Plan details
What is Original Medicare?
Original Medicare is made up of two parts — Medicare Parts A and B. Part A provides hospital coverage. Part B provides medical coverage. Original Medicare does not include coverage for dental, vision, hearing or other kinds of care.
What is Medicare Advantage?
Medicare Advantage offers all the coverage you get with Original Medicare, but with added benefits. These may include vision, hearing, dental and fitness benefits. They also often include prescription drug coverage (MAPD), which is different from stand-alone Part D drug coverage. Instead of pairing with coverage from Parts A and B, they are bundled with your other Medicare Advantage coverage.
Original Medicare vs. Medicare Advantage chart
Use the chart below to compare Original Medicare and Medicare Advantage plans.
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|
Original Medicare |
Medicare Advantage |
|---|---|---|
|
What does the plan cover? |
Original Medicare provides hospital and medical coverage. |
Medicare Advantage provides hospital and medical coverage. It may also include vision, dental, hearing and prescription drug coverage. |
|
Maximum out-of-pocket costs |
There is no Original Medicare out-of-pocket maximum. |
The Medicare Advantage out-of-pocket maximum on covered medical services varies by plan, but every plan has one. |
|
Monthly premiums, deductibles and coinsurance |
For most people, there is no Medicare Part A premium. The Medicare Part B premium is $185 for most people.
The Part A deductible is $1,676 for each hospital visit per benefit period and the Part B deductible is $257.
For Part A, your copayment for inpatient stays after you pay the deductible is $0 for days 1 – 60, $419 for days 61 – 90 and $838 for days 91 – 150 (while using lifetime reserve days). After day 150, you pay all costs.
Coinsurance for Part B is 20% of the cost of each covered service or item. |
Depending on your Medicare Advantage plan, you might have to pay an added monthly premium in addition to your Medicare Part B premium. |
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In-network or out-of-network providers? |
With Original Medicare, you can use any hospitals or providers that accept Medicare. |
With a Medicare Advantage plan, you may need to get care from providers who are in network. |
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Prescription drug coverage |
With Original Medicare, you can get a stand-alone prescription drug plan through Medicare Part D. |
A Medicare Advantage prescription drug plan (MAPD) includes drug coverage alongside your other coverage. But there are Medicare Advantage plans that do not offer drug coverage. |
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How to change plans |
You can change plans during the Medicare Annual Enrollment Period (AEP). |
You can change plans during the Medicare Annual Enrollment Period (AEP). |
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Plan details |
What does the plan cover? |
|---|---|
|
Original Medicare |
Original Medicare provides hospital and medical coverage. |
|
Medicare Advantage |
Medicare Advantage provides hospital and medical coverage. It may also include vision, dental, hearing and prescription drug coverage. |
|
Plan details |
Maximum out-of-pocket costs |
|
Original Medicare |
There is no Original Medicare out-of-pocket maximum. |
|
Medicare Advantage |
The Medicare Advantage out-of-pocket maximum on covered medical services varies by plan, but every plan has one. |
|
Plan details |
Monthly premiums, deductibles and coinsurance |
|
Original Medicare |
For most people, there is no Medicare Part A premium. The Medicare Part B premium is $185 for most people.
The Part A deductible is $1,676 for each hospital visit per benefit period and the Part B deductible is $257.
For Part A, your copayment for inpatient stays after you pay the deductible is $0 for days 1 – 60, $419 for days 61 – 90 and $838 for days 91 – 150 (while using lifetime reserve days). After day 150, you pay all costs.
Coinsurance for Part B is 20% of the cost of each covered service or item. |
|
Medicare Advantage |
Depending on your Medicare Advantage plan, you might have to pay an added monthly premium in addition to your Medicare Part B premium. |
|
Plan details |
In-network or out-of-network providers? |
|
Original Medicare |
With Original Medicare, you can use any hospitals or providers that accept Medicare. |
|
Medicare Advantage |
With a Medicare Advantage plan, you may need to get care from providers who are in network. |
|
Plan details |
Prescription drug coverage |
|
Original Medicare |
With Original Medicare, you can get a stand-alone prescription drug plan through Medicare Part D. |
|
Medicare Advantage |
A Medicare Advantage prescription drug plan (MAPD) includes drug coverage alongside your other coverage. But there are Medicare Advantage plans that do not offer drug coverage. |
|
Plan details |
How to change plans |
|
Original Medicare |
You can change plans during the Medicare Annual Enrollment Period (AEP). |
|
Medicare Advantage |
You can change plans during the Medicare Annual Enrollment Period (AEP). |
Which plan should you choose?
Need help choosing a Medicare plan? Keep these things in mind:
- Costs — How much can you afford to pay each month? Or for specific services? Costs can vary between Original Medicare and Medicare Advantage. It can also vary between individual Medicare Advantage plans.
- Access to providers — Check and see if the providers you want are in network. Remember networks can change. Original Medicare allows you to use any hospitals or doctors that accept Medicare.
- The care you need — If you need care like vision or hearing, does your plan provide coverage for it? Many Medicare Advantage plans offer coverage for this kind of care.
- The condition of your health — Do you have chronic conditions or other ongoing issues? You’ll want to consider the chances you’ll need care. Original Medicare has no out-of-pocket maximum, so repeated care may become more expensive.
