Original Medicare vs. Medicare Advantage: Which Should I Choose? (2024)

FAQs

What is better, Medicare Advantage or traditional Medicare? ›

In a nutshell, most Medicare Advantage plans provide similar coverage to Original Medicare with a Part D prescription drug plan and a Medicare supplement plan. Premiums and overall costs tend to be lower with Medicare Advantage, especially if you expect to have high costs for care.

With a Medicare Advantage Plan, you may have coverage for things Original Medicare doesn't cover, like fitness programs (gym memberships or discounts) and some vision, hearing, and dental services (like routine checkups or cleanings).

As the private plans' share of the Medicare patient pie has ballooned to 30.8 million people, so too have concerns about the insurers' aggressive sales tactics and misleading coverage claims.

If you joined a Medicare Advantage Plan during your Initial Enrollment Period, you can change to another Medicare Advantage Plan (with or without drug coverage) or go back to Original Medicare (with or without a drug plan) within the first 3 months you have Medicare Part A & Part B.

The main reason for all the marketing is the money made by private insurers. Just over half of Medicare beneficiaries are enrolled in Medicare Advantage plans, with under half choosing traditional Medicare.

In some cases, your doctor may not agree with your insurance provider's decision to approve a less expensive treatment before paying for a more expensive one that your doctor may recommend. Providers in Medicare Advantage networks may also have to take time away from patients to spend it on pre-authorization paperwork.

A given carrier may pay slightly more commission to the agent (although there's a cap set by Medicare) and they may "sweeten" the plans to make them sound too good to be true. This is usually in the form of smaller benefits and add-ons at the expense of the important aspect of Advantage plans....the out-of-pocket max!

According to a new survey released today from the Commonwealth Fund, 96% of Medicare Advantage (MA) members and 93% of enrollees in traditional Medicare said that their Medicare coverage met their expectations, including 65% of each group who said their coverage fully met their expectations.

With a Medicare Advantage plan, you often have to stick to a limited network of health care providers and secure prior authorization for many types of services. Plus, you may not have coverage far from where you live.

Medicare Advantage plans can be full of extra benefits like prescription drug coverage, dental, hearing, and vision coverage. Another advantage of a Medicare Advantage plan is a mandatory out-of-pocket maximum. A possible disadvantage of a Medicare Advantage plan is you can't have a Medicare Supplement plan with it.

Are most people happy with Medicare Advantage? ›

Beneficiaries in Traditional Medicare and Medicare Advantage plans say they're largely happy, but have plenty of issues with each program. When Americans are asked what they think about Medicare, they generally rate the program highly.

Medicare Advantage plans are popular, but some seniors feel trapped when ill : Shots - Health News As enrollment in Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.

If you join a Medicare Advantage Plan, the plan will provide all of your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage.

Medicare Advantage is an alternative to traditional Medicare offered by private health insurance companies. Medicare Advantage plans cover all the same services under Original Medicare Part A and Part B, but often include prescription drug coverage and extra benefits.

In addition to your Part B premium, you usually pay one monthly premium for the services included in a Medicare Advantage Plan. Each Medicare Advantage Plan has different premiums and costs for services, so it's important to compare plans in your area and understand plan costs and benefits before you join.

A Medicare supplement plan cannot terminate your coverage and is guaranteed renewable for life, as long as you pay your premium. Medicare Advantage plans can change benefits and networks, or even be discontinued, at the end of each year.

People with Medicare are attracted to the financial protection that comes with an annual out-of-pocket limit that Medicare Advantage plans are required to provide. In contrast, traditional Medicare, with about 30 million beneficiaries, does not have an out-of-pocket limit.