17/11/2025
If my parents were 65, I’d never let them enroll in a Medicare Advantage plan.
What is a Medicare Advantage Plan?
A Medicare Advantage plan (Medicare Part C) replaces Original Medicare (Part A + Part B) and often includes:
* Hospital coverage (Part A)
* Doctor/medical coverage (Part B)
* Prescription drug coverage (Part D)
* Extra benefits like dental, vision, hearing, transportation, gym memberships, etc.
You still pay your Part B premium, but now your care is managed by a private insurance company instead of the federal government.
Sounds good so far, right?
Why it looks appealing
MA plans often offer:
* $0 premiums
* Lower upfront costs
* Extra perks
On the surface, it seems like a better deal than Original Medicare…
But here’s the catch:
1️⃣ You must follow their network rules
If your doctor isn’t in-network, you’re paying out-of-pocket — or you simply can’t see them.
HMOs require referrals and pre-authorizations, which cause delays and denials.
2️⃣ Insurance has more control than your doctor
MA plans can deny or delay care. They often require:
* Prior approvals
* Step therapy
* Extra tests before treatment
* Trying cheaper options first
In emergencies, this can be dangerous.
3️⃣ Networks change every year
Your doctor may accept the plan this year… and drop it next year.
4️⃣ Sick people often end up paying more
MA works best when you’re healthy. When health problems arise, the limits and restrictions become a serious problem.
5️⃣ Top-tier providers often refuse Medicare Advantage
Why? Because reimbursement rates are too low.
Many of the country’s best hospitals no longer accept MA plans.