In our post we discussed what you may pay for Medicare.  Now we will discuss Medicare VS Medicare Advantage Plan and discuss the differences between the two.

 

Original Medicare vs. Medicare Advantage 

Your Medicare health plan decisions affect how much you pay for coverage, what services you get, what doctors you can use, and your quality of care.

Learning about your Medicare coverage choices, getting help from people you trust, and comparing different plans can help you understand all the options available to you. 

There are 2 main ways to get Medicare

Original Medicare

• Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
• If you want drug coverage, you can join a separate Part D plan.
• To help pay your out-of-pocket costs in Original Medicare (like your 20% coinsurance), you can also shop for and buy supplemental coverage.
• You can use any doctor or hospital that takes Medicare, anywhere in the U.S.

 What’s NOT covered by Part A and Part B?

Medicare doesn’t cover everything. If you need certain services Part A or Part B doesn’t cover, you’ll have to pay for them yourself unless:

• You have other coverage (including Medicaid) to cover the costs.
• You’re in a Medicare Advantage Plan that covers these services. Most Medicare Advantage plans cover extra benefits, like vision, hearing, dental, and fitness programs.

Medicare Advantage Plans (also known as Part C)

• Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
• Plans may have lower out-of-pocket costs than Original Medicare.
• In most cases, you’ll need to use doctors who are in the plan’s network.
• Most plans offer extra benefits that Original Medicare doesn’t cover— like vision, hearing, dental, and more.

How do Medicare Advantage Plans work?

Each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to doctors, facilities, or suppliers that belong to the plan’s network for non-emergency or non-urgent care).

What do Medicare Advantage Plans cover?

Medicare Advantage Plans cover almost all Part A and Part B services. However, if you’re in a Medicare Advantage Plan, Original Medicare will still cover the cost for hospice care, some new Medicare benefits, and some costs for clinical research studies. In all types of Medicare Advantage Plans, you’re always covered for emergency and urgent care.

Next up we will discuss what choice may be best for you.  Here we basically review some of the highlights of your options.

As always drop me a line, text or give me a call if you have questions.