Why Some Doctors Prefer Patients with Medicare Supplement Plans

As more Americans age into Medicare, the choices between Medicare Advantage and Medicare Supplement (Medigap) plans have become increasingly important. And this is not just for patients, but for doctors as well. While both types of plans offer coverage to Medicare beneficiaries, many physicians favor patients who carry Medicare Supplement plans over those enrolled in Medicare Advantage.

Simpler Billing and More Predictable Reimbursement

One of the main reasons doctors prefer Medicare Supplement plans is streamlined billing and payment. Medicare Supplement plans work directly with Original Medicare (Parts A and B). When a Medicare-approved service is provided, Medicare pays its share (typically 80%), and the supplement plan automatically covers the remaining balance (depending on the plan, of course). The process is automatic and generally hassle-free for providers.

In contrast, Medicare Advantage plans are administered by private insurance companies. Each plan comes with its own set of rules, billing requirements, and reimbursement schedules. This can create delays, denials, and more administrative burdens for the physician’s office and staff.

A 2021 report from the American Medical Association found that 86% of physicians believe prior authorization requirements, a common trait among Medicare Advantage plans, negatively impact patient care. Additionally, a KFF study revealed that 18% of Medicare Advantage enrollees report being denied or delayed care due to plan restrictions, a frustration often shared by their doctors.

More Choice and Fewer Network Restrictions

Doctors also appreciate that Medicare Supplement plans don’t use provider networks. Beneficiaries can see any provider in the U.S. that accepts Medicare, meaning physicians don’t need to join or remain in narrow networks to see these patients. This allows doctors to spend more time focusing on care rather than insurance logistics.

Key Takeaway

While Medicare Advantage plans may offer low premiums and extra benefits, they often come with network restrictions, pre-authorizations, and complex billing. All of these factors can be frustrating for both patients and providers. In contrast, Medicare Supplement plans offer predictability, ease of use, and broader access to care, making them a preferred option for many physicians.

If you’re weighing your Medicare options, consider not just the cost but also how your choice could impact your access to care.

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