Why do doctors not like Medicare Advantage plans?

Answered by 7 licensed agents

I am not a Doctor, so I can only assume that they might not like Medicare Advantage plans too much because they may not get paid as much for certain services. Medicare Advantage plans are considered managed care plans, so many time the Dr and patient have to get prior authorizations for certain procedures, this could delay the patients care and take administrators time and energy.

Answered by Anthony Castelluccio on April 21, 2025

Agent Licensed in PA, DE, MD, NJ & VA

Answered by Anthony Castelluccio Medicare Insurance Agent
Doctors dislike Medicare Advantage plans due to administrative burdens, low reimbursement rates, and frequent denials of care, which impact their practice and patient care.

Answered by Jason Rubin on April 7, 2025

Broker Licensed in CA, AK, AL & 33 other states

Answered by Jason Rubin Medicare Insurance Agent
Doctors have three main reasons for disliking MA plans: A) they don't want to do the paperwork involved with these types of (free of premiums, govt-subsidized) plans, B) due to that paperwork, they would be forced to hire more people to administer the plans, and

C) Advantage plans take much longer to pay the in and out of network physicians and thus want nothing to do with any Advantage plan. But they gladly take on patients with Medicare Supplements, a.k.a., Medigap plans.

Answered by Steven Bleicher on April 2, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent
Medicare Advantage plans are managed care plans. This means that the insurance companies have the ability to require different things to receive care like preauthorizations, step therapies, and limitations on certain types of procedures.

Answered by Jan Breheny on March 31, 2025

Broker Licensed in MO

Answered by Jan Breheny Medicare Insurance Agent
Because the Advantage plans are MCO Managed Care Organizations who are trying to add profit to their bottom line. They pay less to the Dr and have more restrictions on what they will cover for you. When the rubber meets the road your "grocery card" benefits matter if your Dr is not in network .

Answered by Ellen Diehl on April 7, 2025

Broker Licensed in GA

Answered by Ellen Diehl Medicare Insurance Agent
It isn't that they don't like them per se...it is because they have a higher oversight. Things need to be approved by the carrier. They like to just run the tests for payment on original medicare. They do not want to have a insurance plan tell them no. Now, this could be a good thing and maybe a frustrating thing. But medicare abuse is a real thing.

Answered by Rachael Metcalf on April 23, 2025

Agent Licensed in TN, FL, GA & 5 other states

Answered by Rachael Metcalf Medicare Insurance Agent
Because everything has to go through a pre-authorizion process, the doctors feel like the insurance carriers have to much control over patients health care. Medicare Supplements typically do not need referrals.

Answered by Penny Wegner on April 15, 2025

Agent Licensed in WI, CA, CO & 8 other states

Answered by Penny Wegner Medicare Insurance Agent

Tags: Coverage Medicare Advantage

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