Should You Ditch Medicare Advantage for Good?

Source The Motley Fool

Key Points

  • Medicare Advantage plans allow you to opt out of traditional Medicaid and get coverage from a private insurer.

  • Advantage plans often promise low premiums and more coverage, but they don't always deliver.

  • There are huge downsides, including the fact you may not be able to see the doctor you want or get care when traveling.

  • The $23,760 Social Security bonus most retirees completely overlook ›

On the surface, Medicare Advantage plans may seem like a great option. These plans are an alternative to traditional Medicare, but they're offered by private insurance companies instead of the government. Many Advantage plans are marketed pretty heavily to retirees, with promises of affordable premiums and a lot more coverage than traditional Medicare plans make available.

But, often, these plans are not all they're cracked up to be. In fact, there are some really persuasive reasons why seniors should ditch Medicare Advantage plans for good.

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Here are a few arguments in favor of skipping the Advantage plan coverage and keeping original Medicare with a Medigap plan as a supplement instead.

Patient talking with doctor.

Image source: Getty Images.

You should ditch Medicare Advantage plans if you like to travel or are a snowbird

Snowbirds and senior travelers are the first group of retirees who should think very seriously about ditching their Advantage plan.

One of the great things about being retired is that you can go anywhere. In fact, this is something many people look forward to during the retirement planning process. And if you have traditional Medicare, you don't need to worry about getting sick when you're on a trip or needing to visit a doctor while you're at your vacation home.

That's because original Medicare is accepted by all providers nationwide who participate in the Medicare program. Need to see a doctor in California despite living in Texas? No problem -- there are plenty of physicians who accept Medicare coverage who will see you.

That's not the case if you have an Advantage Plan. Advantage plans typically require you to see in-network doctors to avoid higher costs, which could drain your 401(k). And many plans have networks focused on a specific geographic area.

So, while you can still get emergency service covered when you're away from your home base, you won't get to see a doctor for routine care when you're away unless you want to pay a lot more out of your retirement plans to cover the added out-of-pocket costs.

You should ditch Medicare Advantage plans to reduce the risk of not getting the care you want

You should also seriously think about ditching Medicare Advantage if you want to reduce the chances of not being able to see the doctor you want or having your care denied.

As mentioned, Medicare Advantage plans have networks, so you'll need to stick with an in-network provider. Unfortunately, sometimes these provider networks are really narrow, so you may not be able to see the doctor you've been working with or find a specialist who is close to you who is covered by insurance. This could make it much harder to get care.

Your network can also change from one year to the next, which means that you may get established with a provider, only to find out that you can't keep seeing them for your care the subsequent year unless you change your insurance plans. This isn't something you need to worry about with original Medicare, since all Medicare-participating providers accept the coverage (which is most providers across the country).

Insurers also must preauthorize many different kinds of services when you have an Advantage plan. Unfortunately, if preapproval is denied, this could mean that your insurance won't cover the care you want.

These types of issues don't really arise with traditional Medicare, which requires preauthorizations only in very limited circumstances, such as when you want to use your benefits to buy durable medical equipment.

So, if you want to maximize the chances that you and your preferred doctor will get to decide what care you need without an insurer serving as a gatekeeper and potentially denying services your healthcare provider recommends, you should ditch Medicare Advantage plans for good.

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Disclaimer: For information purposes only. Past performance is not indicative of future results.
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