Is Medicare Advantage cheaper than original Medicare?

Medicare Advantage (MA) can be cheaper upfront with lower premiums (sometimes $0) and includes extra benefits like dental/vision, plus an out-of-pocket max; however, Original Medicare with a Medigap plan offers broader provider choice and predictable 20% costs, but with higher premiums, so the "cheaper" option depends on your health, usage, and tolerance for network restrictions and prior authorizations.

How much does Medicare Advantage cost compared to traditional Medicare?

Original Medicare has higher potential out-of-pocket costs (no cap) but offers freedom to see any doctor, while Medicare Advantage (MA) often has lower premiums (some $0), predictable copays, and crucial yearly out-of-pocket maximums, but usually requires in-network care; the best choice depends on your health, budget, and provider preference, with MA often being cheaper for predictable care and Original Medicare + Medigap better for extensive, nationwide coverage. 

Is it better to have straight Medicare or a Medicare Advantage plan?

Neither Original Medicare nor Medicare Advantage (MA) is inherently "better"; the best choice depends on your health, budget, and lifestyle, with Original Medicare offering provider freedom and MA providing bundled benefits (dental/vision) and cost predictability via an out-of-pocket maximum, but often with network restrictions. Choose Original Medicare + Medigap for nationwide access and no networks, ideal for travelers or those wanting maximum choice, while Medicare Advantage suits those wanting all-in-one coverage (including drugs/extras like dental/vision) with lower upfront costs and a cap on yearly spending, provided they stay in-network. 

What is the downside of Medicare Advantage plans?

The main downsides of Medicare Advantage (MA) plans are limited provider networks (HMO/PPO) with potential referral needs, restrictions on care (prior authorizations), geographic service area limits (trouble traveling), yearly changes to costs/benefits, and higher out-of-pocket costs when you need services, despite potentially low premiums. You may also face upfront copays and risk denied care, unlike Original Medicare's nationwide, less restrictive system with Medigap. 

Why are seniors choosing Medicare Advantage over traditional Medicare?

Simply put, a growing majority of seniors choose MA because it provides better and more coordinated care, more comprehensive benefits, better outcomes and increased savings and financial security compared to FFS Medicare. For most Medicare-eligible patients, these advantages are available for no additional premium.

Why The Price You See Is Always a Lie (And How to Stop It)

Can I drop my Medicare Advantage plan and go back to original Medicare?

Yes, you can drop your Medicare Advantage (MA) plan and return to Original Medicare, typically during the Annual Enrollment Period (AEP) (Oct 15–Dec 7) or the MA Open Enrollment Period (OEP) (Jan 1–Mar 31), though you may qualify for a Special Enrollment Period (SEP) if you move or have other qualifying life events, but be aware you'll need to get a Part D plan and might want a Medigap plan to help with costs. 

Why do people say stay away from Medicare Advantage plans?

Medicare Advantage offers extra benefits, but out-of-network care may be limited or costly. Other disadvantages include difficulty switching out of the plans later, restrictions on care access, and limitations on extra benefits.

Why do doctors not accept Medicare Advantage?

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.

What are the hidden costs of Medicare Advantage?

Medicare Advantage plans bundle these costs into one plan, but you may notice that they charge you additional fees. For example, high drug deductibles and specialist visit copays can add up very quickly over time with some Medicare Advantage plans.

Which Medicare Advantage plan denies the most claims?

Centene (Wellcare) and CVS Health (Aetna) have faced scrutiny for high prior authorization denial rates in Medicare Advantage (MA) plans, with reports showing they had the most denied requests in 2023, though many denials were overturned on appeal, indicating issues with their strict criteria, while UnitedHealthcare also faces lawsuits and uses technology that has led to increased denials, especially for post-acute care, highlighting systemic challenges with MA plan claim approvals. 

What is the best health insurance for seniors on Medicare?

There's no single "best" health plan, as it depends on your needs, but top providers for Medicare Advantage (Part C) include Humana, UnitedHealthcare, Aetna, and BCBS, offering diverse benefits like $0 premiums, extra perks, and strong networks, while Medigap (Medicare Supplement) complements Original Medicare by filling gaps, with popular carriers like AARP/UHC, Anthem, and Cigna providing standardized policies (Plans G, F, N), with personalized choices best found via your State SHIP counselor or broker. 

Does Medicare Advantage pay 100 percent?

Medicare Advantage plans provide a financial safety net due to a set annual out-of-pocket limit. If your costs reach the limit, then your plan covers 100 percent of your Medicare-covered health care costs for the rest of the year.

What states have the worst Medicare Advantage plans?

States often cited for weaker Medicare Advantage performance include Louisiana, Mississippi, Kentucky, West Virginia, and Florida, due to challenges with care access, provider shortages, and quality issues like higher rates of avoidable hospitalizations and inappropriate medication prescriptions, though specific rankings vary by report and focus (e.g., satisfaction vs. overall system). Other states like New York, California, Texas, and Michigan appear on lists for low member satisfaction with specific plans, not necessarily the whole state's system. 

Should I get original Medicare or Medicare Advantage?

Choosing between Original Medicare (Parts A & B) and Medicare Advantage (Part C) depends on your priority for provider choice, extra benefits, and cost structure; Original Medicare offers freedom to see any Medicare doctor but needs a separate Part D plan and Medigap for full coverage, while Medicare Advantage (MA) bundles benefits (dental, vision, drugs) into an all-in-one plan with network restrictions but a yearly out-of-pocket max, ideal for those wanting low premiums and extra perks but willing to manage networks and prior authorizations. 

What are the biggest mistakes people make with Medicare?

The biggest Medicare mistakes involve missing enrollment deadlines, failing to review plans annually, underestimating total costs (premiums, deductibles, copays), not enrolling in a Part D drug plan with Original Medicare, and assuming one-size-fits-all coverage or that Medicare covers everything like long-term care. People often delay enrollment, get locked into old plans without checking for better options, or overlook financial assistance programs, leading to higher out-of-pocket expenses and penalties. 

Does everyone have to pay $170 a month for Medicare?

If you don't get premium-free Part A, you pay up to $565 each month. If you don't buy Part A when you're first eligible for Medicare (usually when you turn 65), you might pay a penalty. Most people pay the standard Part B monthly premium amount ($202.90 in 2026).

What is the biggest problem with Medicare Advantage?

The biggest disadvantage of Medicare Advantage (MA) plans is often the limited provider networks and restricted access to care, requiring prior authorizations, referrals, and potentially forcing you to switch doctors or travel far for specialists, creating barriers to timely treatment, especially for complex health issues, with potential for denials and mid-year changes. While MA offers extras like dental/vision, these networks can significantly limit choice and create hurdles for consistent, high-quality care compared to Original Medicare. 

Is it better to go on Medicare or stay on private insurance?

Neither Medicare nor private insurance is universally "better"; the best choice depends on individual needs, but Medicare often offers lower overall costs and simplicity for seniors, while private insurance excels in covering dependents and potentially offering more choice with networks/out-of-pocket caps, though at higher premiums. Medicare boasts lower admin costs and standardized coverage, but Original Medicare lacks an out-of-pocket maximum, a feature typically found in private plans and Medicare Advantage (Part C). 

What does Dave Ramsey say about Medicare?

Dave Ramsey's Medicare advice centers on planning ahead, understanding enrollment periods to avoid penalties, using Health Savings Accounts (HSAs) if possible, and supplementing Original Medicare with Medigap or Medicare Advantage (Part C) to cover gaps like dental, vision, and long-term care, stressing that mistakes can be costly and recommending expert advice for personalized choices. 

What is the most used Medicare Advantage plan?

While there isn't one single "most popular" plan, UnitedHealthcare (UHC) is the largest Medicare Advantage provider by enrollment, covering about one-third of all MA members, followed by strong showings from Humana, Aetna (CVS Health), and Blue Cross Blue Shield affiliates. Popularity often comes from nationwide availability, strong networks (UHC), or high satisfaction/star ratings (Aetna, Humana, Kaiser Permanente in certain areas). 

Can you pick your own doctor with Medicare Advantage?

Medicare Advantage

With an HMO, you must choose a primary care physician (PCP) from a network of local healthcare providers when you join. Your PCP will provide referrals to a specialist or other care providers when needed. You can change your PCP as often as you like.

Why should I not do a Medicare Advantage plan?

People avoid Medicare Advantage (MA) due to restrictive provider networks, referral/prior authorization requirements that delay care, limited coverage when traveling, potentially high out-of-pocket costs despite low premiums, and the annual risk of plans changing benefits or networks, all contrasting with Original Medicare's broad nationwide access and simpler structure. It's often a trade-off: MA offers bundled extras like vision/dental but with more managed care rules than traditional Medicare, which lets you see any Medicare-accepting doctor.
 

Why are hospitals refusing Medicare Advantage plans?

Across the country, health systems report that Medicare Advantage's growing administrative burden — from denied authorizations to delayed reimbursements — has become unsustainable. Some hospitals have already ended their contracts; others are limiting participation to only a few select plans.

What is happening to Medicare Advantage in 2025?

In 2025, Medicare Part D plans and Medicare Advantage plans that include prescription drug coverage will feature lower out-of-pocket cost limits and new payment options. Changes include: Annual out-of-pocket cap reduced from $8,000 to $2,000. Elimination of the Medicare donut hole in 2025.

Can you go back to regular Medicare after an Advantage plan?

Yes, you can go back to Original Medicare from a Medicare Advantage (MA) plan during specific enrollment periods, primarily the Annual Enrollment Period (AEP) (Oct 15 - Dec 7) or the MA Open Enrollment Period (Jan 1 - Mar 31), with coverage starting Jan 1 or the first of the month after switching. However, be aware that you might not be guaranteed a Medigap (supplemental) plan when returning, as insurers can deny coverage or charge more based on health, except in limited guarantee situations, notes AARP and KFF.