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The advantage of Medicare Advantage

The advantage of Medicare Advantage

I signed up for Medicare Advantage a few years ago, primarily because it offered catastrophic coverage which standard Medicare didn’t provide. With standard Medicare the co-pay was 20%, no matter the size of the bill (which could end up being a fortune). With Medicare Advantage there was a yearly ceiling on copays of between five and six thousand for in-network treatment. Treatment extending beyond New Year’s might well be another five to six grand. I haven’t had the opportunity to put this to the test until a few weeks ago. I went up north for a niece’s wedding and developed a severe gastro intestinal problem. It started up again when I returned home. A local urgent care facility diagnosed the problem as a urinary tract infection and put me on ten days of antibiotics.  The situation was less than ideal because I take medications for high blood pressure and couldn’t keep either food or the pills down. I ended up at McAllen Medical Center’s emergency room. They did a cat scan and detected a mass at the base of the pancreas which was pressing on the bottom of the stomach and sealing it shut. Thus I began my medical odyssey.  They wheeled me upstairs to a room and began all sorts of tests. Another cat scan was followed by an ultrasound and an MRI (to map the arteries in the area). A few days later I was under the knife. The most remarkable thing about this experience is that the hospital did not bring up the subject of money for the first five days. At the end of those days a young lady came up to my room and I cut her a check for just over $1,300 as my co-pay for those days. Under Aetna, there is no room co-pay at all beyond those five days. The staff at the McAllen Medical Center has been magnificent and has pampered me. Their emphasis has been totally on my treatment and recovery. The nurses have all gone the extra mile. During the period when I had a tube down my throat and additional tubes extending from my chest and both arms, these people were the difference between me tolerating what was happening and being devastated by it. I’m now eating again (with a very limited diet). The diagnosis of lymphoma means I’ll have a portal attached to me to administer the chemo to shrink the mass. We’re still ...

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