Original Medicare vs Medicare Advantage

Picking the Right Option

There are typically 2 main ways of getting Medicare coverage—Original Medicare and Medicare Advantage. Here are some important reminders.

Original Medicare (Medicare Part A and Medicare Part B)

Original Medicare includes Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
If you want prescription drug coverage, you can join a separate Medicare Part D Prescription Drug plan.
Can use any doctor or hospital that takes Medicare, anywhere in the U.S.

Medicare Advantage (also known as Part C)

Medicare Advantage is an “all in one” alternative way to get your Original Medicare benefits. These “bundled” plans include Medicare Part A, Medicare Part B, and usually Medicare Part D.
Plans may have different costs than Original Medicare.
In most cases, you’ll need to use doctors who are in the plan’s network.
Each year, Medicare Advantage plans can choose to leave Medicare or make changes to the services they cover and what you pay. If the plan decides to stop participating in Medicare, you’ll have to join another Medicare Advantage plan or return to Original Medicare.

For additional help comparing Original Medicare and the available Medicare Advantage plans in your service area, comparing different plans and making the right choice, please call us at 904-575-5450. You can also email us at info@getmedicareat65.com, and we will reach back out to you.

Medicare Supplement vs Medicare Advantage

Picking the Right Option For You

If you desire or require additional coverage beyond Original Medicare there are two popular options available: Medicare Supplement (Medigap) Policies and Medicare Advantage plans. Medicare Supplement insurance plans and Medicare Advantage plans are both offered by private insurance companies. Both require you to enroll in Medicare Part A and Medicare Part B, as well as pay your monthly Part B Medicare premium. Should you try and fill the gap or take advantage of a convenient all in one plan?

Why pick a Medigap Plan:

Freedom of Choice – you can choose your healthcare provider, physician, specialist, and hospital (if they are Medicare-approved and accepting new patients).
Travel Benefits – Medicare Advantage (MA) plans are often bound to a specific location, Medigap cover access across the U.S. as well as some international travel medical expenses.
Frequent Care Cost Savings – While Medigap Premiums are generally higher than MA Plans, Medigap generally covers more expenses resulting in less out-of-pocket expenses.
Stability – MA plans may leave annual contract with Medicare and vary greatly , while all Medigap policies have the same structure regardless of insurers (though premiums may vary).

Why pick a Medicare Advantage Plan:

- Convenience – One stop shopping as most MA plans include prescription drug coverage. Medigap enrollment would require an additional Medicare Part D Prescription Drug plan, including an additional monthly premium.
- Window of Opportunity – If you miss your initial window to enroll in Medigap, you may not be able to enroll in a Medicare Supplement insurance plan later on unless you meet certain criteria or pay more. It is easy to enroll in an MA plan during multiple enrollment periods, regardless of whether you missed your initial window or not.
- Tailored Benefits – Plans can be tailored or customized for an individual’s specific needs.

Additional Benefits – Most MA plans offer additional benefits not covered by Medigap or Original Medicare.
For additional help comparing Medicare Supplement and the available Medicare Advantage plans in your service area, comparing different plans and making the right choice, please call us at 904-575-5450. You can also email us at info@getmedicareat65.com, and we will reach back out to you.

I like both options, can I have a Medigap policy and a Medicare Advantage plan?

If you have a Medicare Advantage plan, it’s illegal for anyone to sell you a Medigap policy unless you’ve switched back to Original Medicare. If you’re not planning to leave your Medicare Advantage plan, and someone tries to sell you a Medigap policy, report it to your State Insurance Department.
If you have a Medigap policy and join a Medicare Advantage plan, you may want to drop your Medigap policy. Your Medigap policy can’t be used to pay your Medicare Advantage plan copayments, deductibles, and premiums. If you want to cancel your Medigap policy, contact your insurance company. In most cases, if you drop your Medigap policy to join a Medicare Advantage plan, you won’t be able to get it back.
If you join a Medicare Advantage plan for the first time, and you aren’t happy with the plan, you’ll have special rights under federal law to buy a Medigap policy and a Medicare Prescription Drug plan if you return to Original Medicare within 12 months of joining the Medicare Advantage plan.
If you had a Medigap policy before you joined and disenrolled in a Medicare Advantage plan, you may be able to get the same policy back if the company still sells it. If it isn’t available, you can buy another Medigap policy.
If you joined a Medicare Advantage plan when you were first eligible for Medicare, you can choose from any Medigap policy within the first year of joining.