What is the downside of Medicare Advantage plans?

Medicare Advantage (MA) plans are supplied by commercial insurance firms, whereas Original Medicare is a federal health insurance program. Medicare Advantage plans, often known as Medicare Part C, are provided by private insurers under a contract with Medicare. Part A (hospital insurance) and Part B (medical insurance) coverage are combined in Medicare Advantage plans.

Medicare Advantage plans are a popular private insurance option for people who don’t want to take Medicare. Medicare Advantage, on the other hand, has some advantages and disadvantages. You may get long-term savings, plan flexibility, and better treatment with some Medicare Advantage plans, but other MA plans may increase your expenses, and limit the list of provider alternatives.

We’ll look at some of the disadvantages of Medicare Advantage plans in this article.

Medicare Advantage Plans – Drawbacks 

It’s simple to see why Advantage is so popular. Original Medicare doesn’t cover all of your medical bills, whereas Advantage plans include cost-sharing restrictions but limit your out-of-pocket payments. You also benefit from inexpensive rates and the convenience of all-in-one coverage. 

Advantage programs, however, can have hidden hazards, especially for people with serious health problems. When consumers on Medicare Advantage become ill or discover that their network lacks the physicians they require, they may face unexpectedly large expenditures.

Major Drawbacks

1. While a Medicare Advantage Plan can save you money when you’re well, if you get sick in the midst of the year, you’ll be left with any expenditures you pay until the next open season for Medicare. 

   You can then enrol in an Original Medicare plan with Medigap at that time. If you do, keep in mind that you may be charged a higher premium than if you had purchased Medigap coverage when you first became eligible for Medicare.

2. Original Medicare provides countrywide coverage and allows you to visit any doctor or institution that accepts Medicare. A Medicare Advantage plan is more limited and typically works with regional networks, which means that if you go out of network, you may not be covered or your money will not be counted toward your yearly quota. Check your plan’s directory to see if any of your preferred hospitals or physicians are included. 
3. If you become sick, your out-of-pocket expenses will quickly add up over the course of the year. Although the Medicare Advantage Plan may have a $0 payment, the out-of-pocket costs may not be worth it if you become ill. A healthy person is an ideal candidate for Medicare Advantage.

Minor Drawbacks 

• Due to rationing, it may be difficult to obtain emergency or urgent treatment.
• Only certain doctors are covered by the policies, and providers are frequently dropped without explanation, disrupting treatment continuity.
• To get insured treatment, members must adhere to the plan’s restrictions.
• When it comes to picking physicians, hospitals, and other providers, there are always limitations, which is another type of rationing that limits consumers’ choice.

Disclaimer

I undertake that I am the original author of the above blog and it is free from plagiarism, not under consideration by another proprietor or company or anyone whosoever, and has not been previously published on any online/print platforms.

I hereby unconditionally transfer all copyright and full ownership in and relating to the above blog who may use it with or without modifications. 

Name: Vikas Gaur

E-mail: vks.gaur1@gmail.com

Date: 25/11/2021