Medicare vs. Medicare Advantage: Which One Is Right for You?

Choosing the right Medicare plan can be overwhelming. Many beneficiaries wonder whether they should stick with Original Medicare (Parts A & B) or enroll in a Medicare Advantage (Part C) plan. Each option has unique benefits and potential drawbacks, so understanding the differences can help you make an informed decision.

What Is Original Medicare?

Original Medicare consists of Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).

Pros of Original Medicare:

✅ Nationwide coverage – You can see any doctor or specialist that accepts Medicare.

✅ No network restrictions – No need for referrals or primary care physicians.

✅ Flexibility – You can purchase a Medigap (Supplement) plan to help cover out-of-pocket costs.

Cons of Original Medicare:

❌ No routine dental, vision, or hearing coverage.

❌ Out-of-pocket costs – Includes deductibles, copays, and 20% coinsurance.

❌ No prescription drug coverage – You must purchase a separate Part D plan.

What Is Medicare Advantage (Part C)?

Medicare Advantage plans are offered by private insurance companies and include Part A, Part B, and often Part D (prescription drug coverage), plus extra benefits.

Pros of Medicare Advantage:

✅ Lower monthly premiums (in some cases).

✅ Includes extra benefits like dental, vision, and hearing.

✅ May offer gym memberships (SilverSneakers) and wellness programs.

✅ All-in-one coverage (medical, hospital, and prescription drugs).

Cons of Medicare Advantage:

❌ Requires using network providers (HMO or PPO plans).

❌ May need referrals for specialists.

❌ Higher out-of-pocket costs for some services.

Which One Should You Choose?

Choose Original Medicare if:

✔ You want freedom to see any doctor without network restrictions.

✔ You want to add a Medigap plan to lower out-of-pocket costs.

✔ You don’t need extra benefits like dental or vision.

Choose Medicare Advantage if:

✔ You want lower upfront costs and additional benefits.

✔ You’re comfortable with provider networks (HMO/PPO).

✔ You prefer an all-in-one Medicare plan.

Final Thoughts

There is no one-size-fits-all Medicare plan. Your choice depends on your healthcare needs, budget, and provider preferences. If you need help comparing options, Lindbergh and Associates is here to guide you!

📞 Call us today or schedule a free consultation to find the best Medicare plan for you!