Medicare Advantage (MA) plans are offered by private insurance companies and are an alternative to Original Medicare (Parts A and B). While MA plans can provide additional benefits beyond Original Medicare, such as vision or dental coverage, and have lower out-of-pocket costs, some people may have complaints about them.
Here are a few common complaints people have about Medicare Advantage:
Complaint 1: Limited provider networks
Some people may not be able to see the providers they want because they are not in the plan’s network. Each Medicare Advantage plan provider can select networks of participating doctors and facilities. Some are more expansive than others.
Complaint 2: Limited coverage
Some MA plans may have restrictions on certain services, such as out-of-network coverage, or may require prior authorization for certain procedures.
Complaint 3: Large out-of-pocket fees
Some people may find that the additional benefits provided by a MA plan don’t outweigh the extra cost they may have to pay out of pocket in the forms of co-pays, deductibles, and coinsurance. These fees can add up to $8850 in one year on some plans.
Complaint 4: Lack of flexibility
Some people may prefer the freedom and flexibility of Original Medicare combined with a Medigap policy, rather than being restricted to a specific network of providers and doctor referral requirements with a Medicare Advantage plan.
Complaint 5: Not all plans include prescription drug coverage
Some Medicare Advantage plans do not include prescription drug coverage, and you will have to join a separate stand-alone Part D plan.
Next Steps with Medicare Advantage
While it is clear that Medicare Advantage is not for everyone, it does a much better job of containing medical expenses than Original Medicare alone. Those who are not happy with Medicare Advantage often consider a Medigap plan. Learn here the main reasons some people choose Medigap over Medicare Advantage. If you currently have a Medicare Advantage plan and would like to make a complaint, please contact your plans grievance department by calling the customer service number on the back of your card.
Senior65.com recommends you consider your own health, prescription drug needs, and budget when comparing Medicare health insurance. One of our licensed agents can help you compare costs and benefits of both options and make an informed decision. There is no additional cost to work with Senior65.com and we never charge for our services. No one can sell the same Medicare Insurance plan for less than us. Call us at 800-930-7956.