While Medicare can provide great healthcare coverage, it can be difficult to understand all of the options available. Making the right decision, however, is vital to worrying less about your healthcare coverage and saving money.
That’s why it’s important to compare all Medicare options to help you choose the plan that is more suitable for your needs.
Original Medicare vs. Medicare Advantage
Original Medicare (Medicare Part A and Part B) is provided by the federal government to provide coverage for hospital and medical expenses. Medicare Advantage (Medicare Part C), on the other hand, is provided by private insurance companies approved by Medicare, and is an all-in-one alternative to Original Medicare that provides more coverage.
Here are the major differences between Original Medicare and Medicare Advantage to help you better compare options:
- Original Medicare allows you to choose any doctor or hospital that accepts Medicare coverage. However, some Medicare Part C plans have a provider network that they require their members to use to receive care. This makes out-of-pocket costs lower, but also restricts coverage.
- Most Medicare Part C plans include full prescription drug coverage, while Original Medicare only covers limited medication coverage in some conditions. If you prefer Original Medicare, you’ll have to purchase a Part D prescription drug plan.
- Medicare Part C offers additional coverage such as vision, dental, and hearing care that are not included in Original Medicare.
- With a Medicare Advantage plan, there is an annual out-of-pocket maximum, which means a beneficiary will only be required to pay a certain amount in out-of-pocket costs. Original Medicare doesn’t provide this.
- Both plans have deductibles and coinsurance/copayment fees. Both plans also require beneficiaries to pay their Part A and Part B deductibles.
Medicare Supplement Plans
Medicare Supplements, also known as Medigap plans, help cover out-of-pocket costs related to Original Medicare, including deductibles, copayments, and coinsurance. If you already have a Medicare Advantage plan, you cannot have a Medigap plan. The reason being is that Medigap plans are designed to supplement Original Medicare only, nothing else. There are ten plans available which are labeled as A, B, C, D, F, G, K, L, M, and N.
If you choose to opt for a Medicare Supplement plan and not a Medicare Advantage plan, you will still get coverage from Original Medicare, but you won’t get the same additional coverage as provided by Medicare Advantage. As already mentioned, Medicare Supplements will provide coverage for the costs not already covered by Original Medicare. However, each Medicare Supplement plan will differ in its coverage. Some will provide you with more basic coverage while others will provide more comprehensive coverage.
Medicare Supplements also do not provide prescription drug coverage like some Medicare Advantage plans do. You will have to purchase a Medicare Part D plan if you want this coverage.
Medicare can be confusing and there is quite a bit of information out there to read. If you find yourself struggling to understand your Medicare options, contacting a licensed insurance agent may be the best course of action. They can help explore options from multiple carriers, determine which coverage might be ideal for your situation, and constantly strive to find additional insurance products that may help supplement your current coverage.