{"id":57870,"date":"2023-04-07T10:35:33","date_gmt":"2023-04-07T14:35:33","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=57870"},"modified":"2024-10-25T10:47:17","modified_gmt":"2024-10-25T14:47:17","slug":"original-medicare-vs-medicare-advantage","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/original-medicare-vs-medicare-advantage\/","title":{"rendered":"How to choose between Original Medicare and Medicare Advantage"},"content":{"rendered":"

Medicare is one of the many things people can look forward to as they get older. With discounted <\/span>medical insurance<\/span> from the government, who wouldn’t be interested? If you’re 65 or older or meet one of the other criteria for eligibility and are preparing to enroll in Medicare, you’ll soon realize it isn’t as straightforward as you’d imagine. <\/span>Original Medicare<\/span> isn’t your only option; you can also choose from various <\/span>Medicare Advantage plans<\/span>. <\/span><\/p>\n

What is <\/span>Original Medicare vs. Medicare Advantage<\/span>?<\/span><\/h2>\n

We went to the experts to better understand the difference between <\/span>Original Medicare<\/span> and <\/span>Medicare Advantage plans<\/span>. <\/span><\/p>\n

“<\/span>Since 1965, Medicare has been a federal <\/span>health insurance<\/span> program for persons 65 and older, no matter their medical condition or level of income,” explained Michelle Robbins, a licensed <\/span>insurance agent<\/span> in Corona, California, at<\/span> U.S. <\/span>Insurance Agents<\/span><\/a>. “<\/span>There are also people who are under the age of 65, with specific health conditions and diseases, who may also <\/span>enroll<\/span> in <\/span>original Medicare<\/span>.” <\/span><\/p>\n

Original Medicare<\/span> is offered by the <\/span>federal government<\/span>, and is broken into parts, mainly Part A and Part B. <\/span>Medicare Part A, generally speaking,<\/span> is <\/span>inpatient<\/span> coverage that covers your <\/span>hospital stays<\/span> and many of the costs associated with your time there. Medicare Part B covers <\/span>outpatient<\/span> services like <\/span>doctor’s visits<\/span>, some medical equipment, and ambulance services. There are also privately administered <\/span>Medicare Part D plans<\/span> that cover <\/span>prescription drugs<\/span>.<\/span><\/p>\n

Despite being a government-subsidized <\/span>insurance plan<\/span>, there are still costs associated with <\/span>Original Medicare<\/span>. You’ll need to pay premiums for each part of Medicare, and there are also <\/span>deductibles<\/span> and coinsurance.<\/span><\/p>\n

With <\/span>Original Medicare<\/span>, you’ll be covered to see any <\/span>healthcare provider<\/span> nationwide that accepts Medicare. People with limited income and resources may also have access to <\/span>Extra Help<\/span><\/a>, a program to help low-income individuals using Medicare with some Part D costs. Another option to help reduce costs is <\/span>Medicare Supplement Insurance<\/span><\/a>, or Medigaps, which can be used in addition to Medicare to cover the <\/span>out-of-pocket costs<\/span>, like <\/span>co-pays<\/span> and <\/span>coinsurances<\/span>, that Medicare does not cover.<\/span>
\n<\/span><\/p>\n

Robbins went on to explain <\/span>Medicare Advantage plans<\/span>, “<\/span>Part C<\/span>, also known as Medicare Advantage (MA), became another option for Medicare <\/span>healthcare<\/span>, beginning in 1997. <\/span>It’s an alternative to <\/span>Original Medicare<\/span>, which allows patients to choose <\/span>health plans<\/span> with at least the same service coverage as <\/span>Original Medicare<\/span>, including a few extra benefits such as dental, vision, hearing, and <\/span>Part D<\/span> prescription drugs<\/span>.”<\/span><\/p>\n

Medicare Advantage plans<\/span><\/a>, sometimes called <\/span>Medicare Part C<\/span> plans, are offered by <\/span>private insurance companies<\/span> and can be advantageous for some individuals. These plans typically combine Parts A, B, and D into a single private plan. Medicare Advantage plans are most commonly provided through <\/span>health maintenance organizations<\/span> (<\/span>HMO<\/span>) or <\/span>preferred provider organization<\/span> (<\/span>PPO<\/span>) plans; you can pick coverage from various <\/span>insurance companies<\/span>, some of which have $0 premium plans. <\/span><\/p>\n

However, it’s important to note that you may need preauthorization before visiting certain <\/span>healthcare<\/span> professionals with <\/span>Medicare Advantage Plans<\/span>. You may only be able to see doctors in the <\/span>plan’s network<\/span>, usually limited to your area. Otherwise, you may only get partial insurance coverage on your visit or none at all.<\/span><\/p>\n

How to choose between <\/span>Original Medicare and Medicare Advantage<\/span><\/h2>\n

After researching the types of Medicare, the next big question many people face is how to choose between <\/span>Original Medicare<\/span> and Medicare Advantage. This is a personal choice because you’ll need to evaluate the <\/span>Medicare Advantage plans<\/span> available to you and see how they compare to <\/span>Original Medicare<\/span> for your specific <\/span>healthcare needs<\/span>. You’ll want to consider any health conditions you have, which doctors you can visit, and your financial situation. <\/span><\/p>\n

To learn more, we went to the experts to see what general advice they could give. <\/span><\/p>\n

Consider <\/span>Original Medicare<\/span> if:<\/span><\/h3>\n

“<\/span>If you prefer budget predictability and the freedom to choose who and where you will receive your <\/span>healthcare<\/span> services, closer consideration of <\/span>Original Medicare<\/span> might be in your best interest,” explained Robbins. <\/span><\/p>\n

Other considerations for choosing <\/span>Original Medicare coverage<\/span> include: <\/span><\/p>\n