Medicare Blog

how to know whether to pick original medicare or advantage

by Shirley Dickens Published 3 years ago Updated 2 years ago
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Once you’ve decided in principle on a Medicare Advantage plan or Original Medicare plus Medigap, look at the plans available in your area. How to compare specific plans: Go to Medicare’s updated online plan finder tool (Medicare.gov/plan-compare) and enter your zip code. It gives details about your available Medigap and Medicare Advantage plans.

Full Answer

Should I Choose Medicare Advantage or Original Medicare?

With Medicare Advantage, each plan has its own network, and you may be limited to a much more local or regional area. Original Medicare paired with a Medigap plan and Part D coverage might be the better choice if network size is a concern, or if you expect to travel widely within the U.S. during your retirement.

How do I decide what coverage I Want for Medicare?

Use these steps to help you decide what coverage you want: 1 Decide if you want Original Medicare or a Medicare Advantage Plan (like an HMO or PPO). 2 Decide if you want prescription drug coverage (Part D). 3 Decide if you want supplemental coverage.

How do I switch from Medicare Advantage to Original Medicare?

There are three ways you can make the change: Visit your local Social Security Office and ask to be disenrolled from Medicare Advantage; Call 1-800-MEDICARE (1-800-633-4227) and process your disenrollment over the phone; or Contact your Medicare Advantage insurer directly and request a disenrollment form. When Can I Switch to Original Medicare?

What are the pros and cons of Original Medicare vs Medicare Advantage?

Pros and Cons of Original Medicare vs. Medicare Advantage Original Medicare Medicare Advantage Emergency Care in a Foreign Country Very Limited (Expanded with a Medigap Pl ... Limited Medicare Savings Plans Eligible Not Eligible Medigap Plans Allowed Not Allowed Network Broad Narrow 2 more rows ...

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Is it better to have just Medicare or the Medicare Advantage plan?

Consider if you want coverage for dental, vision and other extra benefits. Medicare Advantage plans cover everything Original Medicare covers plus more, so if you want things like dental, vision or fitness benefits, a Medicare Advantage plan may be the right choice.

Why would you not choose a Medicare Advantage plan?

Consider your health care and budget needs. You'll get extra coverage not available through Original Medicare and could be off the hook for a premium each month. Yet, if you prefer predictability regarding costs and coverage year after year, a Medicare Advantage plan may not be the best choice.

What percent of seniors choose Medicare Advantage?

[+] More than 28.5 million patients are now enrolled in Medicare Advantage plans, according to new federal data. That's up nearly 9% compared with the same time last year. More than 40% of the more than 63 million people enrolled in Medicare are now in an MA plan.

What is the biggest disadvantage of Medicare Advantage?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan. If you decide to switch to a Medigap policy, there often are lifetime penalties.

Can I switch from Medicare Advantage to original Medicare?

Yes, you can elect to switch to traditional Medicare from your Medicare Advantage plan during the Medicare Open Enrollment period, which runs from October 15 to December 7 each year. Your coverage under traditional Medicare will begin January 1 of the following year.

Can you have Medicare and Medicare Advantage at the same time?

Can I combine Medicare Supplement with Medicare Advantage? If you already have Medicare Advantage plan, you can generally enroll in a Medicare Supplement insurance plan under one condition – your Medicare Advantage plan must end before your Medicare Supplement insurance plan goes into effect.

Are Medicare Advantage plans becoming more popular?

In 2005, 13 percent of enrollees chose the MA option, and the growth has been steady ever since; enrollment in Advantage plans rose 10 percent between 2020 and 2021 alone.

What Medicare plans do most people choose?

Three plans — Plan F, Plan G, and Plan N — are the most popular (accounting for over 80 percent of all plans sold). Here's an in-depth look at this trio of Medicare Supplement plans, and the reasons so many people choose them.

What are the top 3 Medicare Advantage plans?

The Best Medicare Advantage Provider by State Local plans can be high-quality and reasonably priced. Blue Cross Blue Shield, Humana and United Healthcare earn the highest rankings among the national carriers in many states.

Why do I need Medicare Part C?

Medicare Part C provides more coverage for everyday healthcare including prescription drug coverage with some plans when combined with Part D. A Medicare Advantage prescription drug (MAPD) plan is when a Part C and Part D plan are combined. Medicare Part D only covers prescription drugs.

What's the big deal about Medicare Advantage plans?

Medicare Advantage Plans must offer emergency coverage outside of the plan's service area (but not outside the U.S.). Many Medicare Advantage Plans also offer extra benefits such as dental care, eyeglasses, or wellness programs. Most Medicare Advantage Plans include Medicare prescription drug coverage (Part D).

What is the best Medicare Advantage plan for 2022?

The Best Medicare Advantage Plans of 2022Best User Quality: Cigna.Best User Experience: Humana.Best in Educational Content: Aetna.Best for Bonuses: AARP.Best for Simplicity and Clarity: Blue Cross Blue Shield.

Traditional Medicare vs. Medicare Advantage

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The various offerings under Medicare sound like alphabet soup, but basically, traditional Medicare includes Part A (hospital), Part B (medical) and Part D (prescription drugs). Medicare Advantage plans, which are growing rapidly as an alternative to traditional Medicare, are called Part C but actually incorporate Part…
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Questions to Ask

  • Answering these questions can help you decide which plan is best for you… How essential is it that I be able to choose from a very large network? Medicare plus Medigap is good if… 1. You want to be able to access any health-care provider across the country that accepts Medicare. 2. You split your time between homes in two or more states and need coverage in all those places. …
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Next Steps

  • Once you’ve decided in principle on a Medicare Advantage plan or Original Medicare plus Medigap, look at the plans available in your area. How to compare specific plans: Go to Medicare’s updated online plan finder tool (Medicare.gov/plan-compare) and enter your zip code. It gives details about your available Medigap and Medicare Advantage plans. It...
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More About Advantage Plans

  • To compare Advantage plans, how much should I focus on $0 premiums? It’s important to look beyond the premium, which under some plans is $0, and even past the deductibles to also check what your co-pays would be for each type of medical service, ranging from specialists to tests, and what the maximum out-of-pocket amount is. These could add up to huge amounts. Should I …
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Have More Questions?

  • Try the Medicare Rights Center’s interactive tool at MedicareInteractive.orgfor help with common questions and decision-making or call the Center at 800-333-4114.
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