Original Medicare is Part A (hospital insurance) and Part B (medical insurance). But beneficiaries also have other Medicare coverage options, including Medicare Advantage plans and Medicare Supplement Insurance plans (also called Medigap).
Learn more about how these options compare to find out which one might be right for your needs.
Which Is Better: Original Medicare or Medicare Advantage?
Determining which type of Medicare coverage is better for you depends on your unique health care needs. Here’s how Original Medicare stacks up against Medicare Advantage.
Part A and Part B of Medicare provide coverage for a number of health care costs.
- Medicare Part A
Part A provides coverage for inpatient hospital stays, skilled nursing facility care, hospice and some limited home health services. Before your Part A plan provides any benefits, you must first meet the Part A deductible, which is $1,340 in 2018. After your deductible is met, you may have to pay some coinsurance and copayment costs for certain medical care you receive during long hospital stays.
- Medicare Part B
Part B provides coverage for healthcare you receive or need to treat diseases or conditions. This can include visits to your doctor, consultations with specialists, ambulance services, medical equipment, medical health treatment and other services and supplies. In order to receive any of these benefits, you must first meet your annual Part B deductible, which is $183 in 2018. Once you meet your deductible, you typically pay 20% of Part B costs.
You typically become eligible for Original Medicare when you approach your 65th birthday. Your seven-month Medicare Initial Enrollment Period begins three months before you turn 65, includes your birth month and extends for another three months after that.
Some people are automatically enrolled in Medicare Part A. To learn more about other important Medicare enrollment information and dates, check out our guide to Medicare Enrollment and Eligibility.
Medicare Advantage plans are also referred to as Medicare Part C. These plans are sold by private insurance companies but are regulated by the federal government. This means that if you enroll in a Medicare Advantage plan, your plan is required to offer at least the same benefits offered under Original Medicare. You pay the insurance company monthly premiums for your plan benefits.
Many Medicare Advantage plans include additional benefits, which may include:
- Prescription drug coverage
- Vision and/or dental insurance
- Wellness program benefits
Because Medicare Advantage plans are sold by private insurance companies, premiums and other plan costs can vary based on where you purchase a plan.
When it comes to Original Medicare vs. Medicare Advantage, you should know that you must be enrolled in Medicare Part A and Part B before you can purchase a Medicare Advantage plan. Your Medicare Advantage plan provider will then be the insurance company that provides your Medicare benefits.
Medicare Advantage plans typically restrict you to health care providers and hospitals that are within the plan network. To learn more, check out our guides to Medicare Advantage HMO plans and PPO plans.
Which Is Better: Medicare Advantage or Medicare Supplement Insurance?
If you are considering either a Medicare Advantage plan or a Medicare Supplement Insurance plan, it’s important to evaluate the benefits of each type of plan to find the policy that will best help you cover your anticipated healthcare costs.
Medicare Supplement Insurance (Medigap)
Medicare Supplement Insurance plans — like Medicare Advantage plans — are sold by private insurance companies. Unlike Medicare Advantage, however, Medicare Supplement Insurance doesn’t replace your Original Medicare benefits. A Medigap plan works alongside your Original Medicare coverage to cover some of the out-of-pocket costs that Medicare doesn’t pay for.
Some of the costs that a Medigap plan can cover include the Medicare Part A and Part B deductibles mentioned above. There are 10 standardized Medigap plans sold in most states (Massachusetts, Minnesota and Wisconsin have different options). Each type of Medigap plan offers a different mix of coverage for various out-of-pocket Medicare costs.
This chart illustrates the benefits available with each type of Medigap plan. A check mark indicates that the Medigap plan covers 100% of the costs for the benefit listed.
Medigap plans do not come with network restrictions like most Medicare Advantage plans do. Any health care provider or hospital who accepts Medicare will also accept your Medigap plan.
You can apply for a Medigap plan at any time of the year, but the best time to apply for a plan is during your Medigap open enrollment period. Your Medigap open enrollment period begins as soon as you are at least 65 years old and enrolled in Medicare Part B. During your open enrollment period, insurance providers cannot use medical underwriting to determine your eligibility or to set your premium costs.
How Do I Know Which Type of Medicare Plan Is Right for Me?
Original Medicare, Medicare Advantage plans and Medicare Supplement Insurance can each help you pay for your health care needs in different ways. The best way to decide which type of coverage you need is to read more about these options and determine which type of plan best suits your unique needs and budget.
For additional support, discuss your options with a licensed insurance agent by calling 1-888-264-0148.