When it comes to planning your healthcare in retirement, the choices can be overwhelming—especially when it feels like everyone is pushing you toward one option: Medicare Advantage. From flashy commercials to mountains of direct mailers, the message is clear: Medicare Advantage plans are the affordable, all-in-one solution for retirees.

But is that really the case?

According to retirement planning professionals who work directly with Medicare recipients, the reality is far more complex—and in many cases, alarming. Despite their growing popularity, Medicare Advantage (MA) plans come with a series of structural flaws and hidden costs that could jeopardize both your healthcare freedom and your financial stability in retirement.

Let’s break down why Medicare Advantage plans may not be the deal they appear to be, and why many experts say to steer clear.

1. Medicare Advantage Is Great—Until You Get Sick

At first glance, Medicare Advantage plans look appealing. The zero-dollar premium is an obvious hook. For healthy retirees who don’t often visit the doctor, these plans can seem like a financial win.

But that advantage disappears the moment you actually need care.

Dan explained it like this.

“Medicare Advantage programs are great for people while they're healthy. But when you start to experience the downturn of health that comes along with end of life, do you want an insurance company telling you which doctors you can go to? Which procedures you can have done?”

Unlike Original Medicare with a supplement, MA plans typically limit you to a network of providers. That means if you want to see a specialist outside the network, or even get a second opinion, you may be out of luck. Worse, you often need prior authorization for treatments and procedures, putting your care in the hands of bureaucrats rather than your doctor.

In short, if freedom of choice matters to you, especially in your later years when health concerns are more frequent and complex, Medicare Advantage might not serve you well.

2. The Hidden Costs Add Up: What Is “MOOP”?

One of the least discussed—yet most important—terms in Medicare Advantage is MOOP: Maximum Out-of-Pocket.

Every Medicare Advantage plan has a maximum amount you could potentially spend in a year. In 2025, the average MOOP for these plans is expected to be $5,400.

Let that sink in.

That means you could be on the hook for $5,400 in out-of-pocket costs.... on top of premiums for prescriptions and other services. And it doesn’t stop there. MOOP doesn’t even include your Part D (prescription drug) costs, which could tack on another $2,000 or more depending on your medications.

As Dan explains, “They’ll copay you here and copay you there until it adds up. And $5,400 is still a heck of a lot of money to me, especially in retirement when you don't have the means to go back to work.”

3. Costs Are Increasing, Not Decreasing

One concerning trend is how quickly those MOOP costs have risen. Back in the early 2000s, MOOP on many plans was around $2,500 to $2,800. Today, it’s doubled.

And it’s not just MOOP that’s increasing. With fewer plan options and higher deductibles and copays, the financial burden is shifting more and more to the retiree. Medicare Advantage plans are designed to look inexpensive on the surface, but the back-end costs are growing fast.... right when retirees can least afford them.

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4. Limited Access, Limited Freedom

With a Medicare Advantage plan, you’re not just choosing an insurer, instead, you’re handing over control of your healthcare decisions.

Most MA plans restrict access to specific providers and facilities. Want to go to the hospital or doctor of your choice? You may be required to choose from a narrow list of “in-network” providers. Want to see a specialist without jumping through hoops? Too bad. You often need permission first.

Even your pharmacy choices may be limited. Many MA plans have preferred pharmacy partners—some even co-sponsored by pharmaceutical companies—which raises serious questions about potential conflicts of interest.

As Dan said, “Seems like a conflict of interest to me. But I don't get to make the rules. I only get to analyze them.”

5. Follow the Money: Why Are These Plans So Heavily Marketed?

If Medicare Advantage plans are so restrictive and expensive in the long run, why are they being pushed so aggressively?

One word: commissions.

In 2025, agents can earn a $626 commission for enrolling someone in a Medicare Advantage plan—and an additional $313 every year you stay in that plan. That creates a massive financial incentive for agents to push MA plans over others.

By contrast, enrolling someone in a Medicare Supplement plan (also known as Medigap) pays an agent about $132—less than a quarter of the MA commission.

So when you see endless ads or get flooded with promotional mail, it’s not because Medicare Advantage is the best product for your needs. It’s because it’s the most profitable product for the people selling it.

6. Medicare Supplements Offer Greater Protection and Flexibility

The most effective alternative to Medicare Advantage? Medicare Supplement plans.

While they do involve a modest monthly premium (around $60 on average), they offer much more predictable and comprehensive coverage. Most importantly, they allow you to:

• See any doctor that accepts Medicare
  
• Visit any hospital or specialist without a referral
  
• Avoid prior authorization or insurance gatekeeping
  
• Lower your overall out-of-pocket exposure (average MOOP: $2,800)
  
  

And unlike MA plans, Medicare remains your primary insurer, not a private company. That means Medicare itself pays your claims first, and the supplement fills in the gaps.

In other words: you’re not giving up Medicare, you’re enhancing it.

7. Marketing Noise Drowns Out Better Options

Many people never hear about Medicare Supplement plans simply because they’re not being marketed as heavily. Since the financial incentives aren’t as high, agents don’t promote them. That’s not a reflection on the product—it’s a reflection on how the system is structured.

As Dan points out, “That’s why you don't hear about the plan that I advocate for as much in your mail or on TV. Because it doesn’t pay agents as much.”

But just because something is less advertised doesn’t mean it’s less valuable. In this case, it may mean the opposite.

8. The Emotional and Financial Toll in Retirement

Retirement is supposed to be a time of peace and security—not anxiety about whether you can afford your next medical visit or whether your insurance company will approve your treatment.

Medicare Advantage plans can introduce unnecessary stress at a time in life when predictability and simplicity are most important.

If you or a loved one faces serious illness, the last thing you want is red tape and unexpected bills. The very structure of Medicare Advantage—while workable for the healthy—can be a nightmare for the sick.

So, Why Are Medicare Advantage Plans Bad?

Let’s rephrase… Do you want control or just a fancy sales pitch?

Medicare Advantage isn’t necessarily “bad” for everyone. But for many retirees, it presents more risk than reward. It restricts your choices, increases your exposure to unexpected costs, and places important decisions in the hands of a private company.

When you hear glowing endorsements of these plans, ask yourself: Who benefits?

Is it you—the patient? Or is it the person collecting the commission?

There are better options on the market. Medicare Supplement plans may not come with glossy advertising or catchy slogans, but they offer what truly matters in retirement: freedom, predictability, and peace of mind.

So if you value control over your healthcare and want to avoid financial surprises, it may be time to just say no to Medicare Advantage.