How To Choose Between Medicare Vs. Medicare Advantage
What Is The Difference Between Medicare And Medicare Advantage?
Should you go with Original Medicare, which includes Medicare Parts A and B? Or should you apply for a Medicare Advantage plan, also known as Medicare Part C? Your personal budget and your coverage needs are all factors. It's important to know the difference between Original Medicare and Medicare Advantage when you compare plans to see what works best for you.
Medicare Advantage Vs. Traditional Medicare
Traditional Medicare (also called Original Medicare) includes Medicare Part A and Part B, which give you inpatient and outpatient coverage. The difference with Medicare Advantage plans (Part C) is that they include Part A and Part B coverage, plus much more.
Medicare Part A covers:
- Hospital stays (semi-private rooms) up to 60 days
- Hospital meals
- Nursing services
- Intensive care services
- Drugs, medical supplies and equipment used on the premises
- Lab tests and X-rays taken while hospitalized
- Surgery and recovery costs
- Rehabilitation and therapy services
- Part-time home nursing care
Medicare Part B covers:
- Doctor visits
- Vaccinations and flu shots
- Health screenings and medical tests
- Medical supplies
- Ambulance services
- Smoking cessation and other preventive healthcare programs
Medicare Part C (Medicare Advantage) Includes:
- Everything Medicare Part A and Part B cover
- Additional coverage for dental, hearing, vision, prescription drugs, and more
Do Medicare Advantage Plans Replace Original Medicare?
Medicare Advantage plans can replace Original Medicare plus provide additional coverage depending on the plan you choose.
When looking at the differences between Medicare and Medicare Advantage, keep in mind that Medicare Advantage plans are offered through private insurers like Empire. They include everything that Part A and Part B cover, plus lots of other benefits that Original Medicare doesn’t cover. Think of a Medicare Advantage plan as comprehensive coverage for your healthcare needs.
Some of the benefits most Medicare Advantage plans have that Original Medicare does not have include:
Prescription Drug Coverage
Medicare Advantage prescription drug (MAPD) plans are Part C plans combined with Part D prescription drug plans. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can be combined to cover that and more.
Many Medicare Advantage plans offer dental coverage for things like routine checkups and exams, cleanings, dentures, and coverage for unplanned dental procedures like root canals and crowns.
Eye health becomes more important as we age. Eye exams, glasses, and contacts are a part of many Medicare Advantage plans.
Original Medicare doesn't cover hearing aids, which can be expensive. Many Medicare Advantage plans provide hearing coverage that includes testing and medically required hearing aids.
Wellness And Fitness
Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs like SilverSneakers®, and coaching to improve overall well-being.
What Is The Cost Difference Between Original Medicare And Medicare Advantage?
Original Medicare Costs
Medicare Advantage Costs
Part A premium is most likely free if you or your spouse worked and paid Medicare taxes
Some plans have $0 premiums
Part B includes a premium and deductible
The cost of Medicare Advantage plans varies depending on where you live
Both of your Part B costs are based on your lifetime earnings, so low-income beneficiaries may pay less for Part B
On average, your monthly premiums are usually lower than what you may pay for Original Medicare
Why Enroll In A Medicare Advantage Plan?
As you get older, healthcare protection becomes more important than ever. More coverage can offer more peace of mind, so you don't get surprise medical bills in the event of a sudden injury or illness.
Medicare Advantage plans can also offer more value. With the right plan, you can save on costs for dental, vision, prescription drug coverage, and more.
Because private insurers like Empire offer Medicare Advantage plans, you also have more flexibility with your plan selection. You can tailor your coverage to fit your healthcare needs.
Other Articles From "A Guide to Enrolling in Medicare"
What Is Medicare?
How To Apply For Medicare
Medicare Advantage Vs Original Medicare
How to Enroll in Medicare Part D
About Medicare Enrollment
What Does Medicare Cover?
Medicare Advantage Open Enrollment
Medicare Advantage Enrollment
Compare Part D Plans
Why Choose Empire?
Empire BlueCross BlueShield is a Medicare Advantage plan with a Medicare contract. Empire BlueCross BlueShield is a D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Empire BlueCross BlueShield depends on contract renewal.