Are there any disadvantages to a Medicare Advantage plan?

Yes – for some people. Some Medicare Advantage plans have a restrictive network that requires plan members to use the available network doctors and you may only be able to seek medical assistance outside the network after receiving your Medicare Advantage plan’s authorization – and possibly pay a higher co-payment.

Some people may find that Medicare Advantage plans provide coverage that is somewhat complicated as compared to their Medicare Supplements with different co-payments (like $10 to $30 co-pays per primary-care doctor visit), co-insurance, deductibles, and maximum out-of-pocket costs (or MOOP).

Medicare Advantage plans are allowed to change their provider networks throughout the plan year - this means, your doctor may be participating in your chosen Medicare Advantage plan's network at the time of enrollment, but the plan may drop your doctor during the plan year. If the changes to the provider network are significant enough, you may be granted a Special Enrollment Period allowing you to change Medicare Advantage plans mid-year.

When you travel, you may find that your coverage cost is significantly higher and that the out-of-pocket Medicare Part A and Medicare Part B expenses do not count toward your annual MOOP.

Bottom Line: Know the details about your Medicare Advantage plan before enrolling – especially if you have an established set of doctors and other healthcare providers that may be outside of the Medicare Advantage plan’s network.

See Also:
Are there really any advantages to a Medicare Advantage plan? (Spoiler alert: The answer is "yes".)