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Original Medicare vs Medicare Advantage - Educational Medicare App

Original Medicare vs Medicare Advantage

When you're eligible for Medicare, one of the most important choices you'll make is how to receive your benefits: through Original Medicare or a Medicare Advantage Plan.

Original Medicare (Parts A and B):

  • Managed by the federal government
  • Part A: Covers hospital stays, skilled nursing, hospice, and home health
  • Part B: Covers doctor visits, outpatient care, lab tests, and preventive services
  • See any provider in the U.S. who accepts Medicare
  • Does not include prescription drug coverage — must add Part D
  • No out-of-pocket maximum
  • Option to add a Medigap (supplement) policy to help with costs

Medicare Advantage (Part C):

  • Offered by private insurance companies approved by Medicare
  • Includes all services covered under Parts A and B
  • Most plans include Part D drug coverage
  • Often includes extra benefits: dental, vision, hearing, gym, OTC, transportation
  • Typically limited to a network of doctors and hospitals
  • Has a yearly out-of-pocket max (varies by plan)
  • May require referrals to see specialists

Key Differences:

Feature Original Medicare Medicare Advantage
Provider Choice Any doctor/hospital in U.S. that accepts Medicare Usually in-network only
Drug Coverage Not included (add Part D) Usually included
Extra Benefits Not included Often included
Out-of-Pocket Limit No Yes
Medigap Option Available Not available
Referrals Needed No Often Yes

Which option is right for you?

It depends on your personal needs — such as flexibility, costs, medications, and provider access. If you travel often or want to keep your doctor, Original Medicare may offer more freedom. If you want an all-in-one plan with extra benefits, a Medicare Advantage plan may be a better fit.

🔗 Compare Medicare coverage options on Medicare.gov

Need help deciding?
Tap “Contact Us” or “Virtual Appointment” — or 📞 Call a licensed Medicare agent.

This app is for educational purposes only and is not affiliated with the U.S. government or CMS.