Do your homework before enrolling in any Medicare Plan!
As a healthcare provider, Allied advocates for traditional Medicare over Medicare Advantage (MA) for several key reasons – primarily patient access and care quality. Traditional Medicare typically provides a more straightforward path to care for patients, with fewer pre-authorization requirements and broader access to healthcare providers. In contrast, Medicare Advantage plans, often run by private insurers and pitched aggressively by celebrities on TV commercials, frequently limit patient choice due to network restrictions and impose authorization hurdles that can delay or deny necessary treatments.
Several major healthcare providers, including well-known names like the Mayo Clinic and Cleveland Clinic, have scaled back on accepting certain Medicare Advantage plans due to delayed payments and administrative challenges. These challenges impact patients directly, as they may face longer waits or have to navigate complex appeals if their care is denied or delayed.
For patients, traditional Medicare’s lack of restrictive networks means they can access nearly any doctor or hospital nationwide that accepts Medicare. Furthermore, traditional Medicare beneficiaries often avoid some of the high out-of-pocket expenses that Medicare Advantage enrollees encounter with unexpected co-pays or uncovered services.
We strongly recommend that our patients take the time to review their Medicare coverage every year during open enrollment, which occurs from October 15 to December 7 annually. Although everyone’s needs are different and traditional Medicare may not be right for every patient, it is important to do your homework! Medicare Advantage plans can change benefits, provider networks, and costs yearly, so it’s vital for individuals to evaluate if their current plan still meets their needs. This annual assessment can prevent unwelcome surprises and ensure beneficiaries maximize their coverage benefits for the coming year.
Resources:
NY Times: Medicare or Medicare Advantage? A Guide for 2025
Medicare.gov: Medicare & You 2025, The official U.S. government Medicare handbook
1 million+ patients lose coverage as insurers, hospitals drop Medicare Advantage