Original Medicare and Medicare Advantage are part of the Medicare program and are designed to provide healthcare coverage for seniors aged 65 and older or those under 65 who meet specific requirements. Original Medicare is considered the default option for new Medicare enrollees as this is what they will have to enroll in first. It’s also a must to enroll in Original Medicare if you want to later enroll in another plan, such as a Medicare Advantage plan.

But, what exactly are the similarities and differences between the two? At InvoBH, we can answer that!

What is Original Medicare?

Original Medicare consists of Medicare Part A and Part B. Medicare Part A covers inpatient hospital services such as skilled nursing facility care, hospice care, inpatient hospitalization, home healthcare services, etc. Medicare Part B covers outpatient health services like preventive screenings, diagnostic tests, durable medical equipment, ambulance rides, ER stays, doctor visits, etc. 

With Original Medicare, you will have costs such as premiums, deductibles, copays, and coinsurance you must cover. However, some Medicare enrollees get premium-free Part A.

What is Medicare Advantage?

Medicare Advantage is also known as Medicare Part C and provides the same coverage as Original Medicare. However, most Medicare Advantage plans include coverage for extra services not covered by Part A or Part B, such as prescription drug coverage, dental, vision, hearing, and other benefits like fitness memberships. 

Medicare Advantage plans also have costs such as premiums, deductibles, copays, and coinsurance you will need to cover, but some Medicare Advantage plans have little to no monthly premium costs.

Notable Similarities and Differences

As already mentioned, both Original Medicare and Medicare Advantage provide coverage for inpatient and outpatient hospital and medical services. Both plans have costs such as premiums, deductibles, copays, coinsurance, etc. And, to enroll in Medicare Advantage, you must be enrolled in Original Medicare. 

However, there are key differences between Original Medicare and Medicare Advantage. First, Original Medicare is managed by the federal government, while Medicare Advantage is sold by private insurance companies. Medicare Advantage plans even cover services that are not covered by Original Medicare. In fact, Original Medicare plans are the same in every state, while there are various types of Medicare Advantage plans that will vary by plan, location, and insurer.

Medicare Advantage plans also have an annual out-of-pocket maximum limit, while Original Medicare does not. With the out-of-pocket costs for Original Medicare, you can enroll in a Medicare Supplement plan to help you cover these. However, you cannot enroll in a Medicare Supplement plan if you already have Medicare Advantage.

Last but not least, you can visit any doctor or healthcare facility in the nation as long as they accept Medicare. Some Medicare Advantage plans, though, will require you to use doctors or other healthcare providers that are within their specific network. If you receive care outside of this network, you may not be covered at all by your plan.

Looking For The Best Coverage?

Then look no further!

At InvoBH, we understand how important it is that you know all your Medicare coverage options and know the similarities and differences between each. That’s why we will help you compare your options so you can get the best coverage possible. To learn more about Original Medicare and Medicare Advantage, give us a call today at 314-669-4308!