What Is The Problem With Medicare Advantage?

It appears the answer to the question ‘What Is The Problem With Medicare Advantage?’ depends on whose opinion is being heard. The basic issue is that 25% senior citizens have opted for an advantage plan over traditional Medicare. Coupled with the amount of mailboxes across the country being bombarded with letters from private insurance companies who control these plans and reports concerning whether or not Medicare Advantage will survive under Obamacare it’s almost like being caught in a revolving door.

The Lure of Medicare Advantage versus Regular Medicare

Among the extras afforded to Medicare Advantage members are auditory and optometry benefits not offered by regular Medicare. While Medicare is regulated by the Federal Government, advantage plans are not. Since private insurance companies determine the allowable coverage amount they are free to demand higher premiums. In a claims dispute regarding these extra services no assistance is available from Medicare which leaves the ball squarely in the court of private companies who may or may not settle the claim to the satisfactorily. Another problem with these Medicare Advantage extra benefits is that once a member becomes dissatisfied they may find that going back to original medicare coverage is denied.

Since Medicare is funded by every taxpayer through payroll deductions, many people fail to see the need for some programs included in Medicare Advantage such as health club membership Those who can afford the premium costs for these plans are probably in a financial position to pay for these membership costs out of their own pockets.

Under regular Medicare, payments to doctors, hospitals and other approved medical services occur each month on a fixed-rate basis; however, as Medicare Advantage depends on payments coming from private carrier companies, the payment amount may fluctuate or be reduced based on the whims of each individual carrier.

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