Why You Should Beware of Medicare DIS Advantage Plans


Unknown to many people, Medicare DIS advantage is not a part of the original medicare and is not run by the government. Medicare Advantage (MA), otherwise known as Medicare Part C, is offered by private insurance companies that are contracted with Medicare to provide Part A (hospital insurance) and Part B (medical insurance) benefits.

Watch Keith's Video

Medicare Advantage plans claim to offer additional benefits that are not covered under Original Medicare, such as dental, vision, and hearing services. Meanwhile, the disadvantages of this medicare plan will dawn on you during a health crisis or severe health conditions. 

More instructively, Medicare Advantage plans have more restrictions on providers and healthcare services than Original Medicare, and members may need to stay within the plan’s network of providers to receive coverage. 

It’s thus important to follow the instructions provided by MedicareOnVideo in the course of reviewing plan options and choosing the package that meets your healthcare needs and budget.

What Benefits Do Medicare DIS Plans Offer?

Medicare Advantage plan claims to offer the following benefits:

  • Additional benefits: Medicare DIS plans claim to offer additional benefits beyond the Original Medicare scope of coverage, such as dental, vision, and hearing services.
  • Cost Effective: Depending on the plan, Medicare DIS plans claim to have lower out-of-pocket costs compared to Original Medicare. Some plans purportedly have lower monthly premiums but are more expensive in reality. 
  • Coordinated care: Medicare DIS plans often claim to provide coordinated care. This is a situation in which doctors and specialists work together to provide comprehensive care for patients. This can help reduce the likelihood of medical errors and improve overall health outcomes.
  • Flexibility: Many Medicare DIS plans often claim to give members the freedom to choose their healthcare providers within the plan’s network. Some plans also allow for out-of-network care, but typically at a higher cost.
  • Predictable costs: Medicare DIS plans often provide an annual out-of-pocket maximum, which can help members plan for and manage their healthcare expenses.

Why Should You Be Careful of Medicare DIS Advantage Plans?

While Medicare Advantage (MA) claims to offer numerous advantages, it is loaded with several potential disadvantages as explained below:

  • Limited Provider networks: Most Medicare DIS plans have provider networks, which means you may be limited in your choice of doctors and hospitals. You may need a referral to see a specialist, and out-of-network care may not be covered.
  • Cost-sharing: While some Medicare DIS plans claim to have lower out-of-pocket costs compared to Original Medicare, you may still be responsible for copays, coinsurance, and deductibles. In addition, some services may not be covered, such as certain medications or medical procedures.
  • Prior authorization requirements: Medicare DIS plans may require prior authorization for certain medical services, which can add a layer of bureaucracy and delay care.
  • Plan changes: It is important to note that Medicare DIS plans can change their benefits and coverage from year to year, which may affect the availability of certain services or providers.
  • Geographic limitations: Medicare DIS plans often have limited geographic coverage, which could be a disadvantage if you travel frequently or spend time in multiple locations throughout the year.

It’s important to carefully review the details of any Medicare DIS plan you’re considering to ensure that it meets your healthcare needs and budget. Consider the provider network, cost-sharing requirements, prior authorization requirements, plan changes, and geographic limitations before making a decision.

Why is Medicare Advantage a Bad Choice?

Medicare Advantage can be quite exorbitant if you are sick as a result of uncovered copays. More instructively, a plan may cover a limited network of doctors which thus hinders the patient’s choice. It is also not easy to switch to another plan. 

Additionally, if you decide to change to a Medigap policy, there are usually lifetime penalties. 

The Bottom Line

Read and digest this comprehensive Medicare ebook titled “Medicare Made Clear” before choosing a Medicare Advantage plan. The free e-book contains relevant content, links, and videos on Medicare.

You can also watch Medicare Video titled “Medicare DIS Advantage Plans – Just Be Careful”  for authoritative guidance or call us at 1-877-855-3484.

Medicare On Video signature FINAL

Get Your Free Medicare Quote

Invalid Date Format

Have more questions?