Why do people dislike Medicare Advantage plans?

People dislike Medicare Advantage (MA) plans due to restrictive provider networks, complex rules like prior authorizations, potential for higher out-of-pocket costs, and annual changes in coverage, which can disrupt care, especially for those with chronic conditions, compared to the stability of Original Medicare. Frustrations also stem from aggressive marketing, misleading information, and the administrative burden placed on doctors, leading to denied claims and slower payments.

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 do doctors not like advantage plans?

Do doctors like Medicare Advantage plans? They generally don't like Medicare Advantage plans because the incentive structure is set up to deny needed healthcare to the most vulnerable.

Why does Medicare Advantage have a bad reputation?

The issue is there are too many crappy companies preying on the desperation of people, providing low payments to providers, have fewer in network providers (especially in rural towns) and withholding payments to providers to control costs, leading to more providers leaving the network.

What's the downside to Medicare Advantage?

Medicare Advantage (MA) disadvantages include restricted provider networks (HMO/PPO), needing prior authorization for care, potential denials of coverage, limited out-of-network/travel coverage, annual plan changes (benefits/networks), and complex marketing, making it harder to budget for unexpected costs compared to Original Medicare's broad network and more predictable expenses. 

Medicare Experts HATE Advantage Plans! Are they really THAT bad? 🤨

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 people dropping Medicare Advantage plans?

People are dropping Medicare Advantage (MA) plans due to rising out-of-pocket costs (copays, denials), frustrating network restrictions and prior authorizations, difficulty using extra benefits, and insurers reducing offerings or exiting markets because of financial pressures and lower government payments, forcing seniors to scramble for new coverage. This creates issues, especially for those with serious conditions, as plans may limit care or providers, leading to higher costs or access problems.
 

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. 

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. 

Why is UnitedHealthcare cancelling Medicare Advantage plans?

UnitedHealth now plans to exit unprofitable Medicare Advantage and Affordable Care Act products, raising rates on ACA plans by about 26% alongside other health insurers. They're not fixing the business model, but rather purging the patients who make it look broken.

Why do they push Medicare Advantage so hard?

Medicare Advantage (MA) plans are heavily promoted because private insurers profit significantly from government payments, offering appealing extras like dental, vision, and fitness perks not in Original Medicare, and using aggressive marketing (like celebrity endorsements and extensive ads) to attract enrollees who switch from traditional Medicare, creating a lucrative, competitive market despite potential issues with provider networks and claim denials. 

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.

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 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. 

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.

Who actually pays for Medicare Advantage plans?

Medicare Advantage (MA) plans are paid by the federal government with a fixed monthly amount per person, funded by Medicare's trust funds (from payroll/income taxes, investments), with beneficiaries also paying their standard Medicare Part B premium and potentially plan-specific premiums, copays, and deductibles, with some MA plans even covering part of the Part B premium. Essentially, Medicare funnels federal funds to private MA companies to manage care, and beneficiaries contribute their Part B premium plus any extra costs the plan charges.
 

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. 

What is the number one rated Medicare Advantage plan?

There's no single "number one" Medicare Advantage plan because the best choice depends on your location and needs, but leading providers often include UnitedHealthcare (AARP), Humana, Aetna, and Kaiser Permanente, frequently praised for wide networks, $0 premium options, extra benefits (dental/vision), and high CMS star ratings, with UnitedHealthcare often cited for largest network/nationwide coverage and Humana for overall quality/affordability.
 

What insurance company has the most complaints?

There isn't one single company with the "most" complaints universally, as it varies by insurance type (auto, home, health) and reporting agency, but Allstate frequently appears at the top of "worst" lists for auto/property due to aggressive claims tactics (lowballing, delays). For home insurance, companies like American Bankers and Spinnaker show high complaint ratios, while some reports point to high denial rates for health insurers like AvMed and UnitedHealthcare. 

Is it better to be on original Medicare or Medicare Advantage?

Neither Original Medicare nor Medicare Advantage (MA) is inherently "better"; the ideal choice depends on your health needs, budget, and preference for provider choice, with Original Medicare offering nationwide flexibility and MA providing bundled benefits (dental, vision, drugs) with network restrictions and cost-sharing. Choose Original Medicare (with optional Medigap) for broad doctor access and travel, but budget for potential high out-of-pocket costs; choose MA for lower monthly premiums, an out-of-pocket maximum, and extra perks, but be prepared for network limits and prior authorizations. 

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. 

Is there a penalty for switching from Medicare Advantage to regular Medicare?

No, there's no direct penalty for switching from Medicare Advantage (Part C) back to Original Medicare (Parts A & B), but you risk significant issues: losing drug coverage (Part D penalty if you don't enroll in a separate plan) and potentially being denied or paying much more for a Medigap supplement due to medical underwriting after your initial guarantee period ends. You must switch during specific enrollment periods (Annual Election Period: Oct 15-Dec 7, or MA Open Enrollment: Jan 1-Mar 31). 

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.
 

What is happening to Medicare Advantage plans in 2025?

The future of Medicare Advantage (MA) in 2025 points to continued growth but with policy shifts: expect more focus on accountability, faster prior authorizations, slight declines in some supplemental benefits (like OTC/transport) while core dental/vision/hearing remain strong, increased Special Needs Plans (SNPs), and rising attention to managing costs for beneficiaries, especially as enrollment nears 50% of all Medicare recipients. Key changes include stricter rules for plan payments, efforts to improve access for dual-eligible individuals, and ongoing debates over federal spending, all while plans adjust benefits to stay competitive and compliant. 

Who qualifies for an extra $144 added to their social security?

You qualify for an extra ~$144 on your Social Security check if you have a Medicare Advantage (Part C) plan with a "Part B Giveback" benefit, which refunds some or all of your Medicare Part B premium, appearing as extra cash in your check, but eligibility depends on living in the plan's service area and paying your own Part B premiums. The "144" figure was common when the Part B premium was around that amount, but the actual refund varies by plan and location, potentially exceeding the full premium.