770.262.3982
Two ways to receive Medicare. Very different ways to use it.
Understanding Original Medicare and Medicare Advantage
There are two basic ways to receive your Medicare benefits.
Original Medicare is the traditional federal Medicare program.
Medicare Advantage is an alternative way to receive Medicare benefits through a private insurance company approved by Medicare.
Both can provide Medicare coverage.
They work differently.
Original Medicare
With Original Medicare, Medicare provides your Part A and Part B benefits directly.
Most people who choose Original Medicare also consider:
-
A Medicare Supplement (Medigap) policy to help with costs Original Medicare doesn’t pay; and
-
A separate Part D prescription drug plan for prescription coverage.
Medicare Advantage
With Medicare Advantage, you receive your Medicare-covered benefits through a private insurance company rather than directly through Original Medicare.
Medicare Advantage plans generally combine Part A and Part B, and most also include Part D prescription drug coverage.
Many plans also offer additional benefits such as dental, vision, hearing, fitness, or other services not generally covered by Original Medicare.
The tradeoff is that Medicare Advantage plans may use provider networks, copayments, prior authorization, and other plan rules that do not apply in the same way under Original Medicare.
Different paths. Different tradeoffs.
Neither approach is automatically right for everyone.
The important question is not simply “Which one costs less?” or “Which one has more benefits?”
It is:
Which approach fits the way I want to receive and manage my healthcare?
Look beyond the premium.
When comparing the two approaches, consider the whole picture:
-
Which doctors and hospitals can I use?
-
Are my prescriptions covered — and at what cost?
-
Are referrals or prior authorization required?
-
What could I pay out of pocket during a difficult health year?
-
How important are additional benefits such as dental, vision and hearing?
-
How important is the ability to receive care while traveling or living in another part of the country?
A $0 premium does not mean $0 healthcare costs. And a higher monthly premium does not necessarily mean the coverage is more expensive overall.
Do the math.
Which one makes sense for me?
That depends.
Understand how each approach works. Consider your healthcare needs, doctors, prescriptions, finances and preferences.
Then choose the approach whose tradeoffs make the most sense for you.