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