Articles, Blog

Top 10 Disadvantages of Medicare Advantage Plans | Teska’s Top 10

December 14, 2019


Hi, I’m Rick Teska with Senior Market Solutions, your Medigap Insurance Advisor. In this video, I’m gonna highlight the “Top 10 Disadvantages of Medicare Advantage Plans.” So stay tuned! [Senior Market Solutions animation] Here are the “Top 10 Disadvantages of Medicare Advantage Plans.” #1: Annual Changes. With Medicare Advantage plans, your medical and prescription drug benefits change annually. You’ll have to review your options carefully. Each insurance company’s plan will likely differ from other companies’ plans. This includes company-specific rules, what they charge AND what they provide. Not all plans are available in all states AND details change annually. #2: No Guaranteed Renewals. Medicare Advantage plans are not required to renew benefits or coverage on an annual basis. This can leave policyholders hanging while they search for new coverage that meets their needs and often with very short notice. For example: In 2014, a popular plan in Florida called Physicians United Plan was declared insolvent. Doctors called the insured individuals to cancel their appointments because the plan could no longer pay the claims of its policyholders. #3: Networks, Referrals and Travel. Typically, you must use providers and doctors within a specified network. Referrals for services are also commonly required. Medicare Advantage Plans are NOT travel-friendly. You may experience difficulty getting emergency or urgent care due to rationing. Plans can limit care approvals to control paid claims. They only cover certain doctors, often dropping providers without cause. This breaks the continuity of care. Obtaining healthcare services while you travel can be difficult. #4: Out-of-Pocket Costs. Medicare Advantage plans often come with high out-of-pocket costs, deductibles and co-payments. This can make budgeting a challenge, especially for those on a fixed income. #5: Limited Flexibility. With Medicare Advantage, it’s difficult to switch to other types of plans. You’re subject to enrollment and disenrollment periods, as well as health restrictions. For example: An individual applying for a Medicare Supplement Plan is often required to answer a wide variety of health questions. If that individual can’t pass the health underwriting qualifications, his or her eligibility can be denied. #6: Difficult to Comparison Shop. It’s difficult to comparison shop for Medicare Advantage because plan benefits are NOT standardized. So they can vary greatly from company to company. #7: Give Up Your Right to Original Medicare. If you go with a Medicare Advantage [plan], you must give up your right to Original Medicare. If your doctor decides NOT to accept your Medicare Advantage plan, you can’t just bill Medicare for the services provided! For people on a fixed income, again, this creates significant uncertainty AND limits their ability to budget accurately. #8: You Get What You Pay For. Typically, the worst aspects of Medicare Advantage plans won’t become evident until you’re already sick. For plan beneficiaries, the out-of-pocket costs relating to serious illness frequently go through the roof. #9: Empty Benefits. The extra benefits offered with an Advantage plan can turn out to be less than promised. Some of these empty benefits include: gym memberships, hearing benefits and vision benefits. Policyholders will often get less than what they expect. #10: Lots of Paperwork. Expect to do a lot of paperwork if you decide to go with a Medicare Advantage plan. Some plans – and some providers – make you file your own claims. Not only does this require time, but it also means YOU’RE responsible for many of the up-front costs. So that’s the “Top 10 Disadvantages of Medicare Advantage Plans.” Before you look at – or sign up for – a Medicare Advantage plan, make sure YOU understand ALL of these things before it’s too late. If you’re interested in learning more, I encourage you to watch some of our other Medicare Supplement-focused videos. Be sure to subscribe to the SMS YouTube Channel so you don’t miss any of our new content. Still have questions? Our team has the answers! Schedule your FREE consultation with a licensed Medigap Insurance Advisor today. Either call us toll-free at 1-800-784-8969 or click on the link in the description to book your appointment online. And choose Senior Market Solutions and find “Success With SMS!”

You Might Also Like

No Comments

Leave a Reply