Original Medicare vs. Medicare Advantage
Compare Original Medicare and Medicare Advantage, including provider access, costs, drug coverage, prior authorization and supplemental benefits.
Original Medicare and Medicare Advantage are two ways to receive Medicare benefits. Neither option is automatically best for everyone. Provider access, prescriptions, travel, costs, supplemental coverage, and plan rules should all be reviewed.
Original Medicare
Original Medicare is administered by the federal government and includes Part A and Part B. You can generally use any doctor or hospital in the United States that accepts Medicare. A separate Part D plan can be added for prescription-drug coverage.
Original Medicare generally does not have an annual out-of-pocket maximum for Part A and Part B services. Some people purchase Medicare Supplement Insurance, or Medigap, to help with certain deductibles and coinsurance.
Medicare Advantage
Medicare Advantage, also called Part C, is offered by private companies that contract with Medicare. Plans must cover medically necessary services covered by Original Medicare and may include additional benefits. Most plans include Part D drug coverage.
Costs and rules vary by plan. Members may need to use a provider network, obtain referrals, or receive prior authorization. Medicare Advantage plans have annual limits on out-of-pocket costs for covered Medicare services, but plan details can change.
Questions to compare
Are your doctors, hospitals, pharmacies, and prescriptions covered? What total costs could apply? Do you travel? Could referrals or prior authorization affect care? If considering Original Medicare, when can you obtain Medigap coverage?
Review specific plan documents rather than relying only on premiums or advertised extra benefits.
Disclosure: Not connected with or endorsed by the U.S. government or the federal Medicare program. General educational information only. Plan availability, benefits, costs, networks, and rules vary and may change.
Sources: Medicare.gov coverage comparison and Medicare Advantage plan guidance.
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