Original Medicare vs Medicare Advantage

Original Medicare (Parts A and B)

Original Medicare includes hospital insurance (Part A) and medical insurance (Part B). You can use doctors and hospitals that take Medicare throughout the U.S.; costs may be higher if a provider does not accept assignment. You may add a separate Part D drug plan and a Medigap policy. Original Medicare has no yearly out-of-pocket limit for Part A and B services by itself.

Medicare Advantage (Part C)

Medicare-approved private plans provide your Part A and Part B benefits. Most include Part D, and some offer additional benefits. Plans may use networks, require referrals, or require prior authorization. They have yearly limits for covered Medicare services; plan details and costs vary. Medigap does not pay Medicare Advantage cost sharing.

Questions to compare

Check the monthly premiums, deductibles, and copayments alongside each plan’s yearly limit. Verify whether your doctors, hospitals, drugs, and pharmacies are covered and whether referrals or prior authorization are needed. Consider your expected care and travel, and confirm what happens if you later want to change coverage.

Sources: Medicare.gov: compare Original Medicare and Medicare Advantage and Medicare Plan Finder.