How does Medicare Advantage compare to Original Medicare?

A Medicare plan can either fall under Medicare Advantage or Original Medicare. Each of these plans has its own merits and demerits. Most people are left confused as far as Original Medicare and Medicare Advantage is concerned thus the importance of articles clarification such as this.

How does Medicare Advantage compare to Original Medicare?

Here’s how:

  1. Medicare Advantage
Medicare Advantage plans are normally sold by private insurance companies that specialize in providing Medicare benefits. The most common types of Medicare Advantage plans include Preferred Provider Organizations (PPOs) and Health Maintenance Organizations (HMOs) among others.

This kind of plan is designed to provide coverage for certain hospital/medical costs, prescription drugs, hearing, dental, vision among others. This Medicare supplement policy mainly covers the same services provided in Original Medicare Plans with the exemption of hospice care. Most Medicare Advantage plans cover all emergency health service care needs sufficiently.

In terms of coverage costs, a Medicare Advantage plan includes a yearly out-of-pocket limit. Your coverage will pay 100% of all the services it covers particularly after you reach a specific amount limit. Beneficiaries of Medicare Advantage plans pay a fixed co pay cost. A Medicare Advantage plan can also opt not to pay for services Medicare classifies as unnecessary. Nonetheless, this Plan may provide travel coverage for beneficiaries traveling abroad in case of an emergency.

When it comes to networking, those in this kind of a Medicare Supplement policy have to stick to doctors/hospitals within the set network. Beneficiaries who opt for hospitals or doctors outside the plan’s network have to pay more for the services rendered. It is also impossible to buy a Medigap policy that covers out of pocket expenses in Medicare Advantage plans.

  1. Original Medicare
Original Medicare plans are provided by the Federal governments. They are also regarded as the traditional programs. This plan’s coverage includes both Medicare Parts (Hospital Insurance) A and B (Medical Insurance). It generally covers hospital and medical expenses only. Beneficiaries of this kind of a Medicare Supplemental insurance plan are required to part with a deductible cost of 20% for all approved expenses of outpatient healthcare services provided.

This type of plan does not have restrictions on what beneficiaries pay out of their pocket. Beneficiaries are required to pay standardized prices for all services rendered regardless of their health complications. Original Medicare plans do not provide prescription drug coverage. This plan does not provide travel coverage except for special cases which are very rare. The beauty of Original Medicare plan is that beneficiaries can seek medical assistance from any hospital/doctor provided they accept Medicare.

Learn more about Medicare Supplemental Insurance plans, rates, and more at  Our expert Medicare Supplemental Insurance brokers will help you compare Medicare Supplemental Insurance rates and plans.  To talk to a Medicare expert call toll free 888.404.5049 today!


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