“Over the last several years, Medicare Advantage plans have expanded throughout Nebraska. As these plans have expanded, healthcare providers like doctors, hospitals, and nursing homes have experienced several issues, ranging from denials of coverage, low reimbursement rates, and delays in providing care to our patients.”

The above comment is from Brett Eggleston, CEO of Callaway District Hospital. December is not only the month of twinkling lights and visits from Santa, but it is also the time for health insurance open enrollment - including Medicare. Navigating through the complex Medicare web can be confusing. There are several different options and choices to be made, and most in the healthcare industry agree that one of those options - Medicare Advantage - is not a good choice for most of us.

An October 2025 report from the Nebraska Hospital Association states that Medicare Advantage plans deny care more often than traditional Medicare and can delay your treatment when you need it most. A staggering 98% of hospitals believe prior authorization requirements by MA plans negatively impact clinical care by delaying necessary treatment.

When MA plans don’t approve post-acute care, it means patients who need to go to a skilled nursing facility or rehab are forced to go home or stay in the hospital. Over 90% of Nebraska hospitals find it more difficult to get post-acute care approved for Medicare Advantage patients than traditional Medicare patients.

“In addition, the administrative burden that is placed on healthcare providers continues to grow as Medicare Advantage plans require prior authorizations for many services and frequently deny claims, leading to additional work to receive appropriate reimbursement for the services that we provide to our patients,” Eggleston added.

According to the Nebraska Hospital Association, hospitals are spending more time and money fighting insurance companies, time that could be spent on patient care. In fact, 93% of hospitals report increased costs just to comply with MA policies. Hospitals are forced to hire more staff just to deal with denials and appeals, and Nebraska care teams are spending more and more time on hold justifying their care decisions. The report states that 91% of Nebraska providers feel that the administrative requirements of Medicare Advantage plans contribute to physician and staff burnout.

Medicare Advantage plans are not Traditional Medicare, the program that hardworking seniors have been contributing to for decades, so they have access to health care when they need it most. The name is confusing, and insurance brokers are aggressively marketing a product that can limit patient choice and access to care.

Nebraska seniors need to fully understand their Medicare enrollment choices. Does your plan make you wait for care or deny it? Do you have the best plan for your health care needs, budget, and location? Seniors should know the facts about Medicare Advantage and consult with their healthcare provider before enrolling or switching plans.

The growth of Medicare Advantage coverage is a serious threat to our health care system, particularly in rural Nebraska, where 89% of Nebraska hospitals say the shift to Medicare Advantage has negatively impacted their financial position.

“We need policymakers to stand up for patients and providers by demanding Medicare Advantage plans follow the same rules as Traditional Medicare. It’s time for true oversight and accountability.”

If you have questions regarding your Medicare coverage, visit with your local healthcare provider or reach out to a trusted local insurance agent for guidance.