Describe the difference between original medicare and medicare advantage plans?

Listen up, folks! Today we’re going to dive into the wonderful world of insurance plans. Specifically, we’ll be talking about Original Medicare and its younger (and cooler?) sibling, Medicare Advantage.

The Basics

Let’s start with a bit of background information. Original Medicare is run by our good friends at the federal government (specifically, the Centers for Medicare & Medicaid Services). It consists of two parts:

  • Part A covers hospital stays, skilled nursing care, hospice care, and some home health services.
  • Part B covers doctor visits (both inpatient and outpatient), medical equipment like wheelchairs or oxygen tanks,physical therapy, mental health counseling…the list goes on.

Medicare Advantage plans are offered through private insurance companies who have been approved by CMS. They include everything that Parts A and B cover under Original Medicare plus extra benefits like prescription drug coverage, dental services, hearing exams, gym memberships…you get the idea.

Points of Comparison

Now that you know what each plan entails let’s break down their main differences:


Original Medicare has standardized costs – meaning everyone pays pretty much the same amount for covered services regardless of where they live or which provider they see (gasp, I know). But there are deductibles (money you pay out-of-pocket before your insurance kicks in) for both Parts A ($1,484) and B ($203).

In contrast,Medicare Advantage policies often have premiums as low as $0 per month. Many provide additional benefits mentioned earlier without extra cost. However many patients do incur significant copayments when seeing Doctors outside Insurance Company Network network .

Provider Networks

Under Original medicare,you can go to any provider nationwide accepting medicare while using your identity card .This often resultsin a HUGE relief among seniors.Often, it doesn’t matter what state you live in or where the provider is located across the country; if they participate in Medicare (which most providers do), then you can see them.

With a Medicare Advantage Policy, things are slightly different. You are often required to stick within your policy’s network of healthcare providers, which means there might be limitations on who you can and cannot see for medical treatments .This could mean finding new physician’s offices,hospitals or even pharmacies!. Not cool.

A decision on which of these plans (Original Medicare or Selecting a suitable Medicare Advantage Plan made by analyzing several factors :

  1. Health
    This one is pretty straightforward: Take stock of your health situation,including previous and current illness , chronic conditions like arthritis,tendency towards falls due to instability etc.
    If you’re prone to accidents or have high-risk ailments,it would make sense to opt for a more comprehensive plan that covers additional benefits beyond those offered under Original medicare .
    These extra coverages could include prescription drugs,dental care,paid gym subscription’s,some vision-exam money-back policies+thereby reducing out-of-pocket expenses!

2.Location :
Not all insurance companies offer their services across all states, so if we talk about government operated Medicar Plans {Original} there’s usually no geographic restrictions,you need not worry at while traveling.For MA plan always check whether the Insurer has networks in another State where chances exist that patients must visit frequently

The bottom line: How much will this plan cost me? It makes sense when selecting a policy requiring evaluation from an analytical point weighing upthe many pros and cons,consider ONLY after comparing premium costs along with copay/more importantly deductibles vs expected annual health expenses

Closing Thoughts

At risk of sounding too biased, I’ll say this: The right choice between Original medicareand Medicare Advantage plans depends on your specific needs, expectations and preferences,and seriously sounds like some serious homework to be researched !

But the beauty of Medicare is you don’t have to go it alone. Trusted experts are available:

  • Check out educational resources offered through CMS’s website or any independent agents offering insights into policies.(Holla!)
  • Don’t hesitate to ask friends or family members for their perspectives on how they went about making their own selection !
    They might share some unexpected pros and cons based upon history

-Last but not least, hire a broker;these professionals invite you for meeting sessions,travelling down technical paths ,giving a clearer picture whether going for an MA plan suits better than sticking with Original medicare

In conclusion:It’s alright not comprehending the nitty-gritty details in selecting between both insurance covers.Pick up the phone,research well & discuss your requirements with The VETERANS,the young-adults – several groups of people ought providing opinions worth gold dependingon experiences!

Just remember,your health deserves optimal care(at affordable prices) no matter what!

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