What Is the Difference Between Medicare and Medicare Advantage?

Did you know that there are currently 44 million Americans enrolled in the Medicare program? Sometimes choosing the perfect health insurance can be confusing and a bit overwhelming with all of the terminology. If you are wondering about the difference between Medicare and Medicare Advantage, you are in the right place.

Keep reading to learn all of the main differences.

1. Coverage

One of the main differences is that Original Medicare only covers the medical and the hospital costs. Medicare Advantage, on the other hand, has different plans that cover prescription drugs, vision, hearing, and dental. 

Medicare Advantage also has some plans that cover extra medical costs and additional hospital costs that you might incur. 

2. Cost

With Original Medicare there is no cap on what you pay out of pocket. Medicare will only pay for a certain number of days that you are in the hospital or in a nursing facility.

With Medicare Advantage you will have an out-of-pocket maximum every year. There is a certain dollar amount that when you hit it, the plan will then pay 100% of the cost for most services that it covers. 

3. Travel 

Sometimes Medicare might not cover your health care if you are not in your local state or local area. Even in an emergency, Original Medicare will more than likely not cover you, they only cover in extreme rare cases.

Certain Medicare Advantage plans might cover you when you are out of the country if you choose a plan that you will be covered in case you are out traveling. There are certain plans that you can choose from that will cover emergency care with a maximum of $50,000 lifetime. 

4. Networks

With Original Medicare, you have the ability to go to any facility or doctor that accepts Medicare. The difference with Medicare Advantage is that their plans have fixed networks of hospitals and doctors that you have to choose from. 

When you are searching for Advantage plans at MedicareWire.com you can compare the different rules about whether or not you are able to get care outside of your network. Keep in mind that the more care the plan will cover outside of your network the more you can expect to pay for your premium every month. 

5. Copayments

When you use Original Medicare you pay 20% of the cost for common health services. Medicare Advantage plans use copayments instead of coinsurance for services. With a copayment you pay a fixed amount every time no matter what the cost is for your health service. 

Now You Know the Difference Between Medicare and Medicare Advantage

Now that we answered the question “what is the difference between Medicare and Medicare Advantage?” you can make an informed decision on what plans will work best for you. Now is the time to research the differences between the Medicare Advantage plans if you feel that having extra benefits will help you. Did this blog post help you out today? Please feel free to browse the rest of this section for some more helpful reads.