Jesse Smedley is a Principal of Oakbridge Insurance and the founder of iHealthBrokers. He founded iHealthBrokers in 2007, and Oakbridge acquired iHealthBrokers in 2025. He has spent nearly two decades teaching people how to save money on their health insurance and navigate Medicare, and he is the author of Medicare A to Z: Your Roadmap to Medicare.
Medicare Advantage is a great idea with an arguably flawed execution! But while Medicare Advantage, as we know it, is new-ish at least in relation to Medicare in general, privatized Medicare plans have pretty much always existed.
In the beginning, they were basically a way to allow those with group health insurance to bridge the gap with that and Medicare and perhaps continue to see their regular providers.
Over time, it evolved to offer specific benefits and serve a population in need. Medicare Advantage plans are now so popular that over half of senior citizens are enrolled in one.
There are certainly benefits to Medicare Advantage, but you should know there are other, perhaps more nefarious reasons, that such a large portion of the population is enrolled in MA.
When you enroll in an MA plan, the government pays that plan to take on your medical risk. In many instances, you are an expensive risk that they would rather private carriers take on.
Advantage plans offer major profits to these companies and they are heavily, heavily marketed. Additionally, agents and brokers often make a larger commission on Medicare Advantage plans as opposed to Medicare Supplement Plans.
News
If you follow the news, you are probably aware that Medicare Advantage has become a rather contentious issue.
Restrictive networks often leave a vulnerable population unable to travel to have their medical needs met.
Pre-Authorization has led to denials and delays of lifesaving medical treatments.
Hospitals and physicians rapidly abandoning ship leave beneficiaries feeling bamboozled.
So, what is the answer? Are there changes on the horizon? Is this the end of Medicare Advantage? Well..maybe!
Congressional Action
Should Congress choose to take action? There are really two paths they can follow.
First, they could make improvements to Original Medicare that would make it a more appealing option. One of the main reasons people flock to Medicare Advantage Plans are all of the added benefits; benefits that are clearly missing from Original Medicare, such as dental, vision, hearing, and prescription drugs. Bolstering Original Medicare would certainly make it more competitive.
Another option would be to simply make Medicare Advantage more competitive (then again that’s not as simple as it might seem). If steps are not taken, Medicare Advantage may continue down a slightly scary path.
