Medicare Advantage solution offers an alternative to original Medicare and provides coverage through private insurers. Original Medicare is less expensive but does not cover all Medicare Advantage plan benefits.
In some cases, Medicare Advantage plans offer a variety of healthcare providers and hospitals, including hospitals and doctors that are in-network and those that are out-of-network.
What is Original Medicare?
Original Medicare is the public health insurance program administered by the United States government. It delivers health coverage to people aged 65 and older, younger people with disabilities, and people with End-Stage Renal Disease.
What is Medicare Advantage?
Medicare Advantage Plan is a private healthiness insurance plan that offers Medicare benefits. It was created as an alternative to Original Medicare for those who cannot afford or do not want Original Medicare.
Which is Better Original Medicare and Medicare Advantage Plan?
The main difference between Original Medicare and Medicare Advantage Plan is that Original Medicare is a federal program while Medicare Advantage is a private one.
Original Medicare is a national program that delivers health coverage to people 65 years of age or older and younger people who have received Social Security disability benefits for 24 months or have end-stage renal disease.
Original Medicare (Parts A and B) and Plan Medicare Advantage (Part C) are two different ways of getting your Medicare benefits.
Both options offer the same primary hospital and health coverage levels but differ significantly. It is vital to understand differences in range, costs, and rules about the provider, as those will affect how you decide which option is best for you.
Read on to find out each one below.
- Original Medicare protects inpatient hospital and professional nursing assistance — Part A — as well as physician visits, outpatient services, and certain preventive services — Part B.
- Medicare Advantage plans cover all of the above (Part A and Part B), and most also cover prescription drugs (Part D).
- In addition, Medicare Advantage plans offer additional benefits, which, though these vary from plan to plan and provider, can include coverage for dental, vision, hearing, health programs, transportation to medical appointments, and more.
- Whether you decide to stay on Original Medicare or enroll in a Medicare Advantage plan, you are likely paying premiums, deductibles, copays, and coinsurance.
- Financial Protection Note: One really lovely perk with Medicare Advantage plans, however, is that you are limited in what you will have out-of-pocket costs (deductibles, coinsurance, and copays). This really helps to control Medicare costs. Original Medicare does not offer financial protections like this.
Learn more about Medicare Advantage plans and Medicare Advantage solutions and shop for programs in your area. The last key difference to consider in choosing between Original Medicare and a Medicare Advantage plan is which healthcare providers you may be able to see. With Original Medicare, you can go to any hospital and see any physician or provider in the United States that accepts Medicare.
However, you do have limited coverage in foreign countries. With Medicare Advantage solutions, most plans have networks of doctors and providers that you can visit. If you go outer of your plan’s web, you will likely pay more. However, urgent care and urgent care are covered across the country. You also have restricted coverage in foreign countries, although some plans may offer a specific overseas range or travel benefits.
Tips to help you decide between Original Medicare Advantage
Consider whether you want dental, vision, and other additional benefits covered. Medicare Advantage plans enfold everything that Original Medicare covers, plus some more, so if you need things like dental, vision, or health benefits, Medicare Advantage plans might be a good option.
Think about what the overall cost might be. Your total fees will vary depending on your insurance coverage and healthcare services. But take these factors into account specifically as you compare which options fit your finances the best.
You get built-in financial security with Medicare Advantage solutions. The annual out-of-pocket limits provided help you control costs.
Your premiums can be higher under Original Medicare. You could have higher monthly premium payments with Original Medicare than with Medicare Advantage because you may want to add a prescription drug plan with Part D or some other extra coverage.
You might pay higher copays with Medicare Advantage solutions than with Original Medicare.
Depending on which healthcare services and providers you use, you could pay more for a copay under the Medicare Advantage plan, as costs will vary within and between networks. Medicare Advantage provides financial protections, with annual out-of-pocket limits.
You can add protection from Original Medicare by buying a Medicare Supplement plan. You may have higher monthly premium payments under Original Medicare than Medicare Advantage, as you may wish to add a prescription drug plan, Part D, and/or a Medicare supplement plan.
Consider how much time you spend away from home. Original Medicare covers the care you get from any provider that takes Medicare nationwide. With most Medicare Advantage plans, you must see providers as part of the plan’s network to avoid additional costs.
Network providers accept methods at negotiated prices, so you can reap cost savings. If you travel frequently, think about how your Medicare coverage might work with that.
Can you switch between Original Medicare and Medicare Advantage
As a final note, regardless of what choice you have decided is best for you, you may pick to swap between Original Medicare and Medicare Advantage, or vice versa.
A Medicare Advantage health program is a type of private health insurance. If a Medicare Advantage health plan offers Original Medicare as an option, you may switch between the two types of coverage.
Yes, you can switch between Original Medicare and Medicare Advantage. You need to be aware of the benefits and drawbacks of each one before making a decision.
The two primary times that you can change are during your annual Medicare enrollment period and during your Medicare particular enrollment period for qualifying life events if you are eligible.