Do you lose Medicare if you get a Medicare Advantage plan?
Asked by: Dianna Wiegand | Last update: August 28, 2025Score: 4.6/5 (36 votes)
Do you still pay for Medicare if you have a Medicare Advantage plan?
You'll still pay the government-set annual Part B premium and the Part A premium, if required. Sometimes you'll pay an additional premium for the MA plan although about three-quarters of Medicare Advantage enrollees in 2024 are in plans with no additional premiums.
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.
Why do doctors not accept Medicare Advantage plans?
Many doctors are declining to accept Medicare's payment for services because of the government program's low reimbursement rates, strict rules, and onerous administrative process. Most of the time, Medicare only gives doctors 80% of what commercial health insurance does. I sincerely hope I was of assistance.
Why are people leaving Medicare Advantage plans?
Key takeaways: 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.
Unhappy with Medicare Advantage? How to Leave Your Advantage Plan for Original Medicare
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.
Why do people say not to get a Medicare Advantage plan?
Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.
Why is original Medicare better than Medicare Advantage?
Medicare Advantage plans typically require that you use care providers within a geographic service area, and once you get outside that area, you'll be covered for emergency care only. Original Medicare offers access to a national network of providers — no matter where you are in the U.S. Like to minimize risk.
Do all hospitals accept Medicare Advantage plans?
While most hospitals do accept Original Medicare, there may be some that do not accept Medicare Advantage Plans. However, if you have a medical emergency while you're enrolled in a Medicare Advantage plan, you can seek care at any ER or hospital in the country.
Does everyone have to pay $170 a month for Medicare?
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.
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.
Are hospitals dropping Medicare Advantage plans?
Medicare Advantage provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end or not renew contracts with MA plans over administrative challenges.
Do I still pay for Medicare if I have an Advantage plan?
To qualify for a Medicare Advantage plan, you must be enrolled in Medicare Part A and Part B, so you will already be paying and will continue to pay your Part B premium.
Can I drop my employer health insurance and go on Medicare Part B?
Once you stop working (or lose your health insurance, if that happens first) you have an 8-month Special Enrollment Period (SEP) when you can sign up for Medicare (or add Part B to existing Part A coverage).
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.
Why seniors are choosing Medicare Advantage over traditional Medicare?
People with Medicare are drawn to Medicare Advantage for the extra benefits. Medicare Advantage plans offer extra benefits, like reduced cost-sharing, dental coverage, gym memberships and debit cards for over-the-counter medical supplies that are not covered by traditional Medicare.
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
Do you lose Medicare if you get an Advantage plan?
Most Medicare Advantage plans are all-in-one plans. They cover your Medicare Part A and Part B benefits plus prescription drugs (Part D) and other health services and items not included with Original Medicare. Examples of these other items include coverage for dental health, vision, hearing and gym memberships.
Why do healthcare workers not like Medicare Advantage plans?
Many doctors and healthcare physicians don't like Medicare Advantage plans due to coverage restrictions, limited networking, and overpayment rates, which cause increasing difficulties for patients. Since pre-authorization and referral requirements often impede patients' needs, doctors refuse to accept these plans.
What is the downside of a Medicare Advantage plan?
Many people choose MA plans for their extra benefits and out-of-pocket limits. But MA plans have some potential disadvantages. They have smaller provider networks and often require prior authorization. And with an MA plan, you won't have access to Medigap supplement insurance to cover your out-of-pocket costs.
Is there a Medicare plan that pays 100%?
Medicare Advantage Plan (Part C):
Deductibles, coinsurance, and copayments vary based on which plan you join. Plans also have a yearly limit on what you pay out-of-pocket. Once you pay the plan's limit, the plan pays 100% for covered health services for the rest of the year.
What is the new Medicare rule for 2025?
Medicare Part D cap of $2,000
Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications.