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Disadvantages of Medicare Advantage plans

If you check out at the Medicare Advantage Plans for 2020, you might realize that it has advantages that are not covered under the government-sponsored Medicare. But before you jump into taking the Medicare Advantage plan, you need to consider the disadvantages that come with it so that you make an informed decision. Though the plans are amazing, they are not meant for everyone.

Medicare Advantage plans are a combination of parts A and B together with D into one single plan and are offered by private health insurance companies. This means that they try to replace the original Medicare plan while covering everything.

The disadvantages that come with these plans include:

For Doctors And Hospital Choice

  • If you are enrolled in an HMO on the Medicare Advantage plan, you end up being limited to hospitals and doctors who are contracted within the plan. In case your current doctors are contracted within the plan, then that is good for you. But it is possible that come next year, the doctors are out of the plan. So you have to pay attention and check with your doctors on a yearly basis before signing up.
  • You might require a referral in order to visit a specialist. This might be a disadvantage to you while to others, it could be an advantage. Especially if you want your primary doctor to communicate with the specialist directly.
  • You will be limited to a particular network of hospitals and doctors. Whereas Original Medicare allows you to see any doctor and in any hospital which accepts Medicare.


Medicare Advantage

  • If you don’t like copays, then this cover will be a disadvantage. You might be the type of person who likes paying a one-off payment the whole month and then relax knowing that, the Medicare Supplement plan will be there for you combined with the Medicare cover.
  • Check out the copays that you are going to pay the entire year and compare it with the cost of going for a Medicare Supplement and find out which one is expensive. This might be hard due to the fact that you don’t know when you will have a medical need within the year.
  • If you don’t know your health status for the coming year, then medical Advantage might just end up being expensive if you happen to be requiring a lot of medical attention.


  • Medicare advantage will need that you get prior authorization before you get services. But with the original Medicare, it is straightforward with fewer loops that you will require to jump.
  • It is possible for this type of cover to restrict certain limits when it comes to coverage. An example is a situation where there is a recommendation by your doctor to have at least eight physical therapy sessions because of an outpatient procedure that you underwent. Based on your usual and customary background, the cover might restrict you to only 4 physical therapy sessions. This might affect your health negatively.

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