Do Medicare Advantage plans allow you to see any doctor you wish?
Asked by: Kaitlin Gottlieb | Last update: January 19, 2026Score: 4.8/5 (27 votes)
What is the biggest disadvantage of the Medicare Advantage plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
Can I go to any doctor I want on Medicare?
With Original Medicare, you can:
Go to any doctor or hospital that takes Medicare, anywhere in the U.S. Find providers that work with Medicare. Join a separate Medicare drug plan (Part D) to get drug coverage. Buy a Medicare Supplement Insurance (Medigap) policy to help lower your share of costs for services you get.
Do all doctors accept Medicare Advantage?
Can Doctors Refuse Medicare? The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services. Medicare typically pays doctors only 80% of what private health insurance pays.
Why are people leaving Medicare Advantage plans?
But there are trade-offs. Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up paying more in the long run in copays and deductibles if they develop a serious illness.
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Why do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
Why are seniors losing Medicare Advantage plans?
Health systems and hospitals are also making the decision to cancel contracts due to excessive prior authorization denial rates and slow payments from insurers. Already 27 health systems have canceled their Medicare Advantage contracts this year.
Can I drop my Medicare Advantage plan and go back to original Medicare?
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
Does everyone pay $170 for Medicare Part B?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
Do all hospitals accept Medicare Advantage plans for seniors?
However, not all hospitals accept all Medicare Advantage Plans. In addition, to get full coverage for your healthcare services, you may need to limit your options to a network of healthcare providers. Some plans allow for out-of-network coverage, but this can be expensive. Enrollment Period.
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Does Medicare pay 100% of doctor visits?
Generally, Medicare Part B will cover 80% of the cost of appointments, and you'll need to pay the remaining 20%. This percentage is known as coinsurance. For example, if a doctor charges $110 for a visit, Medicare may pay $88, and you'll need to pay the remaining $22.
Why do people choose original Medicare over Medicare Advantage?
There's no one-size-fits-all answer, but Medicare Advantage typically has lower premiums and optional coverage, while Original Medicare often gives you more choice when it comes to choosing doctors.
What is the disadvantage of UnitedHealthcare for seniors?
Cons About UnitedHealthcare Medicare Advantage
You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.
Why is a plan G better than an advantage plan?
Medigap Plan G offers more comprehensive benefits than the Medicare Advantage plan and is more widely available. It also provides more freedom for enrollees. For example, a Medigap Plan G enrollee can visit a specialist without a referral.
Why is Social Security no longer paying Medicare Part B?
There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.
What are the top 5 medicare supplement plans?
💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.
How much does Humana cost per month for seniors?
Premiums for Humana's plans start at $0 per month in addition to your Medicare Part B premium. In 2024, the standard part B premium amount is $174.70, but this number can go all the way up to $594 per month for high-earning seniors3.
Why are hospitals refusing Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Are there any 5 star Medicare Advantage plans?
"There isn't one Medicare Advantage plan that's the highest-rated; there are multiple plans that get an overall rating of 5 stars, which is the highest rating from CMS.
What is the two midnight rule for Medicare Advantage?
The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.
Is Humana pulling out of Medicare Advantage plans?
Humana will stop offering Medicare Advantage (MA) in 13 counties in 2025, Humana CFO Susan Diamond said in a published report in Becker's Payer Issues dated Sept. 3, 2024.
Why do people leave Medicare Advantage?
People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
Why are doctors dropping Medicare Advantage?
Providers often argue that Medicare Advantage plans impose restrictions that can hinder patient care. Low reimbursement rates, complicated billing recesses and stringent pre-authorization requirements have pushed CFOs to their boiling point.