You must be logged in to bookmark pages. People with Medicare can get their health coverage through either Original
Medicare or a Medicare Advantage Plan (also known as a Medicare
private health plan or Part C). Consider the following key differences between these two options when deciding how you want to receive your Medicare benefits. If you sign up
for Original Medicare and later decide you would like to try a Medicare Advantage Plan–or vice versa–be aware that there are only certain enrollment periods when you are allowed to make changes. Note: Keep in mind that different areas have different Medicare Advantage Plans. A particular plan may not be available where you live. Call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP) to find out about plans available in your area. The table below compares Original Medicare and Medicare Advantage. Remember that there are several different types of Medicare Advantage Plan. If you are interested in joining a plan, speak to a plan representative for more information.
WebMD Connect to Care helps you find services to manage your health. When you purchase any of these services, WebMD may receive a fee. WebMD does not endorse any product, service or treatment referred to on this page. X Original Medicare and Medicare Advantage have identical eligibility requirements. Medicare Advantage, however, is private insurance that offers slightly different benefits. Since the 1990s, Medicare recipients have been able to choose private health plans as an alternative to original Medicare. These health plans, once called Medicare Part C, are now known as Medicare Advantage. Most Medicare recipients still choose the original program, but in 2019, 34% of Medicare beneficiaries opted to enroll in Medicare advantage. In 2016, 29% of new Medicare beneficiaries chose an Advantage plan during the first year of enrollment. The two programs offer similar benefits, but there are some important distinctions. Medicare vs. Medicare Advantage: The BasicsIf you have original Medicare, the goverment directly pays for your Medicare benefits. In contrast, with Medicare Advantage plans, you receive your benefits from private medical insurance companies that Medicare has approved. There are several types of Medicare Advantage Plans:
The Official U.S. Government Site for Medicare online states that you must live in the service area of you prospective plan and also have Medicare Part A and Part B in order to join a Medicare Advantage Plan. Both Medicare and Medicare Advantage are also legally required to cover certain basic health services, though the costs you pay and the specific services that are covered vary. Medicare Advantage began in 1995, though similar programs were available as early as the 1970s. The key distinction between the two programs is that Medicare is government health insurance, while Medicare Advantage is private health insurance that the government helps fund. Medicare vs. Medicare Advantage: DifferencesBoth Medicare and Medicare Advantage will fund most basic health costs, including doctor's visits and hospital stays. The specific cost of each plan, as well as the out-of-pocket copays and other costs, vary. Some key differences between the two programs include:
Why Choose Medicare Advantage?Medicare Advantage plans must offer benefits comparable to original Medicare. The government regulates these plans, ensuring that they meet certain basic care requirements. The costs and copays for various services, however, may be different. For some people, Medicare Advantage is a better choice. You might choose Medicare advantage because:
What is the difference between traditional and Advantage Medicare?Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. Medicare Advantage plans cover all the above (Part A and Part B), and most plans also cover prescription drugs (Part D).
Is Original Medicare more expensive than Medicare Advantage?The costs of providing benefits to enrollees in private Medicare Advantage (MA) plans are slightly less, on average, than what traditional Medicare spends per beneficiary in the same county. However, MA plans that are able to keep their costs comparatively low are concentrated in a fairly small number of U.S. counties.
What is the benefit of choosing Medicare Advantage rather than the original Medicare plan?Plans may have lower out-of-pocket costs than Original Medicare. Plans may offer some extra benefits that Original Medicare doesn't cover—like vision, hearing, and dental services. service area (for non-emergency care). Some plans offer non-emergency coverage out of network, but typically at a higher cost.
What is the biggest disadvantage of Medicare Advantage?The biggest disadvantage of Medicare Advantage plans is the closed provider networks, limiting your choice of which doctor or medical facility to use. Medicare Advantage costs are also largely based on how much medical care you need, making it more difficult to budget for health care costs.
|