Medicare Simplified

Understanding your Medicare choices is a key step for seniors and their families, even if it seems complicated at first. There are two main paths: Original Medicare and Medicare Advantage. Each has its own set of pros and cons.


Original Medicare

Original Medicare is the traditional fee-for-service program. It’s made up of two parts:

  • Part A (Hospital Insurance): This covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health services. Most people don’t pay a premium for Part A if they or their spouse paid Medicare taxes through their jobs.
  • Part B (Medical Insurance): This covers outpatient care, like doctor visits, preventive services, and medical equipment. Unlike Part A, you’ll pay a monthly premium for Part B, and this amount can vary based on your income.

With Original Medicare, you have the flexibility to see any doctor or visit any hospital that accepts Medicare. However, it doesn’t cover everything. For instance, prescription drugs, dental care, and vision care typically aren’t included. Many people buy Medigap (supplemental insurance) to help cover these gaps.


Medicare Advantage Plans

Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare. They combine Part A, Part B, and often Part D (prescription drug coverage) into one plan.

A big draw of Medicare Advantage plans is that they frequently include extra benefits not covered by Original Medicare, such as vision, dental, hearing, and even fitness programs. They may also have lower out-of-pocket costs, often with a set maximum on annual expenses.

However, Medicare Advantage plans usually require you to use a network of doctors and hospitals, which can limit your flexibility. Monthly premiums for these plans vary, and some even offer zero-premium options.


Making Your Decision

Choosing between Original Medicare and a Medicare Advantage plan means considering your personal needs and preferences. Think about things like the importance of additional benefits, whether you’re comfortable with network restrictions, and what your budget looks like. By understanding these options, you’ll be better equipped to make an informed decision about your Medicare coverage.

Scroll to Top