@vic83 Choice and satisfaction depend on the Advantage plan. I have a PPO from a not-for-profit Advantage Plan founded by physicians and overseen by a board that includes medical personnel, no referrals needed. I can go to any medical facility where Medicare is accepted, including Mayo in Rochester where I had a septal myectomy, no questions asked. Many (Most?) advantage plans are administered by insurance companies that have for their goal to make a profit in order to give shareholders dividends. You'd think that this country can do better so we do not need PhD's in insurance coverage to navigate our medical care.