I understand, I was just responding to what you said, "I didn't even know insurance agents could be involved in Medicare Advantage or Medicare". I only wanted others to know that agents are involved because AP's are a private insurance product. The way an insurance agent is involved with Medicare is when they help you find a supplement, such as Plan G. An agent has nothing to do with Medicare A & B.
I know you know this, I was only wanting others to know.
I really should have highlighted the part I was responding to, sorry for the confusion. [/quote]
No worries.

Advantage Plans are great until you have a serious illness…..there is no free ride for insurance… they are all about treating you with meds and keeping you out of the hospital at all costs, because when you go to the hospital you have now lost them money…..my heart surgeon is one of the best in the country….you would not be able to use his services on an A P …..you are relegated to doctors who need more patients and are willing to be paid less to get them….

I have experienced the same with some of the leading insurance companies over the years, at one time I owed numerous outstanding claims while insured with a leading insurance company, once my lawyer got involved, they changed their tune and paid off the claims. You have to be your own advocate and be persistent. I understand the concern if in fact hospitals are turning people away because of their coverage, I have not experienced such behavior, and I never have trouble with referrals or medications. Insurance companies I have found like to place all the responsibility on the consumer regardless of who is at fault for the screw up. The above instance I stated was caused by the doctor supposedly not "coding the service correctly", the insurance company knew the services were valid, but both placed the responsibility on me to correct the issue. Sounds like some of the issues now happening with Medicare Advantage, also sounds like the problems may not be with Medicare Advantage but maybe the insurance company providing said service.

Medicare Advantage IS an insurance product, NOT a government provided entity. When you choose an AP, the government turns it over to that company and THAT COMPANY makes all decisions concerning your health. In other words, a clown in a cubicle at that insurance company decides what you get and don't get.
What has come to light lately is the fact many AP's are relying on AI to decide what service you receive, such as if they will pay for a hip replacement or make you undergo therapy for a year instead. AI is over riding what your doctor says you need. If AI can replace that clown in the cubicle, guess who profits from that? There is a big stink about this going on right now and are finding out it has been going on longer than a lot have thought.