Beware of Biggest Complaints about Medicare Advantage Plans?

It is Medicare Enrollment and the Vultures are out. Medicare Advantage Plans Calling Seniors and People who have disabilities. Do not fall for it. Medicare Advantage is really misunderstood by Medicare beneficiaries. The main reason is that they are less expensive and provide additional benefits than other supplemental Medicare insurance coverage.

These plans combine Medicare Part A, Part B, and in most cases, Part D into an all-in-one plan that’s simple to use and navigate.
“There’s a sucker born every minute” is a phrase closely associated with P. T. Barnum, an American showman of the mid-19th century, although there is no evidence that he actually said it.  He must have foreseen Medicare Advantage plans. So this is how they work.

They Claim:

Low to no premium in many areas
Can include drug coverage
Maximum Out-Of-Pocket
Most have prescription drug coverage
No medical underwriting
Coverage for pre-existing conditions
Additional benefits can include the following:
Dental
Vision
Hearing
Gym Memberships. (REALLY What the Heck)?????
Over-the-counter allowance
Flexible Spending cards  ( Ya they say we will send you $$$ on a card). The problem they will not pay your bill to your providers the way that Medicare does.. DO Not Fall for it..

What Are the Biggest Complaints about Medicare Advantage Plans?
Common criticisms of Medicare Advantage plans include limited provider networks and rising prescription drug costs. Beneficiaries have also had difficulty with the lack of out-of-network coverage, which can be especially concerning for those who travel frequently.

Additionally, some beneficiaries need help understanding the complex plan options and finding the coverage that best fits their needs. Lastly, plans can change yearly. This forces beneficiaries to reevaluate their coverage each year and possibly switch plans if their current one is no longer adequate.

In addition, the dental, vision, and hearing coverage is difficult to navigate, and many need help finding providers that accept the plans. Although these complaints exist, Medicare Advantage plans remain an attractive option for many.

Next, we’ll dive into a little more detail about these complaints.

Restrictive Networks
Medicare Advantage plans are network-based. They will be organized as a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). Despite both of these options being network-based, there are some differences.

Cons of a Medicare Advantage Plan
While all the items listed above may sound great, these plans aren’t all roses. An extensive list of cons comes with these plan extras and benefits offered through Medicare Advantage.

You must continue to pay your Medicare Part B premium
Most plans require referrals to visit specialists
Approval and authorizations for items and services
A Non-Medical plan administrator reviews and either approves or denies these approvals
Limited networks on most plans
Prior Authorization may be required before procedures occur
Denials could result regarding specific services, especially if there is a less expensive alternative.
Higher costs or no coverage for out-of-pocket costs
Annual Contract
You can’t just leave the plan if it’s not working for you