Medicare

Medicare Advantage is an alternative to Original Medicare. Where the government provides Original Medicare, private insurance companies offer Medicare Advantage.

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What is Medicare Advantage?

Medicare Advantage is an alternative to Original Medicare. Where the government provides Original Medicare, private insurance companies offer Medicare Advantage.

Medicare Advantage comes as a "bundled package" of Medicare Part A (hospitalization), Part B (medical insurance), and usually, Part D (Prescription Drug Coverage).

By contrast, Original Medicare provides Medicare Part A and B, but you must enroll in them separately. In this program, you also join a Part D plan individually.

Medicare Advantage is also called Medicare Part C. It is a relatively new way to provide Medicare to beneficiaries. It started in 2003 as a way to shift some of the costs off of the federal government.

What Makes Medicare Advantage Different From Medicare?

Managing Your Policies

With Original Medicare, you have to enroll in and manage each Part individually. Medicare Advantage is an "all-in-one" solution.

ID Cards

You receive multiple ID cards for Original Medicare, but just one for a Medicare Advantage plan.

Out-of-Pocket Maximums

Original Medicare has a 20% coinsurance without a maximum out-of-pocket amount. That means after you've met your deductible, you would pay 20% of all additional expenses yourself. It could go on forever. There is no annual limit.

Typically, Medicare supplements set a maximum out of pocket amount.

On the other hand, Medicare Advantage has yearly limits on your out of pocket expenses. Often, it has lower out-of-pocket costs.

Claims

With Original Medicare, the government pays the claims. They allow a specific amount for any treatment, and that is all they will pay the provider.

Medicare Advantage plans may negotiate with medical providers for lower costs because they typically use networks.

Doctor and Hospital Choice

You can see any doctor in the US who accepts Medicare if you have Original Medicare. If you want to see a specialist, you do not need a referral ahead of time.

In most cases, you'll need to see the doctors in your Medicare Advantage network. You would also need a referral from your primary care physician to see a specialist.

Cost

The cost of Original Medicare is about the same as Medicare Advantage.

Advantage plans must follow the guidelines set by Medicare for coverage and prices.

Dental, Vision and Hearing Benefits

Insurance companies have the flexibility to add more services, like dental, vision, and hearing benefits.

Supplemental Coverage

With Original Medicare, you have the option to buy supplemental coverage, called Medigap policies.

Medicare Advantage does not permit supplemental coverage.

Does Medicare Advantage Include Prescription Drug Coverage?

Most Medicare Advantage plans do. Check with your provider to find out if your policy covers prescriptions.

What Else Does Medicare Advantage Offer?

Most plans offer extra benefits like dental, vision, and hearing services. Some plans also provide access to fitness and nutrition programs like SilverSneakers.

Why Are Some Medicare Advantage Plans $0?

Medicare Advantage works differently from Original Medicare. With Medicare, you pay the government a premium for health insurance, and they process all of the claims.

With Medicare Advantage, you still pay your Medicare Part B premium. However, the government subsequently pays it to the private insurance company that sponsors your Medicare Advantage plan.

If you selected an Advantage Plan that has a $0 premium, the only thing you pay for is Part B. If there is an additional premium for Medicare Advantage, you pay that to the insurer. Usually, plans that include more benefits require an additional premium.

When Can I Get Medicare Advantage?

When you first become eligible for Medicare, you can enroll in Medicare Advantage instead of Medicare Original.

Work with a Medicare Marketplace like AARDY to find the best plan that fits your needs.

How Do I Switch to Medicare Advantage?

If you already have Medicare and want to switch to a Medicare Advantage plan during the annual enrollment period between October 15 and December 5 each year.

When you enroll in Medicare Advantage, you automatically unenroll from Medicare.

Can I Switch Back to Original Medicare?

You can go back to Original Medicare during the same open enrollment period from October 15 through December 5.

If you switch back, Medicare Advantage disenrolls you from the plan without contacting them.

Where Do I Buy Medicare Advantage?

AARDY is the nation's fastest Medicare insurance marketplace. You can compare Medicare supplements, and Medicare Advantage plans to find the one that best fits your needs.

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