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

  • Medicare with Melissa

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?

Popular Search: When is the annual open enrollment period?

Related Article: Why Medicare Advantage Plans Are Bad


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.


Oh my gosh!! I was so confused about the Medicare Supplement process. I am turning 65 soon and am retired and have always had insurance thru my former employer. I didn’t know a thing about going on Medicare and was struggling to sort it all out.

A friend of mine recommended contacting Senior HealthCare Solutions, so I did. Melissa was FANTASTIC!! She was professional, responsive, caring and friendly. She explained the steps I needed to take, gathered my information, helped me choose good plans for MY specific needs and took care of my applications over the phone. 1-2-3, eesy-peesy and I was done!! And it didn’t cost me a DIME!!! WOW!!! I HIGHLY recommend Senior Healthcare Solutions for anyone who’s overwhelmed with making the right choices with Medicare Supplemental Insurance and Rx coverage. It’ll take a load off your mind!

Janice W.

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