Medicare Advantage vs. Original Medicare: Which One Is Right for You?

Medicare Advantage vs. Original Medicare: Which One Is Right for You?

Choosing a Medicare plan is an important decision that requires careful consideration of various factors, including your current health status, anticipated future health needs, and budget. Today, we’re going to discuss the differences between two key choices: Original Medicare and Medicare Advantage.

What is Original Medicare?

Original Medicare, also known as Traditional Medicare, is a federal health insurance program for individuals who are 65 or older and certain younger people with disabilities. It comprises Part A (Hospital Insurance) and Part B (Medical Insurance). Original Medicare covers hospital stays, skilled nursing facility care, doctor’s visits, and preventive services.

What is Medicare Advantage?

Medicare Advantage, also known as Medicare Part C, is an alternative to Original Medicare offered by private insurance companies approved by Medicare. Medicare Advantage Plans include the same coverage as Original Medicare (Parts A and B) and usually also include prescription drug coverage (Part D). Some may offer additional benefits, like vision, hearing, and dental coverage.

Key Differences Between Original Medicare and Medicare Advantage

Cost: Medicare Advantage plans often have lower out-of-pocket costs compared to Original Medicare. However, they also tend to have a more restricted network of healthcare providers.

Coverage: While Original Medicare covers most medically necessary services, Medicare Advantage Plans may offer additional benefits like routine vision, hearing, and dental care, fitness programs, and wellness services.

Out-of-pocket maximum: Original Medicare does not have an out-of-pocket maximum, meaning there’s no cap on what you might pay for healthcare in a given year. Medicare Advantage plans, on the other hand, have an annual out-of-pocket maximum, providing some financial protection if you have a high-cost health condition.

Travel: If you travel frequently or spend part of the year in a different state, Original Medicare may be a better option as it’s accepted by any doctor or hospital that accepts Medicare, without geographic restrictions.

Which One is Right for You?

The choice between Original Medicare and Medicare Advantage depends on your individual health needs, lifestyle, and financial situation. If you value lower out-of-pocket costs, additional benefits, and don’t mind a limited network of providers, a Medicare Advantage plan may be a good fit. If you prefer broader provider options, predictability of costs (especially if you purchase a Medigap policy), or travel frequently, Original Medicare could be the better choice.

At, we understand the intricacies of Medicare and are dedicated to helping you find the plan that best suits your needs. Our licensed insurance agents are standing by to guide you through your options. Contact us today to start the conversation.