Why do people say not to get a Medicare Advantage plan?
Asked by: Marlene Lubowitz | Last update: August 20, 2025Score: 4.6/5 (55 votes)
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 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 shouldn't you get a Medicare Advantage plan?
Some disadvantages of Medicare Advantage plans are: They may have limited service providers, networks, and coverage areas, restricting your choice of doctors and medical offices. They may have high out-of-pocket costs, copays, deductibles, and additional premiums, especially if you have complex medical needs.
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.
Why I Would Never Choose Medicare Advantage
Why are seniors leaving 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.
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 is a Medicare Supplement better than an advantage plan?
Consider Original Medicare with a Medigap plan if you:
Original Medicare with a Medigap plan gives you access to any doctor or hospital that accepts Medicare. Intend to travel. Medicare Advantage plans come with limited service areas; if you travel outside, you may have to pay out of pocket for medical care.
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 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.
Are most people happy with Medicare Advantage?
Beneficiaries in Traditional Medicare and Medicare Advantage plans say they're largely happy, but have plenty of issues with each program. When Americans are asked what they think about Medicare, they generally rate the program highly.
How much do agents make selling Medicare Advantage plans?
Medicare Advantage Commissions
2023 commissions for most U.S. states are $601 for persons new to Medicare and $301 for renewals. Commissions are even higher in some U.S. states like California. Commissions are paid in advance. Renewal commissions stay level for the life of the policy.
How do insurance companies get paid for Medicare Advantage?
Medicare Advantage is funded from two main sources. The plans receive some funding through monthly plan premiums, but most of the money comes from Medicare. The private insurance companies that offer the plans receive a payment each month from Medicare.
What is the alternative to a Medicare Advantage plan?
A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both. You can't buy Medigap while you're in a Medicare Advantage Plan unless you're switching back to Original Medicare.
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.
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.
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.
Why are people leaving Medicare Advantage?
Perhaps more disturbingly, many members of Medicare Advantage plans switched after they encountered problems getting the costs of their care covered, the article showed, The journal published the article, “The Sickest Patients Are Fleeing Private Medicare Plans — Costing Taxpayers Billions,” on Nov.
Why are doctors dropping Medicare Advantage?
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
Why is it not a good idea to have supplemental insurance?
One of the most significant drawbacks of supplemental insurance policies is the coverage limits. For instance, with Mechanical Repair Coverage, you'll typically need to pay out of pocket until your deductible is met on your primary policy before supplemental insurance takes over to cover a costly vehicle repair.
What is the point of a Medicare Advantage Plan?
Like original Medicare, Medicare Advantage plans cover hospital services and doctor visits. However, they may also provide extra health-related benefits not available with original Medicare, such as: Vision / eyeglasses. Hearing / hearing aids.
Why are hospitals refusing Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.
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.