7 Reasons Why Medicare Advantage Plans Are Bad

Medicare Advantage plans (also called Medicare Part C) may sound like a great deal, but are they really? The truth is, they can be a trap that ends up costing you more money in the long run. We'll discuss seven reasons why Medicare Advantage plans are bad and why you might want to stick to Original Medicare Part A and B with a Medicare Supplement plan instead.

Seven Disadvantages of Medicare Advantage Plans

1. Limited Provider Networks

One of the main disadvantages of Medicare Advantage health plans is network limitations. Unlike Original Medicare, where you can see any doctor who accepts Medicare patients, Medicare Advantage plans limit your choice of providers. Private insurance companies have agreements with certain in-network doctors and hospitals to care for their members. If you go outside this network, you may end up paying out-of-pocket healthcare costs or not getting coverage. And lastly, if you have an HMO MA plan, they will require a referral for doctor visits and other outpatient healthcare providers.

2. Out-of-Pocket Costs

While Medicare Advantage plans may have low or no monthly premiums, they often come with higher out-of-pocket costs than Original Medicare with a Medicare Supplement insurance plan. This can include copayments, deductibles, and coinsurance for medical services for inpatient and outpatient care.

3. Not Guaranteed Renewable

Medicare Advantage plans are not guaranteed renewable from year to year, which means the plan can choose not to renew your coverage. If this happens, you'll need to find a new health insurance plan, which can be a hassle and may result in higher costs.

Additionally, suppose you enroll in a Medicare Advantage plan and decide to switch back to Original Medicare; in that case, you might be subject to higher premiums if you don’t enroll in a Medigap plan during the initial enrollment period.

4. More Administrative Hassles

Medicare Advantage plans often require more administrative work on your part, such as getting prior authorization for specific procedures or medications. This extra paperwork can be frustrating and time-consuming, adding even more stress to an already complicated healthcare system.

5. Limited Coverage Areas

Medicare Advantage plans are not available in all areas, so if you move to a different state or county, you may be forced to switch to a new plan or return to Original Medicare. This can create a lot of uncertainty and make it difficult to plan for your healthcare needs in the future.

6. Less Coverage for Travelers

If you’re a frequent traveler, Medicare Advantage plans might not be your best option. These plans may not provide medical care if you’re out of state or out-of-network. The only exception to this rule is if you need healthcare services for emergency-related issues, even if you are out of the plan’s network.

7. Lack of Flexibility

Another drawback of Medicare Advantage plans is their lack of flexibility. If you want to switch plans or return to Original Medicare, you must do it during specific open enrollment periods at certain times of the year. Medicare Advantage plans also frequently change their benefits yearly, meaning the coverage you receive this year may not be the same next year.

Bottom Line

Medicare Advantage plans may seem like a good deal on the surface, but they can quickly become a trap that costs you more money and creates more headaches. You can make a more informed decision about your healthcare coverage by being aware of these seven reasons why Medicare Advantage plans are bad. While Original Medicare isn't perfect, it may be a better option for some people if they also enroll in a Medigap plan, depending on their needs and preferences.