One of the most critical decisions a beneficiary will make is what kind of Medicare coverage to sign up for. From costs to waiting periods, there are many variables to consider. We want to help you make the right choice. Today, The Fussell Group Insurance Advisors compares Original Medicare and Medicare Advantage — your two primary options — so you can get a clear picture of how they work.
What Is Original Medicare?
Medicare part A (hospital coverage) and part B (medical coverage) make up Original Medicare. Most people are automatically enrolled in Part A. The benefits are the same from person to person.
Sometimes it’s called traditional Medicare. If you have it, the government pays (directly) for the services you receive.
What Is Medicare Advantage?
Part C of Medicare is called Medicare Advantage. It’s an “all in one” insurance plan that provides the same benefits as Original Medicare — through a private insurer. It simply replaces your A and B coverage. Some programs include Part D coverage and may have additional perks.
Keep reading to see the pros and cons of each option. As you’ll see, they’re very different programs.
Related Post: How Do Medicare Advantage Plans Work?
Original Medicare: Pros and Cons
| Pros | Cons |
| No copays | Part A and Part B come with a deductible |
| No waiting periods | Part A and Part B come with coinsurance |
| No restrictions for pre-existing conditions | The medical bills can pile up — there’s no maximum out-of-pocket |
| Coverage will travel with you | No coverage for prescription drugs |
| You can see any doctor that accepts Medicare | |
| Out of pocket costs stay the same — no matter the provider you choose |
Medicare Advantage: Pros and Cons
| Pros | Cons |
| $0 premium plans available (in some areas) | You still typically pay your Part B premium |
| Some have a built-in Part B give back option | Limited doctor networks |
| Out-of-pocket maximum limit | Plans don’t travel with you |
| May include additional perks, like dental, vision, and hearing benefits | Plans come with annual coverage changes |
| May include gym memberships | High cost per service |
| May offer coverage for prescription drugs | The maximum out-of-pocket limit can still be too expensive for some |
Which Path Will You Take?
Private insurance may play a critical role in your life. Understanding this role can help you choose the plan that allows you to manage costs, coverage, and care — as you age. There are two specific coverage paths you can take:
Path 1: Original Medicare (A&B), with options to add Part D and Medigap insurance.
With this option, you can choose supplemental coverage to fill some of the gaps of Medicare Parts A, B, and D. This path is best for you if you don’t mind paying higher premiums, prefer low out-of-pocket costs, want freedom to choose doctors, and/or are managing a chronic condition.
Path 2: Medicare Advantage plan.
If you go this route, your plan will likely include Part D coverage. Some programs add services for vision and hearing. This path is best for you if you don’t mind paying copays and deductibles, and are flexible in choosing providers.
Related Post: What to Look for in a Medicare Advantage Plan
We Make Medicare Easy
Need help understanding your options? Can’t decide between Original Medicare and Medicare Advantage? Let us help. The Fussell Group Insurance Advisors are some of the very best insurance advisors in Louisiana. Call 1-877-874-0711 or book an appointment online.