Switching to Medicare Advantage? 3 "Gotchas" You Need to Know About.

Core Insights - The article emphasizes the importance of understanding the potential drawbacks of switching from original Medicare to Medicare Advantage plans during the fall open enrollment period [1][11] Group 1: Medicare Advantage Benefits - Medicare Advantage plans can limit annual out-of-pocket spending and often provide additional services not covered by original Medicare, such as dental care, eye exams, and hearing aids [2] - Access to more covered benefits through Medicare Advantage could help retirees manage healthcare costs, especially for those relying primarily on Social Security for income [3] Group 2: Potential Drawbacks of Medicare Advantage - The $0 premium trap: Many Medicare Advantage plans advertise $0 premiums, but beneficiaries still need to pay for Medicare Part B and may face additional costs through copays, deductibles, and coinsurance [4][5] - The limited provider network trap: Unlike original Medicare, which allows access to any doctor accepting Medicare, Medicare Advantage typically restricts beneficiaries to a specific network of providers, which can complicate care access, especially for those who travel frequently [6][7][8] - The prior authorization trap: Medicare Advantage plans often require prior authorization for higher-cost services, which can lead to delays and denials in care. The Kaiser Family Foundation reports that 99% of Medicare Advantage enrollees are subject to this requirement, compared to a limited number of services under original Medicare [9][10]