Understanding Your Medicare Options: Original Medicare vs. Medicare Advantage
Choosing between Original Medicare and Medicare Advantage can be confusing. Here’s a straightforward guide to help you understand the key differences and make an informed decision.
Original Medicare
Original Medicare is the traditional government-run program. It includes two parts:
1. Part A (Hospital Insurance): Covers hospital stays, skilled nursing facilities, hospice, and some home healthcare.
2. Part B (Medical Insurance): Covers doctors’ services, outpatient care, medical supplies, and preventive services.
Most doctors and hospitals accept it, and you can visit any doctor or specialist without needing referrals, as it’s uniform across the country. However, deductibles and copayments can add up, it requires a separate plan for prescription coverage, and there are limited extra benefits (vision, dental, or hearing coverage) unless you purchase them separately.
Medicare Advantage (Part C)
Medicare Advantage plans are offered by private, for-profit insurance companies and bundle Part A, Part B, and usually Part D.
Advantage plans typically cover your annual expenses and are coordinated through network providers. They also offer vision, dental, hearing, and fitness coverage, but there are network restrictions where you need to use a specific network of doctors and hospitals, and benefits can differ widely by plan and location.
There are also profit-driven limitations that can limit access to and delay care, and plans can change annually, meaning some treatments and medications may not be covered if they’re deemed too costly.
What’s The Difference?
If you value the freedom to choose any doctor or specialist, don’t mind purchasing separate coverage or supplemental insurance, and prefer consistent coverage, Original Medicare would be your best bet.
Alternatively, Medicare Advantage could be a better fit if you’d like all-in-one coverage with extra benefits, you’re comfortable with network restrictions, and you don’t mind waiting for care due to profit-driven practices.
At the end of the day, it depends on what you’re most comfortable with for your health and your lifestyle.
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