Show
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:
Is Medicare Advantage different from original 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 the disadvantages of Medicare Advantage?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 are the disadvantages of original Medicare?Cons of Original Medicare
Alongside the out-of-pocket costs, another con is that Original Medicare does not provide additional benefits. These include dental, vision, hearing, and drug coverage. If you require this coverage, you will have to seek additional policies.
Do you still pay Medicare premiums with an Advantage plan?In addition to your Part B premium, you usually pay a monthly premium for the Medicare Advantage Plan. In 2022, the standard Part B premium amount is $170.10 ($164.90 in 2023) (or higher depending on your income).
|