As you start your initial enrollment into Medicare, or are currently enrolled and questioning your coverage, you may be wondering if Original Medicare or Medicare Advantage provides the best coverage for the best price.
While the choice of which plan is best is up to you and your coverage needs, you should still be aware of the similarities and differences between both options.
Original Medicare consists of two parts: A and B. With Parts A and B, you receive coverage for your inpatient and outpatient costs. Original Medicare also provides coverage for care received in a skilled nursing facility, durable medical equipment, lab tests, and preventive care services.
Medicare Advantage, also known as Part C, is seen as an alternative to Original Medicare. It offers the same benefits and includes extra coverage, such as dental, vision, and hearing coverage. There are several plans offered with Medicare Advantage.
Original Medicare and Medicare Advantage are similar in many ways:
- Both options offer Part A and B coverage
- Both can provide prescription drug coverage (however, Original Medicare is strictly limited to only cover prescriptions in certain situations, and does not usually include the prescriptions that are taken home)
- Original Medicare and certain Medicare Advantage Plans give you the choice of any doctor or provider as long as they accept Medicare
- Original Medicare and certain Medicare Advantage Plans have deductibles
- Both have coinsurance and copayments as out-of-pocket costs
- Original Medicare has a premium for Part B as many receive premium-free Part A, and depending on the Medicare Advantage Plan, you may or may not have a premium to pay
Despite their similarities, there are also several differences:
- Original Medicare does not offer extra benefits
- Medicare Advantage Plans offer additional benefits such as coverage for dental, hearing, vision, prescription drugs, fitness memberships, nutritional programs, and more
- Original Medicare offers coverage anywhere in the U.S.
- Medicare Advantage only covers services if you are within your plan’s service area or need emergent care
- Original Medicare does not have an out-of-pocket maximum
- Medicare Advantage offers a yearly maximum out-of-pocket spending limit, which varies among each plan
Original Medicare or Medicare Advantage?
While Original Medicare and Medicare Advantage are similar in many ways, they also have differences, which can be a dealbreaker when it comes to deciding on a plan. To determine which plan is right for you, give Joseph Cioffi Insurance a call. I can help you find a plan based on your coverage needs.