الاثنين، 24 أكتوبر 2016

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

By Joyce Davis


Since the inception of a social health insurance in 1966 in the United States millions of people older than sixty five and younger people with disabilities have received medical care in terms of this program. There are conditions, however. Enrolled members need to have contributed to the funding of the program through payroll taxes. In 2015, the program had more than 55 million members. The services provided in terms of the program are strictly controlled but now, with Medicare Advantage Lakeland members can enjoy 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.

The entire social medical insurance program consist of four parts. Basic membership include only the benefits offered by Parts A and B, Part A being a hospital plan and Part B medical insurance and a limited list of drugs. Part D provides for a wider variety of drugs and Part C is the key to the Advantage plans that are so popular. They offer additional benefits.

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.

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.

Part C plans offer many benefits. Members never lose the benefits of basic membership and enjoy cover for many other diseases and drugs. These plans are very affordable too. Also, members are protected by an out of pocket restriction. There is a limit to the yearly amount they have to pay themselves. When the limit is reached treatment becomes free.

Critics say that Part C plans have severe limitations. Members may not see practitioners of their choice, but must choose from the list of approved professionals. In some practices, members may not even see the same doctor at each visit. This creates a danger that their medical histories will not always be up to date and this, in turn, can be a big problem during medical emergencies.

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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