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