What Is The Difference Between Medicare And Medicare Advantage?
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? 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.
Traditional Medicare (also called Original Medicare) includes Medicare Part A and Part B, which give you inpatient and outpatient coverage. The difference with Medicare Advantage plans (Part C) is that they include Part A and Part B coverage, plus much more.
Medicare Part A covers:
Hospital stays (semi-private rooms) up to 60 days
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:
Vaccinations and flu shots
Health screenings and medical tests
Smoking cessation and other preventive healthcare programs
Medicare Part C (Medicare Advantage) includes:
Everything Medicare Part A and Part B cover
Additional coverage for dental, hearing, vision, prescription drugs, and more
Do Medicare Advantage Plans Replace Original Medicare?
Medicare Advantage plans replace Original Medicare Part A and Part B plus provide additional coverage depending on the plan you choose.
When looking at the differences between Medicare and Medicare Advantage, keep in mind that Medicare Advantage plans 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 a Medicare Advantage plan as comprehensive coverage for your healthcare needs.
Some of the benefits most Medicare Advantage plans have that Original Medicare does not have include:
Prescription Drug Coverage
Medicare Advantage prescription drug (MAPD) plans are Part C plans combined with Part D prescription drug plans. While Medicare Part D provides only prescription drug coverage, Medicare Advantage plans can be combined to cover that and more.
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.
Eye health becomes more important as we age. Eye exams, glasses, and contacts are a part of many Medicare Advantage plans.
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.
Over-the-counter health items
Many Medicare Advantage plans have allowances for common over-the-counter health items like aspirin, band-aids, and more.
Wellness And Fitness
Medicare Advantage plans give you options for maintaining a healthy lifestyle. Many plans include access to gym memberships, senior fitness programs like SilverSneakers®, and coaching to improve overall well-being.
What Is The Cost Difference Between Original Medicare And Medicare Advantage?
Original Medicare Costs
Medicare Advantage Costs
Part A monthly premium is most likely free if you or your spouse worked and paid Medicare taxes. There are also benefit period deductibles and potential copays for hospital stays.
Plans have $0 or low monthly premiums. Many cover your Part A deductibles and copays as well.
Part B has a monthly premium, an annual deductible, and coinsurance for doctor visits.
Medicare Advantage plan costs vary depending on where you live. You still have to pay your Part A and Part B monthly premiums, but most plans cover deductibles and coinsurance.
There is no annual out-of-pocket maximum with Original Medicare.
Medicare Advantage plans cap your annual maximum out-of-pocket costs.
Why Enroll In A Medicare Advantage Plan?
As you get older, healthcare protection becomes more important than ever. More coverage can offer more peace of mind, so you don't get surprise medical bills in the event of a sudden injury or illness.
Medicare Advantage plans can also offer more value. With the right plan, you can save on costs for dental, vision, prescription drug coverage, and more.
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 healthcare needs.
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Choose 2023 if shopping for coverage beginning January 1, 2023.
When to Enroll in Medicare: Eligibility, Deadlines, and More
Medicare Eligibility and Qualification Requirements
What Does Medicare Cover?
Medicare Advantage Open Enrollment Period
Enrolling in Medicare Advantage Plans
Compare Medicare Part D plans
Why Choose Anthem for Medicare Coverage?
Anthem Blue Cross and Blue Shield is a Medicare Advantage plan with a Medicare contract. Anthem Blue Cross and Blue Shield is a D-SNP plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Anthem Blue Cross and Blue Shield depends on contract renewal.
Not connected with or endorsed by the U.S. Government or the federal Medicare program.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent or insurance company.
This policy has exclusions, limitations, and terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, please contact your agent or the health plan.
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