Original Medicare vs. Medicare Advantage
Medicare covers many of your health care needs. Today’s Medicare is working with private companies' health plans to provide different ways to get your health care coverage in the Medicare program. The Medicare health plan that you choose affects many things like cost, benefits, doctor choice, convenience, and quality. Your Medicare health plan choices include:
The Original Medicare Plan - This is a fee-for-service plan that covers many health care services and certain drugs. You can go to any doctor or hospital that accepts Medicare. When you get your health care, you use your red, white, and blue (Figure 1).
You can look on your Medicare Card to see if you are enrolled in Medicare Part A or Part B. Your medicare enrollment is indicated under the "Is Entitled To" section (See Figure 1 Above).
The Original Medicare Plan pays for many health care services and supplies, but it doesn’t pay all of your health care costs. There are costs that you must pay, like coinsurance, copayments, and deductibles. These costs are called “gaps” in Medicare coverage. You might want to consider buying a Medigap or Medicare Supplement policy to cover these gaps in Medicare coverage. You can also add prescription drug coverage by joining a Medicare Prescription Drug Plan.
For more information on the Original Medicare Plan, visit the What is Medicare? section of this website.
For more information on the Medicare Advantage Plans visit the What is Medicare Advantage? section of this website.
Medicare Advantage Plans are available in many areas. If you have one of these plans, you don’t need a Medigap policy. These plans include:
- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
- Private Fee-for-Service (PFFS) Plans
- Medical Savings Accounts (MSA)
- Special Needs Plans (SNP)
These plans may cover more services and have lower out-of-pocket costs than the Original Medicare Plan. Some plans cover prescription drugs (these plans are known as, MA-PD for Medicare Advantage-Part D). In some plans, like HMOs, you may only be able to see certain doctors or go to certain hospitals to get covered services.
from Medicare.gov, Medicare Options Compare (2012) & Medicare.gov, Medicare Plan Choices Overview (2012)