When you first sign up for Medicare, and each year after that during the Annual Enrollment Period, you have the opportunity to choose Original Medicare or a Medicare Advantage plan.
What’s the difference?
Original Medicare consists of Part A and Part B. Part A helps pay for care you receive in a hospital or in a skilled nursing facility. Part B helps pay for doctor visits and other outpatient medical services. Original Medicare provides the same coverage for the same cost to everyone who has it.
Medicare Advantage is another way to get Medicare benefits. Every Medicare Advantage plan must provide, at minimum, the same coverage offered by Original Medicare. Beyond that, plan benefits and pricing vary a great deal.
Added Benefits with Medicare Advantage
Medicare is a federal program designed to provide access to health insurance for people 65 or older and people younger than 65 with certain disabilities. Original Medicare is health insurance run by the federal government under the Medicare program.
Congress created Medicare Advantage to give beneficiaries more choices in how they receive Medicare benefits. Medicare Advantage (Medicare Part C) plans are offered by private insurance companies. The companies decide where in the country they will offer their plans. They also decide what their plans will cover beyond the minimum Medicare requirements.
Here is a summary of some of the extra benefits you can get with a Medicare Advantage plan:
- Prescription drug coverage – Most Medicare Advantage plans include drug coverage, often for no additional premium. Or, you can buy a separate standalone Medicare prescription drug plan to add to Original Medicare, if you wish.
- Dental care, eye care and hearing care coverage – Coverage may include dental exams, eye exams, hearing exams, glasses, contacts, hearing aids and more.
- Wellness and fitness programs – Benefits can include chronic disease management programs, fitness club memberships, dietary counseling, health coaching, health education and more.
- Worldwide urgent care and emergency coverage – You can get care anytime, anywhere. Original Medicare does not cover emergency care outside the country.
- Mail order pharmacy benefit – Many plans offer savings on prescriptions filled through mail order pharmacy partners.
- Cap on out-of-pocket costs – All Medicare Advantage plans must cap your annual out-of-pocket expenses at a level set by Medicare. These expenses can include deductibles, copays and coinsurance. Premiums are not included. For 2012, the cap is $6700. Original Medicare has no out-of pocket cap.
Compare Your Choices
If you choose to explore Medicare Advantage plans, you will likely find many plans in your area to learn about and compare. You can get a complete list of what’s available by using the Medicare.gov plan finder. Enter some basic information and the site generates a list of plans. For each plan, you get a summary of coverage, premiums, deductibles, copays, estimated annual costs and more. You can select the plans you’re interested in and get a side-by-side comparison. Find a plan you like, and you can even enroll online.
For more information contact the Medicare helpline 24 hours a day, seven days a week 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. You can also contact UnitedHealthcare® Medicare Made Clear to learn more at 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.Resources
What is a Medicare Advantage Plan (Part C)? – Medicare.gov
Decide How to Get Your Medicare – Medicare.gov
CMS’ Medicare & You – Medicare.gov
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