What are two disadvantages of Medicare?

Two major disadvantages of Medicare are the significant out-of-pocket costs (premiums, deductibles, copays) and limited coverage for crucial services like dental, vision, hearing aids, and long-term care, often requiring extra plans or leading to unexpected expenses. Additionally, Medicare Advantage (Part C) plans, while popular, can further restrict care through provider networks and prior authorization requirements, and their benefits change yearly.

Is there a downside to Medicare?

Medicare's disadvantages often stem from its different parts, with Medicare Advantage (Part C) having network restrictions, referral needs, prior authorizations, and potential for mid-year benefit changes, while even Original Medicare (Parts A & B) leaves gaps like dental/vision, requiring supplemental plans (Medigap/Part D) that add premiums and costs, plus coverage limitations when traveling. 

What are the 5 things Medicare doesn't cover?

Medicare generally doesn't cover long-term care, most dental care, routine vision services (like glasses), hearing aids/fittings, and cosmetic surgery, though it does provide strong coverage for hospital and doctor services; you can often get coverage for these gaps through Medicare Advantage (Part C) or supplemental plans. 

Why do people say not to get a Medicare Advantage plan?

People warn against Medicare Advantage (MA) plans due to limited doctor/hospital networks, complex pre-authorization for care, higher potential out-of-pocket costs for serious illnesses, annual plan changes (benefits/networks), denials of care, and difficulty switching back to Original Medicare with a Medigap plan later, especially if you become sick. While MA offers extra perks (dental, vision, low premiums), these restrictions can be burdensome, prioritizing insurer profits over patient freedom, making it risky for those with ongoing health issues. 

Why are doctors dropping Medicare patients?

Physician Medicare reimbursement dropped 33% since 2000, when adjusted for inflation, according to the AMA. As a result, Ferguson said, many practices—particularly small, independent ones—can no longer afford to absorb the losses. "It's gotten to a point where you can't absorb it.

Top Disadvantages of Medicare Advantage Plans

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 health insurance denies the most?

In 2023, roughly one third of all in-network claims made to AvMed were denied by the medical insurance company. In this year, AvMed and United HealthCare were the medical insurance companies with the highest denial rate for in-network claims in the United States, at 33 percent each.

Is it better to have plain Medicare or Medicare Advantage?

Neither Original Medicare nor Medicare Advantage (MA) is universally "better"; the best choice depends on your healthcare needs, budget, and preference for provider choice, with Original Medicare offering nationwide provider freedom but requiring separate drug/supplement plans, while MA provides all-in-one coverage with networks and extra benefits like dental/vision but often requires referrals and has regional limits. 

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 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. 

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. 

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 is the most popular Medicare supplement plan?

The most popular Medicare Supplement (Medigap) plan for new enrollees is Plan G, offering comprehensive coverage similar to the old Plan F but without covering the Medicare Part B deductible; however, Plan F remains popular for those already enrolled, while Plan N is also a top choice for lower premiums in exchange for some copays and deductibles, according to Boomer Benefits and KFF.
 

Why are doctors against Medicare for all?

Shifting to a Medicare for All system means massive reform. Some healthcare physicians are against these changes, citing the increased demand and lack of resources. Overburdened doctors could lead to burnout, which would hurt the quality of healthcare.

What is the average cost per month for Medicare?

Medicare costs vary, but for 2026, the standard Part B premium is around $202.90/month, Part A is often $0, Medicare Advantage (Part C) averages low premiums (around $14-$34.50), and Part D (drugs) averages around $34.50-$38/month, but all costs depend on income, plan choice, and work history. Many people pay more for Part B or Part D if they have higher incomes or delayed enrollment. 

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 are seniors losing Medicare Advantage plans?

Citing decreased federal payments and rising health care costs, the private health insurers Martin's Point, UnitedHealth and Anthem are pulling their Medicare Advantage plans from New Hampshire in 2026. In Cheshire County, only two insurers will continue offering Medicare Advantage plans.

Do all hospitals accept Medicare for seniors?

If you have Original Medicare (Part A & Part B): You have nationwide access. You can visit any hospital or doctor in the U.S. that accepts Medicare. You do not need to worry about “networks” or referrals. If you have a Medicare Advantage Plan (Part C): You are likely restricted to a local network.

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. 

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.

Do I really need supplemental insurance with Medicare?

Supplemental insurance is advisable for those with Medicare to help cover out-of-pocket costs and gaps in coverage, offering financial protection for deductibles, coinsurance, and other medical expenses not fully covered by Medicare.

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.

Which insurance to avoid?

8 Insurance Policies You Should Avoid

• Mortgage, Whole, and Child Life Insurance. ...
• Accidental Death Insurance. ...
• Credit Card Loss Protection Insurance. ...
• Extended Warranties. ...
• Identity Theft and Cyber Breach Insurance. ...
• Cell Phone Insurance. ...
• Flight Insurance. ...
• Old Car Collision.

What is the 80% rule in insurance?

When it comes to insuring your home, the 80% rule is an important guideline to keep in mind. This rule suggests you should insure your home for at least 80% of its total replacement cost to avoid penalties for being underinsured.

What health insurance company has the most complaints?

There isn't one single "worst" company for complaints as it varies by source, but Allstate is frequently cited in the U.S. for aggressive tactics and lowball offers in property/casualty, while UnitedHealth and Elevance Health (Anthem) (now part of larger groups) are often named in health insurance for claim denials and low reimbursement rates, with some reports highlighting Star Health & Allied Insurance (India) as having high complaint volumes. Common complaints across insurers involve claim handling, denials, delays, and unsatisfactory settlements, with specific issues depending on whether it's health, auto, or property insurance.