Yes, some States are strict about things...but how much did it all cost you? Advantage plans are cheap if you don't use them, but otherwise you pay premium plus copays. What is your max out of pocket? How long do you wait for approval for a procedure? With Advantage plans you need to check each year to see if your doctor is still in network. I have several doctors at Mayo who have told me flat out they don't like Advantage plans. And Mayo Oncology warns to check benefits, and even has brochure on what to do if your insurance company first says it will pay and then refuses to pay for your cancer treatment. That speaks volumes! And later if you want to change you need to find an insurance company that will accept you and at what price?

I have the best Medigap plan - granted the most expensive. I pay a premium of about $3600/year, and I never see a bill. I research the doctor I want to see and just make an appointment. For many years they made money off of me, but now it is my turn. In 2.5 years I have had two lung surgeries (VAT procedures), a cardiac stent, two additional angiograms, 4 PET scans, 12 CT scans, 6 series of pulmonary function tests, Radiation SBRT treatment, several biopsies, many blood tests, countless doctor's appointments including 7 different specialists and eye exams, and a couple of emergency room visits. I never saw a bill or needed any approval before scheduling something. In fact, I went from an abnormal chest x-ray to lung surgery in 7 weeks with Thanksgiving and Christmas in-between.
To make a profit the insurance company has to limit your benefits! They have higher costs than Medicare. That is a fact of life. Just read their financial statements. There is no way that they are so efficient that they can deliver the same care for less. I worked in Corporate America. I know that they are not any better than the government at doing things. It is all about having the right objectives and skill sets. Call Medicare and then call Delta airlines or Comcast. Who answers the phone right away? Medicare! Medicare should be adding benefits and insurance companies should be out of this market. Healthcare is a "captive" market and that means it is not suitable for competition like when one buys a car.
Providers have additional costs to process the different types of policies. US private health care system costs twice what it does in Europe without having better outcome. I had a job where I had to research these things.