What is a Medicare Advantage plan?
These are county-based network programs which offer services in addition to what Medicare covers. They get paid by CMS. The extra goodies are advertised, but not always available to all members. What is the catch? The catch is restriction to network is enforced heavily in most cases. This may put a person at a disadvantage for unusual medical problems. For example: A person is going blind due to diabetic retinopathy (damage to retina due to diabetes). He needs a specialized procedure performed by a specialist. The only such specialist in the network does not have good results. Most experience resistance on the part of the company for this out-of network service from a good specialist who can doe this.