality care at very affordable premiums. For many people these plans are godsend.




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