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 Medicare coverage you get with Original Medicare, but with added benefits. These may include vision, hearing, dental and fitness benefits. Medicare Part C also often includes 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 the difference between Original Medicare and Medicare Advantage plans.
| Plan details | 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 Part C 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 $1,736 for each hospital visit per benefit period and the Part B deductible is $286.
For Part A, your copayment for inpatient stays after you pay the deductible is $0 for days 1–60, $434 for days 61–90 and $868 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. | Premiums, deductibles and coinsurance for Medicare Advantage all vary depending on your plan. You pay the Part B premium while on a Medicare Advantage plan. Some Medicare Part C plans require you to pay an extra Medicare premium, and some don’t. Depending on your Medicare Advantage plan, you might have to pay an added monthly premium in addition to your Medicare Part B premium. |
| 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. |
| 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 Part C coverage. But there are Medicare Advantage plans that do not offer drug coverage. |
| 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). |
Which Medicare 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? Medicare 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 dental, vision and hearing 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.
