Dr. Katherine A. Im, DDS ,

Recent reports from the Office of Inspector General (OIG) reveal that Medicare Advantage plans often deny coverage for medically necessary treatments, with many approvals only granted after time-consuming appeals. This can pose significant challenges for seniors who require ongoing care, costly diagnostic tests, or specialized procedures, as administrative delays may hinder timely access to essential services. In contrast, Original Medicare generally does not require prior authorization, making it a more dependable option for those in need of immediate and comprehensive care. By outlining these important findings, the article empowers seniors to make informed choices about their health insurance, helping them better understand the benefits, risks, and potential costs associated with different Medicare plans.