Here is How They Compare:

In 1997, Congress approved a competitor to original Medicare.  Known first as Medicare+Choice (M+C), then renamed Medicare Advantage in 2003, Part C plans allowed health maintenance organizations (HMO’s) and preferred provider organizations (PPOs) into the system.  Suddenly, Medicare enrollees had to make a distinct choice for their coverage:  original Medicare, managed directly by the federal government, or Medicare Advantage, through a private-sector provider.  Here are some of the key factors in choosing either.

 

ENROLLMENT

Original:  About 39 million                                                                            Medicare Advantage(MA):

enrollees as of 2019, equal to 63 percent of enrollees                     Roughly 22 million, or 37 percent of enrollees

 

JOINING PROCESS

Original:  Beneficiaries sign up for parts A and B                 Medicare Advantage:  First you sign up for Medicare

(hospital and doctor coverage) directly with                                         Parts A and B with the government in order

Medicare; a prescription drug plan (and, if desired                            to receive your Medicare card.  You then fill out an

a Medigap policy) is bought directly from private                               enrollment form with the plan you wish to join;

insurers.                                                                                                              you’ll need your Medicare number and other personal information.

 

FLEXIBILITY

Original:  You may choose any doctor or hospital that                      Medicare Advantage:  These private insurance plans have networks

accepts Medicare                                                                                             of specific doctors and hospitals you must use to be covered.

 

COSTS

Original:  The government annually adjusts premiums,                   Medicare Advantage:  Private plans also adjust their premiums, fees and

deductibles and copays that apply to all enrollees                             coverages annually; be sure to review each autumn, when they are

nationwide.  Generally, you (or your Medigap insurer)                    announced.  But generally these plans tend to have lower copays and

are responsible for 20 percent of health bills.                                       out-of-pocket costs than original Medicare.

 

COVERAGE

Original:  Medicare pays for most basic medical needs                    Medicare Advantage:  Coves everything original Medicare does; some plans also

                                                                                                                                cover dental, vision, and hearing, as well as prescription drug costs.  Some also provide

                                                                                                                                services such as transportation, home-delivered meals and health-related

                                                                                                                                home improvements.

 

WHO PREFERS ORIGINAL MEDICARE?

Generally, original Medicare is popular among people who:

*Want Flexibility in choosing doctors and providers

*Travel Often or have more than one residence

*Prefer to Manage their own health care by picking their own doctors