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Original Medicare and Medicare Advantage: What's the Difference?

When you reach the age of 65, you have some new decisions to make regarding health coverage, including enrolling in Medicare and creating the right plan for you. It can be easy to get discouraged and lost in the sea of information about Medicare and its many parts, but we are here to help. Let’s start with the basics.

What exactly is Medicare?

Medicare is a government health care program for those who are 65+, certain younger people with disabilities, and those with End-Stage Renal Disease. It is funded by Social Security, Medicare taxes, premiums that people pay on Medicare, and the federal budget.

When you become eligible to enroll in Medicare, there are two different main plans you can choose from to decide how to get your Medicare coverage. These are Original Medicare and Medicare Advantage (Part C).

What is Original Medicare?

Original Medicare is the traditional fee-for-service program offered by the federal government. Under Original Medicare, you can visit any doctor or hospital that accepts Medicare, and Medicare will pay for any covered services you undergo. You’ll have to pay for the rest of the services not covered by Original Medicare unless you have additional insurance to cover the costs.

Original Medicare is broken up into two main parts: Medicare Part A and Medicare Part B.

  • Medicare Part A (Hospital Insurance) covers inpatient hospital stays, hospice care, care in a skilled nursing facility, and some home health care.

  • Medicare Part B (Medical Insurance) covers certain doctor services, outpatient care, medical supplies, and preventive services.

An important thing to note about Original Medicare is that it doesn’t include prescription drug coverage. To add prescription drug coverage to your Original Medicare plan, you’ll want to enroll in Medicare Part D. This plan will help you pay for the prescription drugs you need.

Still unclear? Check out this video!

What is Medicare Advantage?

Suppose you are looking for a bundled plan that includes Part A, Part B, and Part D while offering extra benefits not included in Original Medicare. In that case, you’ll want to consider enrolling in a Medicare Advantage plan. Some of the additional services covered in Medicare Advantage plans include vision, hearing, dental, and other health and wellness programs. Medicare Advantage plans are offered by private companies that have been approved by Medicare.

Want to learn more? Watch the video below.

Now that we’ve covered the basics to help you determine the difference between Original Medicare and Medicare Advantage, we hope that you are better equipped to make the right decision for your health care coverage.


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