What is the difference between Medicare Advantage and Original Medicare?

Original Medicare (Parts A and B) is run by the federal government and covers hospital and medical services. Medicare Advantage is offered by private insurers and must cover at least the same services, but often adds drug coverage and extras. The key trade-off: Advantage plans typically have lower premiums but use provider networks, while Original Medicare lets you see any provider who accepts Medicare.

Do I still pay my Part B premium with Medicare Advantage?

Yes. You keep paying your standard Part B premium regardless of which coverage you choose. Some Medicare Advantage plans pay part of that premium back to you as a benefit, lowering your total monthly cost.

Can I see any doctor with a Medicare Advantage plan?

It depends on the plan type. HMO plans require you to use a network of providers and usually need a referral to see a specialist. PPO plans give you more flexibility to see out-of-network providers, though at a higher cost. Your licensed insurance agent will show you which plans include your current doctors before you enroll.

How do I know which Medicare Advantage plan is right for me?

Your licensed insurance agent will run a comparison based on your medications, your doctors, where you live, and how you use healthcare. There is no single best plan. The right one depends on your situation, not a generic ranking.

Coverage

Medicare Advantage

Medicare Advantage (also called Medicare Part C) bundles hospital, medical, and often drug coverage into one plan from a private insurer.

What Medicare Advantage covers

Medicare Advantage plans must cover everything Original Medicare covers. Beyond that, most plans add prescription drug coverage (Part D) and extras like dental cleanings, vision exams, and hearing aids. Plans are offered by private insurance companies that contract with Medicare, so benefits, costs, and networks vary by plan and ZIP code. Unlike Original Medicare, every Medicare Advantage plan also includes an annual out-of-pocket maximum that caps what you pay for covered medical care each year.

Hospital stays (Part A): Inpatient care, skilled nursing, hospice.
Doctor visits (Part B): Outpatient care, preventive services, durable medical equipment.
Prescription drugs (Part D): Included in most plans, with no separate drug plan needed.
Dental, vision, hearing: Routine cleanings, eye exams, and hearing aids in most plans.
Extra benefits: OTC allowances, transportation, fitness memberships on select plans.

Who it is for

Medicare Advantage tends to fit people who want predictable, lower out-of-pocket costs, are comfortable using a network of providers, and want benefits like dental and vision bundled in. If you travel frequently or want nationwide coverage with any doctor, a Medicare Supplement plan may be a better fit. Your licensed insurance agent will compare both side by side.

Questions about your Medicare options?

Talk to a licensed insurance agent, at no cost.

1-800-940-0633

Compare Medicare Advantage with Supplement coverage.

Read the basics