Medicare Advantage

What’s the Difference Between Original Medicare and Medicare Advantage?

Medicare comes in two basic options: Original Medicare and Medicare Advantage. Original Medicare is the well-known type of Medicare that is provided by the federal government. Medicare Advantage plans are provided by private insurance companies.

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There are a few additional differences to know:

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• Original Medicare takes care of inpatient and outpatient hospital visits, some nursing services, and some preventative health care. Medicare Advantage covers all of that plus some additional options, such as dental, vision, and hearing coverage.

• Original Medicare doesn’t take care of prescriptions, while Medicare Advantage plans typically do.

• Most hospitals and doctors accept Original Medicare, and you can visit any that do accept it. Most Medicare Advantage plans involve a set network of doctors and medical providers that you are limited to. If you visit any outside of that network, you typically pay more.

• Premiums, deductibles, and copay amounts differ between Original Medicare and Medicare Advantage.

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Types of Medicare Advantage

Medicare Advantage plans come in many shapes and sizes. Some of these include the following:

HMOs

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HMOs or Health Maintenance Organization plans are typically provided through employers. These plans typically offer a set provider network, require that you choose a primary care provider in that network, and require a referral to see a specialist.

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PPOs

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PPOs or Preferred Provider Organization plans are group plans that are usually provided through employers. They also provide a set provider network but allow you to use providers outside of the network for higher costs. They also don’t require referrals to see specialists.

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MSAs

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MSAs or Medicare Medical Savings Accounts are plans that are similar to a bank account for health care needs. These charge a higher deductible but allow you to choose any doctor that accepts Medicare.

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This list of Medicare Advantage plans is not a comprehensive one as there are several available for your needs, which is why you should consider speaking with a Medicare consultant.

As a Medicare consultant, I can help you navigate the waters to ensure you find the best coverage for you and your family. Contact me today to get started.