All of the terms associated with Medicare can become really complex. They sound so similar, but they mean very different things. One such example of this is the difference between Medicare Advantage and Original Medicare. This is a hot topic right now during Annual Enrollment (Oct 15 – Dec 7), so, this week, we’re going to talk about the differences between the two Medicare options, and why you may want to consider one over the other.
If you have specific questions about your Medicare Advantage plan or how you can supplement your Original Medicare, give us a call at 901-460-7220. Our Medicare representatives are ready to help you make the best choices in your healthcare coverage.
What Is Original Medicare?
Original Medicare refers to Parts A, B, and D. With Original Medicare, the government is the coverage provider. Through its various parts, your Original Medicare benefits cover the following types of services:
Part A Coverage:
- In-patient hospital stays
- In-patient surgery
- Skilled nursing facilities (SNF) care
- Hospice care
- Home health care
Read more about Part A coverage here.
Part B Coverage:
- Medically necessary outpatient services
- Durable medical equipment
- Preventative services (example: flu shots)
Read more about Part B coverage here.
Original Medicare also includes Part D, which covers your prescriptions. You can read more about your Part D coverage here. If you choose to add any Medigap coverage AKA Medicare supplement plans, these will “fill the gaps” within your Original Medicare plan.
What Is Medicare Advantage?
Medicare Advantage, also known as Medicare Part C, is a different way to receive your Medicare Parts A, B, and D. It’s offered by private insurance companies, which gives it different benefits that don’t exist with Original Medicare. Some of the benefits with a Medicare Advantage plan include:
- A lower premium than Medigap plans. Most of the time Part C plans have a $0 premium
- Part D coverage is typically included. With Original Medicare, Part D plans are enrolled into separately through private insurance companies. Medicare Advantage plans allow you to group the parts together under one insurer.
- It’s offered by private insurance companies, operating more like a traditional insurance plan with some co-pays and max-out of pocket provisions. This also means that networks are used to hold down the costs.
- Other benefits, such as dental, vision, gym, and in some cases OTC allowance, are included at no cost.
- No underwriting is required
Quick Comparison: Medicare Advantage Vs Original Medicare
Original Medicare:
- Part A is free
- Part B is $148.50 for most people in 2021 (the amount you pay is based on your designated Part B premium – see chart here) In 2022, the Part B premium will be $170.10 for most people.
- Part D will cost somewhere between $10 to $75 (the cost may be lower or higher, depending on your medications and other factors – click here for more information on Part D costs)
- Supplemental coverage will range from $85 to $110 for most 65-year-olds (the cost may be lower or higher, depending on certain factors)
- There are no networks, so Original Medicare is accepted anywhere that Medicare is accepted
- Dental, vision, and hearing are not covered
Medicare Advantage Plan:
- Part A is free
- Part B is $170.10 for most people in 2022 (note that you’ll still pay your designated Part B premium, as discussed above)
- Part D is included
- In most cases, there is a $0 premium
- Includes dental, vision, hearing, gym, and OTC benefits
How Do I Get a Medicare Advantage Plan?
To change to a Medicare Advantage plan, you can call our Medicare representatives at Delta Medicare Benefits Group. We’ll walk you through the entire process and let you know which plan makes the most sense for you depending on your specific situation. Call us at 901-460-7220 to set up an appointment. You can also email us at info@deltabenefitsgroup.com or fill out our convenient online form, and we’ll reach out to you.
Remember that you have from October 15 to December 7 yearly to do any of the following updates to your MAPD:
- Make changes to or enroll in a Medicare Advantage Plan
- Add or drop drug coverage on their Medicare Advantage Plans
- Update insurance coverage by changing to a new plan or switching insurance companies entirely
We look forward to speaking with you about your Medicare. If you have additional questions, give us a call, or check out our Frequently Asked Questions page here.
