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    Home » Medicare Advantage vs. Original Medicare: What’s the Real Difference?  
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    Medicare Advantage vs. Original Medicare: What’s the Real Difference?  

    Lily JamesBy Lily JamesJuly 10, 20254 Mins Read
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    Are you exploring Medicare advantage plans Houston? Do you want to see which plan is better, viz. Medicare Advantage or Original Medicare? This question comes to the mind of all those for whom Medicare is new and they are finding it difficult to understand it.

    Choosing the right plan while selecting Medicare is a bit of a difficult task because this one plan determines your future healthcare costs and coverage.

    Anyway, in this blog we will try to clear up all your confusion.

    Let’s dive right in..!!

    Table of Contents

    Toggle
    • Let’s Understand the Basics first.
    • Key Differences You Should Know
      • 1. Coverage Extras
      • 2. Doctor and Hospital Choices
      • 3. Costs and Budgeting
      • 4. Prescription Drug Coverage
      • 5. Travel Considerations
    • Why Work with a Medicare Insurance Agent?
    • Conclusion

    Let’s Understand the Basics first.

    The original Medicare is run by the government to protect people’s health. It mainly has two parts.

    • Part A covers hospital care.
    • Part B covers doctor visits, outpatient care, and preventive services.

    But the most important thing to note is that original Medicare doesn’t cover everything. It doesn’t include prescription drugs, dental, vision, or hearing services.

    In contrast, private insurance companies manage Medicare Advantage. Compared to the original Medicare, these offer patients a lot more facilities. In addition to prescription medication coverage, dental, vision, and hearing care, their plans cover original Medicare and even wellness benefits like gym memberships.

    Key Differences You Should Know

    1. Coverage Extras

    The best thing about the original Medicare is that it covers all the basic things such as doctor visits and hospital stays. But if you want more services, you need to enroll in separate plans and have to pay more for them.

    Medicare Advantage plans Houston can help with that. These plans frequently combine a lot of those additional benefits into one, which simplifies and facilitates life. It’s a more comprehensive approach to your medical care.

    2. Doctor and Hospital Choices

    If you want flexibility in your medical visits, original Medicare is best for you. You can see any doctor or go to any hospital in the U.S. that accepts Medicare—no referrals are needed.

    However, networks are often used by Medicare Advantage plans. 

    3. Costs and Budgeting

    After paying your deductible, you must pay 20% of your medical expenses, which is typically the monthly premium for Part B of Original Medicare. There’s no annual spending cap, which could be dangerous if you have a serious illness.

    Medicare Advantage plans include an annual cap on the amount you will pay for covered services and frequently have lower out-of-pocket expenses. The plan pays for all of your expenses for the remainder of the year after you reach that threshold. Many find peace of mind in this.

    4. Prescription Drug Coverage

    Prescription medication coverage is not covered by original Medicare; you must purchase a separate Part D plan. Drug coverage is typically integrated into Medicare Advantage plans, saving you one worry.

    5. Travel Considerations

    Do you frequently travel in the United States? You can get coverage anywhere in the nation with Original Medicare. If you’re always on the go, Medicare Advantage plans usually limit you to their service areas, unless there’s an emergency.

    How to Decide What’s Best for You?

    Ask these questions to yourself. 

    Would I like additional benefits like vision, hearing, and dental in a single plan?

    Should I stick to a network or is it necessary for me to see any doctor?

    Am I seeking fixed expenses with an annual spending cap?

    Do I want drug coverage included because I take medications?

    If you answered “yes” to most of these, a Medicare Advantage plan might suit you.

    Original Medicare might be a better option if you want the most flexibility and don’t mind paying for additional coverage on an individual basis.

    Why Work with a Medicare Insurance Agent?

    Both original Medicare and Medicare Advantage plans have their own set of offerings. But when it comes to selecting the right plan, it may be very difficult. So to clear up this confusion, you have to search for a medicare broker near me. This broker will explain both plans to you deeply, and you will clearly understand the benefits of both. And you will be able to choose a better plan.

    Conclusion

    You do not have to choose the right Medicare plan based on someone’s advice. Always remember that whatever plan you are going to select, you should choose it according to your financial situation, your lifestyle, and your level of health. For people who want all-in-one convenience and also want to avail additional benefits, Medicare Advantage is a better option. For those who do not want to understand flexibility, Original Medicare is a good option.

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    Lily James

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