Why do people enroll in Medicare Advantage?
Asked by: Ms. Delilah Mayert III | Last update: January 9, 2026Score: 5/5 (55 votes)
Why would someone get Medicare Advantage?
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 is the downside to a Medicare Advantage plan?
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. Those drawbacks can limit access and affordability for enrollees.
Is it better to have straight Medicare or a Medicare Advantage plan?
There are zero circumstances where Medicare Advantage is better than Original Medicare + Medicare Supplement. However, if your question is just about carrying ONLY Original Medicare with no backstop insurance behind it then literally ANY Medicare Advantage policy is better than Original Medicare by itself.
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.
8 Reasons to DELAY Medicare Past 65 That Will Save You Thousands and Avoid ALL Penalties
Why are people leaving Medicare Advantage?
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.
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.
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.
Do I still pay Medicare premiums with an Advantage plan?
Medicare Advantage Plan (Part C):
You must keep paying your Part B premium to stay in your plan. Deductibles, coinsurance, and copayments vary based on which plan you join. Plans also have a yearly limit on what you pay out-of-pocket.
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.
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.
Why is Medicare Supplement better than Advantage Plan?
Summary: Medicare Advantage offers broader coverage including prescription drugs and dental care, while Medicare Supplement focuses on covering most out-of-pocket costs. Medicare Advantage plans are managed by private insurers with network restrictions, whereas Medicare Supplement allows freedom of provider choice.
What is the biggest disadvantage of Medicare Advantage?
- Plans can also cost more overall than Original Medicare if you have complex medical needs. ...
- With some plans, you don't have any coverage if you use a doctor that isn't in the network.
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 do agents push Medicare Advantage plans?
Why do brokers push Advantage plans so hard? It's money. Sorry, that's the honest truth. The commission for an Advantage plan can be roughly double that of the most popular Medicare supplement plan and it's paid all at one time.
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.
What is the monthly cost for Medicare Advantage?
Costs of Medicare Advantage
According to the Centers for Medicare & Medicaid Services (CMS), the average monthly plan premium for all Medicare Advantage plans in 2025 is around $17. In addition to the MA plan premium, Medicare members enrolled in an MA plan are responsible for their Part B premium ($185 in 2025).
Why are people dropping 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.
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.
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).
Do doctors have to accept Medicare Advantage plans for seniors?
While it is rare for a doctor to stop accepting a Medicare Advantage plan, it could happen. The most common reason that doctors may discontinue their acceptance of Medicare Advantage is that the private insurance company makes it difficult or time-consuming for the doctor to get paid for their services.
Why do people disenroll from Medicare Advantage?
The 2 most frequently chosen reasons for voluntarily disenrolling were reported problems with coverage of doctors and hospitals and financial reasons.
Which company has the best Medicare Advantage Plan?
- Best Overall, Best for Low Costs: Cigna.
- Also Great for Low Costs: Alignment Health.
- Best for Nationwide Coverage: Aetna.
- Best for Patient Experience, Best for Drug Coverage: Kaiser Permanente.
- Best for Special Needs Plans: Humana.