Why We Do Not Offer Medicare Advantage Plans
We have chosen not to offer Medicare Advantage based on Our Promise to you. We feel that for the foreseeable future there are going to be major uncertainties regarding protection, coverage and availability.
Key Concerns, Problems And Issues With Medicare Advantage Plans:
- Restricted provider networks:
Many Medicare Advantage plans only allow patients to see doctors within their specific network, which could limit access to preferred providers or specialists depending on location. Many providers are choosing not to or opting out of accepting Medicare Advantage.
- Prior authorization requirements:
Plans often require prior authorization for certain procedures or medications, which can create delays in treatment and administrative burdens for patients.
- Claim denials:
Some beneficiaries report experiencing issues with their Medicare Advantage plans denying necessary medical services, even when clinically appropriate.
- Marketing practices:
Concerns exist about aggressive marketing tactics used by some Medicare Advantage plans that may mislead potential enrollees about the full scope of coverage and potential limitations.
- Switching difficulties:
Switching between Medicare Advantage plans can be challenging due to limited open enrollment periods and potential restrictions on switching based on health status.
- Geographic limitations:
Coverage can vary significantly depending on location, potentially impacting individuals who travel frequently or have multiple residences.
- Potential for higher out-of-pocket costs:
While premiums may appear low, unexpected high out-of-pocket costs can occur if a serious medical condition arises and requires extensive treatment within the plan's network.
Below are some links supporting these points:
https://www.kiplinger.com/retirement/medicare/problems-with-medicare-advantage-plans-keep-mounting
https://www.thenation.com/article/society/medicare-advantage-privatization-inequity-fraud/
https://cepr.net/34-million-seniors-in-medicare-advantage-plans-face-rude-awakening/
https://www.kff.org/from-drew-altman/the-semi-sad-state-of-consumer-protection-in-health-care/
https://www.nbcnews.com/health/rejecting-claims-medicare-advantage-rural-hospitals-rcna121012