Medicare Advantage Plans may be an advantage to some people, depending on their requirements. For others, however, there is no advantage to them at all; in fact, they are oft heard to be called major pains in the - pocketbook. Texas health insurance agents can tell you this information if you ask.

So let's talk finances for a bit. There are people looking to be totally covered, not having to pay a dime when they need services. Then there are others who can afford to pay the 20% difference between what the doctor charges and the insurance company pays (the other 80%). Each group has its own wants and needs, but how each group is actually serviced is another matter entirely.

For instance, let's say you are in one smaller network and have a doctor that you really like. Things are going well for about a year or so and then the doctor decides s/he wants to opt out of the network. Great, this leaves you stuck unless you try and follow your doctor. Good luck on that one.

Following your doctor involves finding out if s/he will take other Medicare plans/ supplements or not. In the alternative, you may see the doctor and pay full freight to do so. If your doctor makes the decision to go the fee for service route, you might find out s/he refuses to accept the terms of the plan. That means you pay the bill.

What's going on here is that coverage options are so confusing it's difficult to get straight answers. With the Medicare Advantage Plans their coverage is fairly black and white - what you see is what you get (mostly). If you choose to go with private health insurance you might think you're covered. Wrong, as the insurance company may say they don't have to cover your particular case. This is a little like playing Russian roulette.

To get Medicare Advantage or not to get the advantage and go private are haunting questions that are usually only resolved when you've had personal experience either way. The bottom line is, for coverage that makes the most sense Medicare supplements are the better route.



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