What is the Biggest Difference Between Original Medicare and Medicare Advantage?

Understanding Medicare Advantage Plans

If you’re looking to get Medicare, it’s important to understand the differences between Original Medicare and Medicare Advantage. A Medicare Advantage Plan, sometimes called Part C, is an alternative to Original Medicare. These plans are offered by private insurance companies that contracts with Medicare to provide all of your Part A and Part B benefits.

What Are the Differences Between Original Medicare?

To understand the differences between Original Medicare and Medicare Advantage, we need to take a closer look at what each option offers:

Original Medicare: Includes Part A (hospital insurance) and Part B (medical insurance). You can also add a standalone Part D plan for prescription drug coverage.
Medicare Advantage: Includes Part A and Part B, and often includes Part D. Some plans may also offer additional benefits like dental care, vision, and hearing.

Medigap and Medicare Supplements

If you’re enrolled in Original Medicare, you may want to buy a Medigap policy to help with out-of-pocket costs like deductibles and coinsurance. Medigap policies are offered by private companies and can provide more predictable costs. However, Medigap policies are not available if you choose a Medicare Advantage Plan.

What Medicare Advantage Plans Cover

Unlike Original Medicare, Medicare Advantage Plans must cover all services that Original Medicare covers. This includes inpatient and outpatient care. Many plans also offer extras such as:

Prescription drug coverage
Dental care
Vision and hearing services

Each Medicare Plan can have different rules for how you get services, such as requiring prior authorization for certain procedures.

Switching from Original Medicare to Medicare Advantage

Thinking about making the switch from Original Medicare to Medicare Advantage? It’s important to compare plans in your area to find one that fits your needs. You can do this during the annual open enrollment period. Keep in mind that if you switch from Original Medicare, you may not be able to go back to your old Medigap policy.

Enrolling in Original Medicare and Medicare Advantage

To enroll in Original Medicare, you must first be eligible for Medicare. Once you are eligible, you can choose whether to stay with Original Medicare or opt for a Medicare Advantage Plan. If you choose Medicare Advantage, you’ll still need to pay your Part B premium, and you may also have an additional premium for your Medicare Advantage Plan.