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Should I stay with Original Medicare or Choose a Medicare Advantage Plan?


Remember, Original Medicare (Part A and Part B) will only cover about 80% of your Medicare eligible costs.  This can be devastating financially if you have to pay the other 20% of costs.  If you can’t budget for a Medicare Supplement Plan, you should at least choose the best Medicare Advantage plan that fits your needs.  These plans provide All the benefits of Part A and Part B and they also provide extra benefits too.  

The table below shows high-level differences between Original Medicare and a Medicare Advantage plan.

Original Medicare vs Medicare Advantage

Original MedicareMedicare Advantage
CostsYou will be charged for standardized Part A and Part B costs, including monthly Part B premium. Responsible for paying a 20% coinsurance for Medicare-covered services if you see a participating provider and after meeting your deductible.Your cost-sharing varies depending on plan. Usually pay a copayment for in-network care. Plans may charge a monthly premium in addition to Part B premium.
Supplemental InsuranceYou have a choice to pay an additional premium for a Medicare Supplement (Medigap) Plan to cover costs that Medicare does not cover. Remember, Medicare covers about 80%.Cannot purchase a Medicare Supplement (Medigap) policy.
Provider AccessNo Networks:  Can see any provider and use any facility that accepts Medicare (participating and non-participating).Networks of doctors, hospitals and facilities.  Typically, you only want to see in-network providers or your costs go up.
ReferralsDo not need referrals for specialists.Typically need referrals for specialists.
Drug CoverageMust sign up for a stand-alone prescription drug plan. Most plans provide prescription drug coverage (you may be required to pay a higher premium).
Other BenefitsDoes not cover vision, hearing, or dental services.Most plans cover additional services, including vision, hearing, and/or dental (additional benefits may increase your premium and/or other out-of-pocket costs).
Out-of-Pocket LimitNo out-of-pocket limit.Annual out-of-pocket limit. Plan pays the full cost of your care after you reach the limit.

Learn More: How do I compare all the different Medicare Advantage Plans?

People Also Read: What are the different types of Medicare Advantage Plans?


Meet Melissa MacCalla

Medicare is not simple and can be hard, frustrating, and downright confusing for most. I love when I get someone on the phone and I am given the opportunity to explain the difference in plans to them and have Medicare make sense. I enjoy talking to clients year after year, hearing about their families growing or them asking about mine.


Senior Healthcare Solutions, you truly stand out from most other insurance agents. Thank you so much for all of your help and I know that you will have nothing but success with how you conduct business.

Joan B.

Montgomery, AL

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