Choosing the right Medicare plan can be a confusing and overwhelming task, especially for those who are new to the program. Medicare provides health insurance to millions of Americans over the age of 65, as well as some younger individuals with certain medical conditions or disabilities. However, there are two different options available for Medicare coverage: Original Medicare and Medicare Advantage. While both plans offer comprehensive healthcare coverage, they differ in terms of benefits, costs, and network restrictions. Continue reading where we’ll explore the key differences between Medicare Advantage and Original Medicare, to help you make an informed decision about which plan might be the best option for you.
Read: How To Pick The Right Medicare Plan For Seniors
Medicare Advantage vs. Original Medicare
Medicare Advantage and Original Medicare are two different healthcare coverage options and are available to individuals who are eligible for Medicare. While both plans provide comprehensive healthcare coverage, there are some key differences between the two. Here are some of the main differences:
Provider Networks
Original Medicare allows you to see any healthcare provider in the United States that accepts Medicare. Medicare Advantage plans, on the other hand, typically have a restricted provider network, which means you may be limited in your choice of doctors, hospitals, and other healthcare providers.
Benefits
Original Medicare provides coverage for Part A (hospital insurance) and Part B (medical insurance), but does not typically include coverage for prescription drugs, vision, dental, or hearing. Medicare Advantage plans often include additional benefits, such as prescription drug coverage, vision, dental, and hearing, as well as other benefits like gym memberships and transportation services.
Cost
Original Medicare typically has lower monthly premiums than Medicare Advantage plans, but may require you to pay deductibles and coinsurance for certain services. Medicare Advantage plans often have higher monthly premiums, but may have lower out-of-pocket costs for services.
Flexibility
Original Medicare allows you to see any healthcare provider in the United States that accepts Medicare, without needing a referral. Medicare Advantage plans may require you to choose a primary care physician and obtain a referral to see a specialist.
Coverage for Travel
Original Medicare covers healthcare services received anywhere in the United States, while Medicare Advantage plans may have restrictions on coverage when traveling outside the plan’s service area.
Which Medicare Is Right For You?
Understanding these differences can help you decide which Medicare plan is right for your healthcare needs and budget. It’s important to carefully review the benefits and costs of each plan before making a decision. It can be difficult to make a decision about your medicare plan. To make your research a little easier, you can use the following tips & tricks:
1. Understand Your Healthcare Needs
The first step in choosing the right Medicare plan is to understand your healthcare needs. Consider the types of healthcare services you need and the frequency of these services. This will help you choose a plan that provides the coverage you need.
2. Compare Plans
Compare the benefits and costs of different Medicare plans to find the one that meets your healthcare needs and budget. You can use the Medicare Plan Finder tool on the Medicare website to compare plans.
3. Review Provider Networks
If you have a preferred healthcare provider, check to see if they are in the network for the Medicare plan you are considering. This will ensure that you can continue to see your preferred provider.
4. Consider Prescription Drug Coverage
If you take prescription medications, consider a Medicare plan that includes prescription drug coverage. This can help you save money on your medications.
5. Review Annual Enrollment Periods
Review the annual enrollment periods for Medicare plans. This is the time of year when you can make changes to your Medicare coverage. If you want to switch plans, you will need to do so during this time.
6. Seek Assistance
If you are having difficulty choosing a Medicare plan, seek assistance from a licensed insurance agent or a Medicare counselor. They can provide you with personalized guidance to help you choose the right plan.
By following these tips and tricks, you can choose the Medicare plan that meets your healthcare needs and budget. It’s important to review your coverage regularly to ensure that it continues to meet your changing healthcare needs.