The purpose of insurance companies running Medicare Advantage plans is to make money, pure and simple. Seniors across the country rely on these plans – yet the record shows that insurers don't value the quality and affordability of care, and don't want beneficiaries to use the medical services they need.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
"Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield. These companies stood out based on plan types offered, premiums, discounts, complaint rates and nationwide availability."
Insurance carriers may decide to end certain Medicare Advantage plans altogether. If that happens, you should be notified by October 2. Your coverage will continue through the end of the year, but you must choose a new plan for 2025.
Summary: Medicare Advantage offers broader coverage including prescription drugs and dental care, while Medicare Supplement focuses on covering most out-of-pocket costs. Medicare Advantage plans are managed by private insurers with network restrictions, whereas Medicare Supplement allows freedom of provider choice.
However, not all hospitals accept all Medicare Advantage Plans. In addition, to get full coverage for your healthcare services, you may need to limit your options to a network of healthcare providers. Some plans allow for out-of-network coverage, but this can be expensive. Enrollment Period.
Many doctors and healthcare physicians don't like Medicare Advantage plans due to coverage restrictions, limited networking, and overpayment rates, which cause increasing difficulties for patients. Since pre-authorization and referral requirements often impede patients' needs, doctors refuse to accept these plans.
Humana declined to name the areas; about 560,000 Medicare Advantage beneficiaries impacted. Humana will stop offering Medicare Advantage (MA) in 13 counties in 2025, Humana CFO Susan Diamond said in a published report in Becker's Payer Issues dated Sept.
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
Premiums and overall costs tend to be lower with Medicare Advantage, especially if you expect to have high costs for care. (That's because Original Medicare doesn't limit your annual expenses, whereas Medicare Advantage does.)
Advantage insurers such as Humana have recently struggled with rising medical costs as their members seek more care. Some insurers are exiting unprofitable markets for 2025, and about 1.5 million enrollees will see their plan eliminated, according to Healthpilot, a digital Medicare broker.
The best Medicare Advantage provider for 2025 is Cigna, thanks to its low costs and excellent member experience. Kaiser Permanente and Aetna also rank among the top providers.
One of the most significant drawbacks of supplemental insurance policies is the coverage limits. For instance, with Mechanical Repair Coverage, you'll typically need to pay out of pocket until your deductible is met on your primary policy before supplemental insurance takes over to cover a costly vehicle repair.
A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both. You can't buy Medigap while you're in a Medicare Advantage Plan unless you're switching back to Original Medicare.
High out-of-pocket costs
Unlike Original Medicare, Medicare Advantage plans do have out-of-pocket maximums. This protects you from astronomical costs in a year you may need more (or expensive) healthcare services. But when you compare out-of-pocket costs to those paid by Medigap enrollees, you might just faint.
Some major changes in 2025 include a new $2,000 out-of-pocket max under Part D, eliminating the plan's “donut hole” coverage gap, and fewer Medicare Advantage plans.
If you're already in a Medicare Advantage plan and you want to switch to traditional Medicare, you should contact your current plan to cancel your enrollment and call 1-800-MEDICARE (1-800-633-4227). Note there are specific enrollment periods each year to do this.
Medigap Plan G offers more comprehensive benefits than the Medicare Advantage plan and is more widely available. It also provides more freedom for enrollees. For example, a Medigap Plan G enrollee can visit a specialist without a referral.
The short answer is “No”. However, if a doctor accepts Medicare itself, which is your primary coverage, then they will also accept your Medigap plan, regardless of what company sold you the plan or which Medigap plan you have. The key thing to remember is that Medigap plans “follow” Medicare.
The best Medicare Supplement insurance provider is AARP/UnitedHealthcare, according to Investopedia's extensive research. It boasts excellent customer satisfaction and financial strength ratings, a wide range of plans, and affordable prices.