As a senior, it is important to understand the different types of Medicare available to you. The two main types of Medicare are Original Medicare and Medicare Advantage. Understanding the difference between these Medicare types will help you make an informed decision about which type of Medicare is right for you.
What is Original Medicare?
Original Medicare is the federal health insurance program for people who are 65 years old or older, as well as for some people with disabilities. It is comprised of two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). Part A covers hospital stays, including inpatient care, some home health services, and hospice care. Part B covers doctor visits, outpatient care, durable medical equipment, and some home health services. Original Medicare gives beneficiaries the freedom to see any doctor or provider who accepts Medicare, making it a flexible and comprehensive option for those who prefer a wider choice of healthcare providers. However, it does not cover all costs and beneficiaries may need to pay for deductibles, coinsurance, and copayments out-of-pocket. Despite its limitations, Original Medicare remains a popular option for those who want a traditional Medicare experience and value its extensive coverage options.
What is Medicare Advantage?
Medicare Advantage, or Part C of Medicare, is a type of Medicare health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans must provide all the benefits of Original Medicare, but they can also offer additional benefits such as prescription drug coverage and routine vision or dental care. In the next paragraph, we will describe the key differences between those two Medicare parts.
What are the differences between Original Medicare and Medicare Advantage?
There are several key differences between Original Medicare and Medicare Advantage.
Coverage
One of the main differences between Original Medicare and Medicare Advantage is the coverage each type of Medicare provides. Original Medicare covers hospital and medical services but does not cover prescription drugs. Medicare Advantage plans, on the other hand, must cover all the benefits of Original Medicare and can also cover prescription drugs and additional benefits such as routine vision or dental care.
Cost
Another key difference between Original Medicare and Medicare Advantage is the cost. With Original Medicare, you will generally have to pay a deductible for each benefit period, as well as coinsurance for some services. With Medicare Advantage, you will typically have a monthly premium, as well as a deductible and coinsurance.
It is important to compare the costs of Original Medicare and Medicare Advantage to determine which type of Medicare is more affordable for you.
Provider Network
Original Medicare allows you to see any doctor or provider who accepts Medicare, while Medicare Advantage plans typically have a network of providers. If you choose a Medicare Advantage plan, it is important to make sure the plan you choose has a network of providers that includes the doctors and hospitals you prefer, because if not, you may have to pay more for services received outside of the plan’s network.
Annual Enrollment Period
The Annual Enrollment Period (AEP) is the time each year when you can enroll in or change your Medicare Advantage plan. The AEP begins on October 15th and ends on December 7th. During this time, you can switch from Original Medicare to a Medicare Advantage plan, switch from one Medicare Advantage plan to another, or return to Original Medicare.
Conclusion
In conclusion, Original Medicare and Medicare Advantage are two different types of Medicare that offer different levels of coverage and cost. Original Medicare covers hospital and medical services but does not cover prescription drugs. Medicare Advantage plans must cover all the benefits of Original Medicare and can also cover prescription drugs and additional benefits. When choosing between Original Medicare and Medicare Advantage, it is important to carefully consider the coverage and costs of each type of Medicare to determine which type of Medicare is right for you.
Dr. Susan Johnson is a Medicare Health Advisor with extensive knowledge and experience in health insurance, particularly Medicare. She has spent over 15 years working in various healthcare settings, including hospitals, clinics, and private practices.
As a Medicare Health Advisor, Dr. Johnson specializes in helping people navigate the complex world of health insurance, including original Medicare, Medicare Advantage, Medicare supplements, and Medicare Part D. She is committed to providing personalized guidance to her clients, helping them make informed decisions about their coverage and reduce their healthcare costs.