When you become eligible for Medicare, one of your major decisions is how you want to receive your benefits. The two main approaches are Original Medicare and Medicare Advantage.
Both provide Medicare-covered benefits, but they work differently.
What is Original Medicare?
Original Medicare includes:
- Part A, which helps cover inpatient hospital care and certain other services
- Part B, which helps cover medical and outpatient services
With Original Medicare, you can generally visit any doctor or hospital in the United States that accepts Medicare.
You can choose to add a separate Part D prescription drug plan. You may also be able to purchase a Medicare Supplement policy to help pay certain out-of-pocket costs.
Original Medicare does not include an annual out-of-pocket maximum for covered Part A and Part B services.
What is Medicare Advantage?
Medicare Advantage, also known as Part C, is offered by private insurance companies approved by Medicare. These plans provide your Part A and Part B benefits and usually include prescription drug coverage.
Depending on the plan, additional benefits may be available, such as dental, vision, or hearing benefits. Medicare Advantage plans have an annual limit on what you pay out of pocket for covered Part A and Part B services.
Many Medicare Advantage plans use provider networks and may require prior authorization for certain services.
What should you compare?
Consider:
- Whether your preferred doctors and hospitals are available
- How your medications are covered
- Monthly premiums and other costs
- Whether you want coverage when traveling
- The plan’s rules for specialists and prior authorization
- Whether you want to explore Medicare Supplement coverage
There is no single choice that is right for everyone. Your health needs, budget, and preferences all matter. www.medicare.gov
We are here to help you understand your options. Contact our office at (210) 744-0553 to discuss what is available in your area.