How Are MA Plans Different From Original Medicare?

Understanding Original Medicare and Medicare Advantage

Are you trying to understand the difference between Original Medicare and Medicare Advantage Plans? At Casa Arteaga Insurance, located in Plano, Texas, we have the answers you need to make an informed decision about your healthcare.

Understanding Original Medicare

Original Medicare is a federal program that provides healthcare coverage to people aged 65 and older and certain younger people with disabilities. It consists of two parts:

Part A: Covers hospital stays, nursing facilities, hospice care, and some home health care.
Part B: Covers outpatient care, doctor visits, preventive services, and some home health care.

Original Medicare does not include prescription drug coverage, dental, vision, or hearing services. Beneficiaries need to pay monthly premiums, deductibles, and coinsurance.

Original Medicare and Medicare Advantage

Medicare Advantage Plans, also known as MA Plans or Part C, are an alternative to Original Medicare. These plans are offered by private insurance companies approved by Medicare. They provide all Part A and Part B benefits and often include additional coverage like dental, vision, hearing, and prescription drugs.

The Difference Between Original Medicare and Medicare Advantage

There are several key differences between Original Medicare and Medicare Advantage Plans:

Provider Network: Original Medicare allows you to see any doctor or hospital that accepts Medicare. Medicare Advantage Plans usually have a network of doctors and hospitals you must use.
Costs: Original Medicare has standard costs like premiums, deductibles, and coinsurance. Medicare Advantage Plans may have lower out-of-pocket costs but can include copays and network restrictions.
Coverage: Original Medicare does not include prescription drug coverage, which requires a separate Part D plan. Many Medicare Advantage Plans include prescription drug coverage and additional benefits like dental and vision.

Medicare Advantage Plan Benefits

Many Medicare Advantage Plans offer extra benefits that Original Medicare does not:

Prescription drug coverage
Dental, vision, and hearing services
Fitness programs and wellness benefits
Lower out-of-pocket costs for medical care

Comparing Original Medicare and Medicare Advantage

When comparing Original Medicare and Medicare Advantage, consider the following:

Do you want the freedom to choose any healthcare provider?
Are you looking for additional benefits like dental and vision?
What are your monthly premium and out-of-pocket cost preferences?
Do you need a prescription drug plan included?

Switching From Original Medicare to Medicare Advantage

If you decide to switch from Original Medicare to a Medicare Advantage Plan, you can do so during the annual enrollment period. Consider your healthcare needs, budget, and preferred providers before making a change.

Medigap: A Medicare Supplement Plan

Medigap, also known as Medicare Supplement Insurance, is an option for those who choose Original Medicare. It helps cover some of the out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles. Medigap does not include prescription drug coverage, so a separate Part D prescription drug plan is necessary.

Choosing Between Original Medicare and a Medicare Advantage Plan

The decision to go with Original Medicare or a Medicare Advantage Plan depends on your personal healthcare needs and preferences. Consider the following:

Your current health and future medical care needs
Your budget for premiums and out-of-pocket costs
Your preference for having a broader network of providers
Your need for additional benefits like prescription drug coverage, dental, or vision