More about Medicare plans

I would like to answer the letter from Dora Golubski about Medicare Advantage Plans and my original letter on the subject.

It was not my intent to denigrate all Medicare Advantage Plans but only to make people aware that the cold calls they are getting are not coming from the U.S. government. I firmly believe Medicare Advantage Plans have a place in the Medicare landscape. I know firsthand that they can be the best fit in certain circumstances. I also know first-hand that the callers do not always advise people of the limitations inherent in these plans.

I know also that coverage outside the network of an Advantage Plan is more than "slightly" different. I have seen patient bills from out-of-network doctors in the hundreds of dollars. If people understand that out of network expenses are paid at a lower rate, and where they can happen, then they can reasonably choose a lower- cost Advantage Plan.

I never said that there is no coverage outside of Florida with a Florida Advantage Plan. I said "they are usually not portable" and services provided outside Florida will not be covered as in-network expenses. Advantage PPO (Preferred Provider Organization) Plans do offer coverage outside of their networks, which would be for services in other states, but usually it is for a higher cost as an "out of network" expense and the provider must agree to treat you. I don't know of any Advantage Plan that has in-network providers in all 50 states. It is important to know this difference. Anyone who lives in two states should discuss this situation with their insurance advisor.

I firmly believe that reputable medical insurance advisors provide an invaluable service. As someone who spent 10 years as a medical insurance fraud investigator, I know how confusing the literature can be. I saw medical insurance from the claims side of the equation and I saw distraught people who did not understand in-network and out of network medical expenses. Only someone who has been in the business knows where the fine print of a policy can cause problems. Kudos to all the good agents who know where the problems could surface and point them out to their customers.

Mary Lynn

Homosassa