Original Medicare vs. Medicare Advantage:
How Do They Compare?
Original Medicare
VS
Medicare Advantage
Medicare Parts A and B
Also Known As
Medicare Part C
Federal Government
Who Offers the Coverage
Private Insurance Companies
Original Medicare includes Parts A and B.
Part A:
- Inpatient care in hospitals and skilled nursing facilities
- Hospice care and some home health care
Part B:
- Doctor Visits
- Outpatient hospital services
- Durable medical equipment
- Some preventive health care
What it Covers
Medicare Advantage combines all of your coverage into one plan and often includes prescription drug coverage
Plans can also offer additional benefits Original Medicare doesn't cover, like:
- Vision, hearing and dental care
- Gym memberships
- Disease Management
- 24/7 access to health care preofessionals
Part A is free for most people
The standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10 from $135.50 in 2019.
Medicare also charges deductibles, copays and coinsurance.
What it Costs
Each Medicare Advantage plan sets its own premium, in addition to your Part B premium.
Plans have predictable copays and coinsurance.
No.
Generally speaking, Part B covers about 80 percent of a person's health care costs, leaving them to cover the remaining 20 percent out of pocket.
Annual Cap on Out-of-Pocket Expenses
Yes.
Medicare Advantage plans set an out of pocket max to help you predict how much may have to pay for health care services each year. The limit depends on the plan but can't be more than $6,700 in 2020.
Benefits and Features
Original Medicare
Medicare Advantage *
Coverage for hospital stays
Coverage for some medical care, like doctor visits
Preventive service, like flu shots
Preventive service, like flu shots
No coverage
Prescription drugs
No coverage
Routine vision coverage
No coverage
Routine hearing exam and hearing air coverage
No coverage
Limits your annual out-of-pocket costs
No coverage
*Benefits vary by plan.
Option 1
Add one or both of the following to Original Medicare.
Option 2
Choose a Medicare Advantage plan.
Medicare Supplement Insurance Plan Offered by private companies
Helps pay some of the out-of-pocket costs that come with Original Medicare
Medicare Part D Plan Offered by private companies
Helps pay for prescription drugs
Medicare Part D Plan Offered by private companies
Combines Part A (hospital insurance) and Part B (medical insurance) in one plan
Usually includes prescription drugs coverage
May offer additional benefits not provided by Original Medicare