[mac9]

The Advantage programs make some of their money because they are paid the last day of the quarter BEFORE and are able to keep that money and the interest accrued by it before they have to make any payments. Doesn't sound like it would be much to you or me, but it is garnering them millions. Also, not all Advantage programs are localized. Many of the larger insurance companies (Aetna, for instance) are nationwide as you can purchase an HMO version which is local, but they also have a PPO that is usually accepted by any Medicare certified physician throughout the country.