Medicare Advantage Warning: Read This Before You Auto-Renew

Every year around this time, I get flooded with questions from people on Medicare or approaching Medicare age — and almost all the marketing they’re seeing is for Medicare Advantage.

That’s not an accident.

Insurance companies and salespeople push these plans like crazy because they make big commissions when they sign you up for an Advantage plan instead of traditional Medicare. These plans have become so common that about half of all Medicare participants are now enrolled in them.

I’ve called them “Medicare Disadvantage” plans for years — and I know that offends some people. I’ve heard from listeners who love their Advantage plan and have had great experiences. If that’s you, consider yourself lucky — like “you should buy a Powerball ticket” lucky.

But for many people, these plans come with big tradeoffs that you don’t see in the commercials.

Why Medicare Advantage Looks So Good — at First

When you first hear about Medicare Advantage, it sounds like a great deal. You might get:

• A free gym membership

• Dental, vision, or hearing coverage

• Other little “bonus” perks

It’s easy to think, “Why would I pay more for traditional Medicare when I can get all this?”

But here’s what’s really going on: Advantage plans limit your choice of doctors and hospitals, and often require prior authorizations before you can get care. In other words, the insurance company — not you — decides what’s covered and where you can go.

That’s how they make money.

With traditional Medicare, you get to choose your doctors and hospitals. You don’t have to ask for permission to get care. You’re the boss. You can also buy a Medicare supplement (Medigap) plan that helps pay for what Medicare doesn’t cover.

It’s a simpler system that gives you control — and that’s worth a lot when you’re sick and need care fast.

Why This Year’s Enrollment Period Matters More than Ever

Right now, during the Medicare Advantage open enrollment period, a lot of plans are quietly cutting back on benefits.

The reason? Many insurance companies overspent on those “free” extras and are now pulling back. So, if you automatically re-up with your current plan without reviewing the details, you could lose benefits or find your out-of-pocket costs going up.

If you’re in an Advantage plan, this is the time to:

• Compare what’s changing for 2025.

• See if another Advantage plan has better coverage or a broader network.

• Consider switching if your doctors or hospitals are being dropped.

And in a small number of states, you might even be able to switch back to traditional Medicare without a medical exam. But in most states, once you’ve joined an Advantage plan, it’s hard to get out later because of medical underwriting rules.

When Advantage Plans Can Really Let You Down

The moment most people regret enrolling in a Medicare Advantage plan is when they face a serious illness. That’s when they find out:

• They can’t go to the specialist they need.

• They can’t get approval for a certain treatment.

• Or they can’t access a top hospital that could help them.

When the chips are down, that’s when the “disadvantage” part of the name really shows up.

Final Thought

If you’re happy with your plan, great — but don’t just assume everything’s staying the same. Take the time to review your coverage and compare options this enrollment season.

Medicare decisions are among the most important financial and healthcare choices you’ll make in retirement. Make sure you’re getting what’s best for you — not what’s best for the insurance companies.

Clark Howard is a nationally syndicated talk show host who focuses on helping you save more, spend less and avoid getting ripped off. A listing of all the radio stations that carry his show can be found at http://www.Clark.com in addition to his podcast "The Clark Howard Podcast" and his YouTube channel.