Original Medicare vs. Medicare Advantage: How Do They Compare?

                                        Original Medicare vs. Medicare Advantage: 
                                                        How do they compare?

  Original Medicare

                      vs.

  Medicare Advantage

  Federal government

  Who offers the coverage

  Private insurance                  companies

  Original Medicare includes
  Part A and Part B. 

  Part A

  • Inpatient care in hospitals and skilled nursing facilities 
  • Hospice care and some home health care

  Part B

  • Doctor visits
  • Outpatient hospital services
  • Durable medical equipment
  • Some preventive health care

 

 

 

 

 

 

What it covers

Medicare Advantage 
combines all of your  coverage into one plan and often includes prescription drug coverage. 

Plans can also offer
additional benefits Original Medicare doesn’t cover, like: 

  • Vision, hearing and dental care
  • Gym memberships
  • Disease management programs
  • 24/7 access to health care professionals

Part A is free for most  people. 

The standard monthly premium for Medicare Part B enrollees is $164.90 in 2023.

Medicare also charges
deductibles, copays and coinsurance.

 

 

 

 

What it costs

Each Medicare Advantage plan sets
its own premium, in addition to your Part B premium. 

Plans have
predictable
copays and coinsurance. 

No

Generally speaking, Part B covers about 80 percent of a person’s health care costs,
leaving them to cover the remaining 20 percent out of pocket. 

 

 

Annual cap on
out-of-pocket
expenses

  Yes

  Medicare Advantage plans
  set an out-of-pocket max to
  help you predict how much
  you may have to pay for
  health care services each
  year. The limit depends on
  the plan but can’t be more
  than $8,700 in 2022.