Medicare Advantage vs. Traditional MedicareTraditional Medicare (also called Original Medicare) includes Medicare Part A and Part B, which gives you inpatient and outpatient coverage. Medicare Advantage plans (Part C) include Part A and Part B coverage plus much more. Show
Medicare Part A covers:Medicare Part C (Medicare Advantage) includes:
Do Medicare Advantage Plans Replace Original Medicare?Medicare Advantage plans can replace Original Medicare plus provide additional coverage depending on the plan you choose. When looking at the differences between Medicare and Medicare Advantage, keep in mind that Medicare Advantage plans are offered through private insurers like Anthem. They include everything that Part A and Part B cover, plus lots of other benefits that Original Medicare doesn’t cover. Think of a Medicare Advantage plan as comprehensive coverage for your healthcare needs. Some of the benefits most Medicare Advantage plans have that Original Medicare does not have include: Prescription drug coverage Medicare Advantage prescription drug (MAPD) plans are Part C plans combined with Part D prescription drug plans. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can be combined to cover that and more. Dental Care Many Medicare Advantage plans offer dental coverage or things like routine checkups and exams, cleanings, dentures, and coverage for unplanned dental procedures like root canals and crowns. Vision Care Eye health becomes more important as we age. Eye exams, glasses, and contacts are a part of many Medicare Advantage plans. Hearing care Original Medicare doesn't cover hearing aids, which can be expensive. Many Medicare Advantage plans provide hearing coverage that includes testing and medically required hearing aids Wellness and fitness Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs like SilverSneakers®, and coaching to improve overall well-being. Compare The Costs: Medicare vs. Medicare AdvantageOriginal Medicare If you or your spouse worked and paid Medicare taxes, you will most likely receive Part A premium-free with Original Medicare. Part B with Original Medicare has a premium and a deductible. Both of your Part B costs are based on your lifetime earnings, so low-income beneficiaries may pay less for Part B. Medicare Advantage The cost of Medicare Advantage plans varies depending on where you live. Some plans have $0 premiums. On average, your monthly premiums are usually lower than what you pay for Medicare Part B with Original Medicare. Why Enroll In A Medicare Advantage Plan?As you become older, healthcare protection becomes more important than ever. More coverage can offer more peace of mind, so you don't get surprise medical bills in the event of a sudden injury or illness. Medicare Advantage plans can also offer more value. With the right plan, you can save on costs for dental, vision, prescription drug coverage, and more. Because private insurers like Anthem offer Medicare Advantage plans, you also have more flexibility with your plan selection. You can tailor your coverage to fit your healthcare needs. Find a Medicare plan that fits you.
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 are the disadvantages of a Medicare Advantage plan?Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.
What is the difference between Medicare Advantage and regular 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).
What are advantages of Medicare advantage over regular Medicare?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.
Is Medicare Advantage the best option?Is Medicare Advantage or Medigap Coverage Your Best Choice? If you are in good health with few medical expenses, Medicare Advantage can be a suitable and money-saving choice. But if you have serious medical conditions with expensive treatment and care costs, Medigap is generally better.
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