Medicare Advantage vs. Original Medicare: Which option should I choose?

The main difference is Original Medicare is administered by the federal government and Medicare Advantage plans are offered by private companies. Here’s a deeper look into what makes them unique.

What is Original Medicare?

Medicare is our country’s federal health insurance program for people age 65 and older, as well as some younger people with disabilities, or any age with end-stage renal disease (ESRD). There are 2 parts:¹

• Medicare Part A—generally helps cover inpatient hospital care, nursing facility care, nursing home care, hospice care and home healthcare
• Medicare Part B—covers certain doctors’ services, outpatient care, medical supplies and preventive services

There are some things Original Medicare won’t cover, including long-term care and most vision, dental and hearing services.

What is Medicare Advantage?

Medicare Advantage is an alternative to traditional Medicare offered by private health insurance companies. Medicare Advantage plans cover all the same services under Original Medicare Part A and Part B, but often include prescription drug coverage and extra benefits. Some benefits may provide coverage for:²

• Routine dental care (dental exams, X-rays, teeth cleanings)
• Routine vision care (eye exams, eyeglasses and contacts)
• Routine hearing care (hearing tests, hearing aids)
• Fitness programs and gym memberships
• Over-the-counter drugs

Medicare Advantage plans can also include prescription drug coverage. To get the same coverage with Original Medicare, you’d have to buy a separate prescription drug plan and pay a separate premium.

Let’s compare Original Medicare and Medicare Advantage side-by-side to help you better understand each one’s advantages.

When reviewing your options, here are some important things to remember:

• Medicare cost—How much will I pay for premiums, deductibles, coinsurance and copayments?
• Doctors and hospitals—Does the Medicare plan have a network? Do the healthcare providers I use accept the plan?
• Medicare coverage and benefit—Does the plan include prescription drug coverage or coverage for vision, dental and hearing care?
• Your health history—How often have I needed care over the past few years? Do I have a chronic condition that requires ongoing care? Do I think my healthcare needs will increase or stay about the same?

You have choices—and that’s a good thing! As you continue exploring your options, take some time to compare Medicare Advantage plans and see how to switch your Medicare plan.