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THE BIG CHOICE: ORIGINAL MEDICARE VS. MEDICARE ADVANTAGE
WHICH PATH YOU TAKE WILL DETERMINE HOW YOU GET YOUR MEDICAL CARE — AND HOW MUCH
IT COSTS
--------------------------------------------------------------------------------
By
Dena Bunis
415 Comments
En español
Published November 29, 2022
/ Updated June 29, 2023
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As you think about how Medicare will cover your health care needs, your first
major decision should be whether you want to enroll in federally run original
Medicare or select a Medicare Advantage plan, the private insurance alternative.
Think of it as choosing between ordering the prix fixe meal (Medicare Advantage)
at a restaurant, where the courses are already selected for you, or going to the
buffet (original Medicare), where you must decide for yourself what you want.
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If you elect to go with original Medicare, your buffet will include Part
A (hospital care), Part B (doctor visits, lab tests and other outpatient
services) and Part D (prescription drugs). If you decide to go with Part C, a
Medicare Advantage plan, it will be more like a set menu, since a private
insurer has already bundled together parts A and B and almost always D into one
comprehensive plan.
Some aspects of your care will be constant whichever plan you choose. Under both
choices, any preexisting conditions you have will be covered and you'll also be
able to get coverage for prescription drugs.
But there are significant differences in the way you'll use Medicare depending
on whether you pick original or Advantage. Here's a comparison of how each
works.
GOING TO THE DOCTOR
Under original Medicare, you can choose any providers — primary care doctors and
specialists — who accept Medicare. You don't need referrals to see any medical
provider and you don't have to worry about your doctor leaving a plan's network.
According to the Kaiser Family Foundation, only 1 percent of doctors don't
participate in Medicare and, for example, 83 percent of primary care physicians
accept new Medicare patients. That means chances are pretty good that any doctor
you are currently seeing will accept Medicare and you won't have to change
providers.
Under Medicare Advantage, you will essentially be joining a private insurance
plan like you probably had through your employer. The most common ones are
health maintenance organizations (HMOs) and preferred provider organizations
(PPOs). Medicare Advantage employs managed care plans and, in most cases, you
would have a primary care physician who would direct your care, meaning you
would need a referral to a specialist. HMOs tend to have more restrictive
choices of medical providers than PPOs. Medicare Advantage plans have become
increasingly popular. Nearly 32 million, almost half of all Medicare
beneficiaries, are enrolled in one of these plans and the average enrollee has
more than 43 plans to choose from.
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COVERED CARE
While Medicare will cover most of your medical needs, there are some things the
program typically doesn't pay for — like cosmetic surgery or routine dental ,
vision and hearing care. But there are also differences between what services
you get help paying for.
Health & Wellness
AARP® Dental Insurance Plan administered by Delta Dental Insurance Company
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Under original Medicare, you can get a wide variety of medical services
including hospitalizations; doctor visits; diagnostic tests, such as X-rays and
other scans; blood work; and outpatient surgery.
Under Medicare Advantage, you will get all the services you are eligible for
under original Medicare. In addition, some MA plans offer care not covered by
the original option. These include some dental, vision and hearing care. Some MA
plans also provide coverage for gym memberships. And in the past few years the
federal government has been adding services these plans can offer, including
such home improvements as wheelchair ramps to help Medicare beneficiaries remain
at home, providing transportation to doctors’ offices, coverage of some
over-the-counter medications, acupuncture and getting meals delivered. Which
services are available varies by plan.
COSTS
Under original Medicare, the federal government sets the premiums, deductibles
and coinsurance amounts for Part A (hospitalizations) and Part B (physician and
outpatient services). For example, under Part B, beneficiaries are responsible
for 20 percent of a doctor visit or lab test bill. The government also sets
maximum deductible rates for the Part D prescription drug program, although
premiums and copays vary by plan. Many beneficiaries who elect original Medicare
also purchase a supplemental – or Medigap – policy to help defray many
out-of-pocket costs, which Medicare officials estimate could run in the
thousands of dollars each year. There is no annual cap on out-of-pocket costs.
Under Medicare Advantage, enrollees must still pay the government-set annual
Part B premium and sometimes an additional premium for the MA plan. But instead
of paying the 20 percent coinsurance amount for doctor visits and other Part B
services, most MA plans have set copay amounts for a physician visit, and
typically that means lower out-of-pocket costs than original Medicare. MA plans
also have an annual cap on out-of-pocket expenses.
You should also check if you are eligible for Medicaid or any of the
other assistance programs Medicare offers to low-income enrollees.
AARP Audio · Does Medigap Cover Preexisting Conditions?
LOGISTICS
Under original Medicare, to get the full array of services you will likely have
to enroll in four separate elements: Part A; Part B; a Part D prescription drug
program; and a supplemental or Medigap policy. Physicians and hospitals have to
file claims for each service with Medicare that you'll have to review.
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Medicare Advantage is a one-stop-shopping program that combines Part A and Part
B into one plan. In addition, about 90 percent of MA plans also include
prescription drugs, which means you wouldn't have to enroll in a separate Part D
plan. There are no Medigap policies for Advantage plans. You do want to be
careful to make sure all your doctors are in the plan's network, though that
could change over time.
WHERE YOU LIVE
Under original Medicare, you can access care anywhere in the United States as
long as the provider accepts Medicare.
Medicare Advantage plans are based around networks of providers that are usually
self-contained in a specific geographic area. So, if you travel a lot or have a
vacation home where you spend a lot of time, your care may not be covered if you
go to out-of-network providers, or you would have to pay more for care. In
addition, while MA plans are pretty much available throughout the United States,
the choice of plans is more limited in rural areas.
Neither original Medicare nor Medicare Advantage covers your health care abroad.
%{postComment}%
Editor's note: This story, originally published July 1, 2020 has been updated to
reflect the most current information.
Dena Bunis covers Medicare, health care, health policy and Congress. She also
writes the “Medicare Made Easy” column for the AARP Bulletin. An award-winning
journalist, Bunis spent decades working for metropolitan daily newspapers,
including as Washington bureau chief for the Orange County Register and as a
health policy and workplace writer for Newsday.
What’s the Difference Between Original Medicare and Medicare Advantage?
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MEMBERS ONLY
Restaurants
Carrabba's Italian Grill®
10% off dine-in or curbside carryout orders placed by phone
Learn More
See more Restaurants offers >
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MEMBERS ONLY
Travel
AARP Travel Center Powered by Expedia: Hotels & Resorts
Up to 10% off select hotels
Learn More
See more Travel offers >
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MEMBERS ONLY
Home & Real Estate
ADT™ Home Security
Savings on monthly home security monitoring
Learn More
See more Home & Real Estate offers >
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Health & Wellness
AARP® Staying Sharp®
Activities, recipes, challenges and more with full access to AARP Staying Sharp®
Learn More
See more Health & Wellness offers >
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234
*
*
*
*
* MEMBERS ONLY
Restaurants
Carrabba's Italian Grill®
10% off dine-in or curbside carryout orders placed by phone
Learn More
See more Restaurants offers >
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* MEMBERS ONLY
Home & Real Estate
ADT™ Home Security
Savings on monthly home security monitoring
Learn More
See more Home & Real Estate offers >
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* Health & Wellness
AARP® Staying Sharp®
Activities, recipes, challenges and more with full access to AARP Staying
Sharp®
Learn More
See more Health & Wellness offers >
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