October 5, 2021
People over the age of 65 often depend on Medicare to provide health insurance for the medications, medical experts, and treatments they require.
Typically, those who collect Social Security benefits are automatically enrolled in a Medicare plan unless they choose to delay enrollment. There are two paths that new enrollees can take: 1) sign up for Original Medicare (crafted and provided by the Government) or 2) select Medicare Advantage (provided by private health insurance companies).
While it’s true that both paths follow government regulations, there are some striking differences between the two. In this guide, we discuss the two methods of Medicare insurance, the pros and cons, and how to determine which is better for you.
What is Medicare?
In 1965, the government health insurance program introduced the “Original Medicare” plan to the public. This is now referred to as Medicare and includes two types, Part A and Part B.
Part A covers nursing homes, hospital insurance, and nursing facilities. Part B covers medical insurance and preventive care. Both come with coinsurance, deductibles, and copayments. Typically, enrolling in Medicare means you’re registering for both parts.
What is Medicare Advantage?
Medicare Advantage made an appearance in 1995 when the government decided to provide the public with different benefits. Medicare Advantage may be referred to as “Medicare Part C” or simply “MA”.
Medicare Advantage adds extra coverage to Original Medicare. These plans may offer more coverage for medical and hospital costs, and they may also cover routine hearing, dental, vision, and prescription drugs. As a result, Medicare Advantage plans often cost more per month than Original Medicare.
Moreover, once you enroll for a Medicare Advantage plan, you must continue using it for a year.
Medicare vs. Medicare Advantage
One key advantage of Original Medicare is that you don’t have to worry about provider networks (like PPOs and HMOs). As long as your chosen doctor accepts Medicare, you can receive your benefits. On the flip side, Medicare Advantage has provider networks, limiting the doctors and facilities you can access.
That said, there are still boundaries with Medicare. A big one is the lack of coverage if you travel outside the United States. Original Medicare also lacks coverage for prescription drugs, dental, vision, and hearing, and other coinsurance and copayment costs (for that, you’ll have to get a separate prescription drug plan as well as a dental, vision, and hearing plan). Whereas Medicare Advantage will combine some or all of those health care costs into one plan with a single monthly premium.
The Bottom Line
Original Medicare or Medicare Advantage? The best option for you depends on your unique lifestyle. If you’d like to simplify your insurance and keep all of your health care coverage in one plan, Medicare Advantage may be right for you. However, if you would rather not deal with provider networks that change annually, and don’t mind paying for coverage separately, Original Medicare may be a better option.
Once you know the pros and cons of both Original Medicare and Medicare Advantage, you’ll likely have a clearer picture of which method is best for you. If you’re still unsure, consider consulting a licensed insurance agent from SmartMatch. We can help you research and select a plan that caters to your health needs and budget. Call us at (888) 411-7647 TTY: 711 or visit our Comparison Shopping tool to get started.
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