Connect
← Return to Best Medicare Advantage drug plan for Prostate Cancer?
Discussion
Best Medicare Advantage drug plan for Prostate Cancer?
Prostate Cancer | Last Active: Oct 28, 2023 | Replies (24)Comment receiving replies
MA plans contract with a provider network and that is one of the ways that they keep their premiums low and can provide additional (minor) benefits. .
If you are not in network, you need an exception to be treated out of network.
MA plans try to "squeeze" providers on reimbursement, and some top line facilities will not accept the reduced payments.
Traditional Medicare together with a comprehensive Med Supp (G) provides the most coverage and choice available, if you can afford the Med Supp premium.
Nothing wrong with MAs per se, just understand that they are private insurance companies marketing a profitable product, with network restrictions.
Replies to "MA plans contract with a provider network and that is one of the ways that they..."
Connect
For instance, a company starting with the first letter of the alphabet refused to cover my mpMRI. When I appealed I never heard a thing back...ever! Fortunately, I could afford to pay for that MRI, even though it turned out the in-network provider had less than up-to-date equipment and I had to redo it. Further, the redo, to guide the transperineal biopsy, found a more advanced node of cancer that the first MRI missed in either the view or the analysis.
And, fortunately for me, I was within the initial window after age 65 that allowed me to switch back to traditional medicare with a high-deductible plan G supplement, and not to deal with the medicare advantage squeeze for people who actually need expensive care.