Medicare Advan-tage, or privatized Medicare, is forcing millions of seniors into health plans that put profits over their health. As a medical student in Peoria, I am alarmed by its growing impact on the patients I serve. With Medicare Open Enrollment running until Dec. 7, 2025, I urge seniors to take a closer look before choosing a plan and consider Traditional Medicare instead.

Traditional Medicare is funded by taxpayers and enrollees. Hospitals and clinics are paid directly by the federal government with no private insurance companies in between. It includes Part A (hospital insurance), Part B (doctor and outpatient care), and Part D (prescription coverage). Many people also buy Medigap (Part G) to cover remaining costs such as vision and dental. Altogether, these premiums average about $5,280 per year for patients with Part G.

In Medicare Advantage, called Part C, the government pays private insurance companies a fixed amount per enrollee to cover the same services. On top of that, patients have about $185 per month ($2,220 per year) automatically deducted from their Social Security checks. These plans often advertise low or no premiums, but those savings come with a catch.

When insurers spend less than this fixed payment, they keep part of the savings as “rebates,” meant to lower patients’ costs. But studies show up to 60% becomes profit instead. Companies further increase profits by requiring prior authorization for expensive treatments, leading to delays and denials of needed care. In 2022, Medicare Advantage denied 22% of prior authorizations, compared to just 1% under Traditional Medicare.

Medicare Advantage plans also restrict patients to narrow provider networks. For example, a patient with an OSF MedAdvantage plan can only see OSF providers. Out-of-network care can mean paying the full cost, even for rare conditions. Private practices are less likely to see patients with Medicare Advantage due to the added administrative burden, estimated at 20 million clinician hours per year.

Despite its marketing, Medicare Advantage does not improve health outcomes. Studies show no difference in recovery after major illnesses like heart attacks. And added “benefits” are misleading: 30% of enrollees skipped dental care due to cost, compared to 24% in Traditional Medicare. Yet it costs taxpayers more, spending 18% on administrative overhead, versus 2% for Traditional Medicare. If everyone switched to Medicare Advantage, the program could cost $1.5 trillion more over 10 years, threatening Medicare’s solvency while boosting insurer profiIf you want to switch back to Traditional Medicare and buy a Medigap plan later, you may not be able to. In Illinois, Medigap insurers can deny coverage or charge more for pre-existing conditions if you apply after your initial six-month enrollment period at age 65. This effec ely traps many seniors in plans that limit care when they inevitably get sick and need it most.

To disenroll from Medicare Advantage, call 1-800-MEDICARE (1-800-633-4227) or contact Illinois’ Senior Health Insurance Program (SHIP) at 1-800-252-8966 or aging.ship@illinois.gov for free, unbiased help.

— Kelley Baumann, MPH, is a medical student at the University of Illinois College of Medicine and president of the Peoria chapter of Students for a National Health Program.