Medicare Advantage vs. Original Medicare—Which Is Right for You?

The two primary types of Medicare plans are Original Medicare and Medicare Advantage, each with its own benefits and drawbacks. Understanding the differences between these plans is essential to determining which one best suits your healthcare needs and lifestyle.

What Is Original Medicare?

Original Medicare has two parts: 

• Part A—Covers hospital stays, skilled nursing facility care, hospice care and some home health services. Most people qualify for Part A without a premium if they or their spouse have paid Medicare taxes for at least 10 years.

• Part B—Covers outpatient care, doctor visits, preventive services and some home health services. Part B typically requires a monthly premium.

Original Medicare allows you to visit any doctor or hospital that accepts Medicare, offering flexibility in choosing providers. However, it does not cover everything—such as routine dental care, vision care or hearing aids.

Original Medicare does not include prescription drug coverage, but you can purchase Part D (prescription drug) coverage through a private insurer.

What Is Medicare Advantage?

Medicare Advantage plans, or Medicare Part C, are private insurance plans that provide an alternative to Original Medicare. These plans may offer additional benefits, such as coverage for vision, dental and hearing services, which Original Medicare does not cover.

Many Medicare Advantage plans come with built-in prescription drug coverage (Part D), making it easier to manage your healthcare needs in one plan.

While Medicare Advantage plans often have lower out-of-pocket costs, they may also have limitations on coverage and require prior authorizations for certain services. These plans often have network restrictions, meaning you may need to use specific doctors and hospitals within the plan’s network to get the full benefits.

How to Decide Which Is Right for You

Choosing between Original Medicare and Medicare Advantage depends on your individual healthcare needs and preferences. The following are some questions to consider:

What are your healthcare needs?

If you require frequent medical care or have specific health conditions, evaluate which plan offers better access to specialists and additional services.

How do you feel about network restrictions?

If you prefer the freedom to choose any doctor or hospital, Original Medicare may be more appealing.

Are you looking for additional benefits?

If you want coverage for dental, vision or prescription drugs, a Medicare Advantage plan may be more suitable.

Learn More

Contact Anzar Insurance Group LLC, to evaluate your Medicare Advantage options.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.