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 Medicare||Medicare Advantage|
|Costs||You 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 Insurance||You 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 Access||No 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.|
|Referrals||Do not need referrals for specialists.||Typically need referrals for specialists.|
|Drug Coverage||Must 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 Benefits||Does 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 Limit||No out-of-pocket limit.||Annual out-of-pocket limit. Plan pays the full cost of your care after you reach the limit.|
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