The Difference Between Original Medicare and Medicare Advantage

The Difference Between Original Medicare and Medicare Advantage

There are two different ways you can receive Medicare benefits: Original Medicare (Parts A & B) and Medicare Advantage (Part C).

Both plans offer the same basic level of hospital and medical insurance, but they also have many differences when it comes to coverage, cost, and care providers.

Original Medicare (Parts A & B)

What’s Covered?

  • Inpatient hospital and skilled nursing services (Part A).
  • Doctor visits, outpatient services, and some preventive care (Part B).

What Does It Cost?

  • Part B premium paid to Medicare; Part A is premium-free (for most people).
  • Additional premium costs when Medicare supplement and Part D plans added.
  • Average Premium is $200.
  • Part A & B deductibles; 20% Part B coinsurance; copays for some services.
  • No limit on out-of-pocket costs (deductibles, coinsurance, copays).

What Providers Are Available?

  • Doctors and other providers in the United States who accept Medicare.
  • Limited coverage in foreign countries.
  • Medicare Advantage (Parts C)

What’s Covered?

  • Inpatient hospital and skilled nursing services (Part A).
  • Doctor visits, outpatient services and some preventive care (Part B).
  • Prescription drug coverage (Part D) included with most plans.
  • Extra benefits which may include: Dental, vision, hearing care, fitness programs, and services benefits such as rides to the doctor, home safety devices, etc.

What Does It Cost?

  • Part B premium paid to Medicare; Part A is premium-free (for most people).
  • Low or $0 plan premium.
  • Plan may have deductible; copays for most services.
  • Yearly limit on out-of-pocket costs (deductibles, coinsurance, copays).
  • Medicare sets maximum out-of-pocket limit. The plan limits may be less than the maximum.

What Providers Are Available?

  • Doctors and other providers in the plan network with most plans; you may pay more outside the network.
  • Limited coverage in foreign countries.
  • Emergency and urgent care covered nationwide.

Now that you know the differences, which plan should you choose? Medicare Advantage covers everything Original Medicare does plus more – all your coverage is in one plan; however, you will likely have more copays. Medical Advantages provides financial protection with an out-of-pocket limit. With Original Medicare, you can see any provider who accepts Medicare (he/she does not have to be in the network like with Medicare Advantage).

If you choose one of these plans and want to change, you can do that. You can make the change during the Medicare Annual Enrollment Period and the special enrollment periods.

At Thomas & Associates, our certified agent brokers can help you through the Medicare process. We know some of the above information can be overwhelming and confusing. You may need help figuring out which Medicare is best for you, and we can help you do that.

Apply for Medicare in Florida

At Thomas & Associates, we have years of experience helping people find and apply for the right Medicare insurance plan. We will help you choose a plan that covers the services you need, whether that’s Original Medicare or Medicare Advantage.

We know which plan will work better for you depending on your prescription needs, doctor visit needs, and more. Our certified agent brokers at Thomas & Associates insurance agency in Jacksonville, Florida, will help you select a Medicare insurance plan that is best suited to medical needs and finances.

Let us help you find the right Medicare plan. Contact us for more information and to get a quote today! To work with our agents, click our Jacksonville Medicare insurance contact page or call 904-730-3900 .


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