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Medicare Advantage vs. Original Medicare

Young woman explaining the difference between Medicare Advantage vs Original Medicare to a Medicare eligible couple

If you're turning 65, you're most likely ready to apply for Medicare. There are many choices to consider and you will need to weigh your options; for example, comparing Medicare Advantage vs. Original Medicare.

Should you go with Original Medicare, which includes Medicare Parts A and B? Or should you apply for a Medicare Advantage plan,  also known as Medicare Part C? And do you need Part D?

Your personal budget and your coverage needs are all factors. It's important to know the difference between Original Medicare and Medicare Advantage when you compare plans to see what works best for you.

About Original Medicare

Medicare Parts A and B, the main parts of Original Medicare, give you inpatient and outpatient coverage. When comparing Original Medicare vs. Medicare Advantage, consider the following:

Medicare Part A covers:

  • Hospital stays (semi-private rooms) up to 60 days
  • Hospital meals
  • Nursing services
  • Intensive care services
  • Drugs, medical supplies and equipment used on the premises
  • Lab tests and X-rays taken while hospitalized
  • Surgery and recovery costs
  • Rehabilitation and therapy services
  • Part-time home nursing care

Medicare Part B covers:

  • Doctor visits
  • Vaccinations and flu shots
  • Health screenings and medical tests
  • Medical supplies
  • Ambulance services
  • Smoking cessation and other preventive health care programs

The difference between Medicare and Medicare Advantage

When looking at the differences between Medicare and Medicare Advantage, keep in mind that Medicare Advantage plans, also known as Part C, are offered through private insurers like Anthem. They include everything that Part A and Part B cover, plus lots of other benefits that Original Medicare doesn’t cover.

Think of Medicare Advantage plans as comprehensive coverage for your health care needs. Some of the benefits Medicare Advantage plans have that Original Medicare does not have include:

Prescription drug coverage

Medicare Advantage plans can cover your prescription drugs, much like Medicare Part D. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can cover that and more.

Dental care

Many Medicare Advantage plans offer dental coverage for things like routine checkups and exams, cleanings, dentures and coverage for unplanned dental procedures like root canals and crowns.

Vision care

Eye health becomes more important as we age. Eye exams, glasses and contacts are a part of many Medicare Advantage plans.

Hearing care

Original Medicare doesn't cover hearing aids, which can be expensive. Many Medicare Advantage plans provide hearing coverage that includes testing and medically required hearing aids.

Wellness and fitness

Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs and coaching to improve overall well-being, including nutrition.

Compare the costs

If you or your spouse worked and paid Medicare taxes, you will most likely receive Part A premium-free in Original Medicare. Part B with Original Medicare has a premium and a deductible. Both of your Part B costs are based on your lifetime earnings, so low-income beneficiaries may pay less for Part B.

While you continue to pay for your Medicare Part B premium, costs of Medicare Advantage plans vary depending on where you live. Some plans have $0 premiums, but on average your monthly premiums are usually lower than what you pay for Medicare Part B.

Compare the differences between Medicare and Medicare Advantage

As you get older, health care protection becomes more important than ever. More coverage offers peace of mind, so you don't get surprise medical bills in the event of a sudden injury or illness. So, think about the pros and cons of Medicare Advantage plans vs. Original Medicare when selecting your coverage.

More coverage can also offer more value. You save more money with the added benefits in Medicare Advantage plans. With the right Part C plan, you can save on costs for dental, vision and prescription drug coverage.

Because private insurers like Anthem offer Medicare Advantage plans, you also have more flexibility with your plan selection. You can tailor your coverage to fit your health care needs.

Find a Medicare plan that fits you. Explore all your plan options.

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