.\u201d\u00a0<\/span><\/p>\nOriginal Medicare<\/span> is offered by the <\/span>federal government<\/span>, and is broken into parts, mainly Part A and Part B. <\/span>Medicare Part A, generally speaking,<\/span> is <\/span>inpatient<\/span> coverage that covers your <\/span>hospital stays<\/span> and many of the costs associated with your time there. Medicare Part B covers <\/span>outpatient<\/span> services like <\/span>doctor\u2019s visits<\/span>, some medical equipment, and ambulance services. There are also privately administered <\/span>Medicare Part D plans<\/span> that cover <\/span>prescription drugs<\/span>.<\/span><\/p>\nDespite being a government-subsidized <\/span>insurance plan<\/span>, there are still costs associated with <\/span>Original Medicare<\/span>. You\u2019ll need to pay premiums for each part of Medicare, and there are also <\/span>deductibles<\/span> and coinsurance.<\/span><\/p>\nWith <\/span>Original Medicare<\/span>, you\u2019ll be covered to see any <\/span>healthcare provider<\/span> nationwide that accepts Medicare. People with limited income and resources may also have access to <\/span>Extra Help<\/span>, a program to help low-income individuals using Medicare with some Part D costs. Another option to help reduce costs is <\/span>Medicare Supplement Insurance<\/span>, or Medigaps, which can be used in addition to Medicare to cover the <\/span>out-of-pocket costs<\/span>, like <\/span>co-pays<\/span> and <\/span>coinsurances<\/span>, that Medicare does not cover.<\/span>
<\/span><\/p>\nRobbins went on to explain <\/span>Medicare Advantage plans<\/span>, \u201c<\/span>Part C<\/span>, also known as Medicare Advantage (MA), became another option for Medicare <\/span>healthcare<\/span>, beginning in 1997. <\/span>It\u2019s an alternative to <\/span>Original Medicare<\/span>, which allows patients to choose <\/span>health plans<\/span> with at least the same service coverage as <\/span>Original Medicare<\/span>, including a few extra benefits such as dental, vision, hearing, and <\/span>Part D<\/span> prescription drugs<\/span>.\u201d<\/span><\/p>\nMedicare Advantage plans<\/span>, sometimes called <\/span>Medicare Part C<\/span> plans, are offered by <\/span>private insurance companies<\/span> and can be advantageous for some individuals. These plans typically combine Parts A, B, and D into a single private plan. Medicare Advantage plans are most commonly provided through <\/span>health maintenance organizations<\/span> (<\/span>HMO<\/span>) or <\/span>preferred provider organization<\/span> (<\/span>PPO<\/span>) plans; you can pick coverage from various <\/span>insurance companies<\/span>, some of which have $0 premium plans.\u00a0<\/span><\/p>\nHowever, it\u2019s important to note that you may need preauthorization before visiting certain <\/span>healthcare<\/span> professionals with <\/span>Medicare Advantage Plans<\/span>. You may only be able to see doctors in the <\/span>plan\u2019s network<\/span>, usually limited to your area. Otherwise, you may only get partial insurance coverage on your visit or none at all.<\/span><\/p>\nHow to choose between <\/span>Original Medicare and Medicare Advantage<\/span><\/h2>\nAfter researching the types of Medicare, the next big question many people face is how to choose between <\/span>Original Medicare<\/span> and Medicare Advantage. This is a personal choice because you\u2019ll need to evaluate the <\/span>Medicare Advantage plans<\/span> available to you and see how they compare to <\/span>Original Medicare<\/span> for your specific <\/span>healthcare needs<\/span>. You\u2019ll want to consider any health conditions you have, which doctors you can visit, and your financial situation.\u00a0<\/span><\/p>\nTo learn more, we went to the experts to see what general advice they could give.\u00a0<\/span><\/p>\nConsider <\/span>Original Medicare<\/span> if:<\/span><\/h3>\n\u201c<\/span>If you prefer budget predictability and the freedom to choose who and where you will receive your <\/span>healthcare<\/span> services, closer consideration of <\/span>Original Medicare<\/span> might be in your best interest,\u201d explained Robbins.\u00a0<\/span><\/p>\nOther considerations for choosing <\/span>Original Medicare coverage<\/span> include:\u00a0<\/span><\/p>\n\n- You want provider flexibility without a <\/span>referral<\/span>\u00a0<\/span><\/li>\n
- You\u2019re a frequent <\/span>healthcare<\/span> user or have <\/span>disabilities<\/span><\/li>\n
- You need cost-sharing programs like <\/span>Medigap<\/span> plans<\/span><\/li>\n
- You don\u2019t want to deal with prior approval for most medical services and equipment<\/span><\/li>\n
- If you plan on moving or are traveling within the United States, you\u2019ll still be covered<\/span><\/li>\n
- You want peace of mind in the case of a significant medical emergency<\/span><\/li>\n<\/ul>\n
Consider Medicare Advantage if:\u00a0<\/span><\/h3>\n\u201c<\/span>Conversely, if lower <\/span>monthly premiums<\/span> and ancillary benefits like dental, vision, and hearing with <\/span>Part D<\/span> prescription benefits are most important in a <\/span>healthcare<\/span> plan, further examination of Medicare Advantage (MA) may be worth consideration,\u201d said Robbins.\u00a0<\/span><\/p>\nYou may want to consider Medicare Advantage if:\u00a0<\/span><\/p>\n\n- You want added benefits that <\/span>Original Medicare<\/span> doesn\u2019t provide, like vision and <\/span>dental care<\/span><\/li>\n
- You want lower premiums as you don\u2019t need to visit a <\/span>healthcare provider<\/span> frequently<\/span><\/li>\n
- You don\u2019t mind waiting for prior authorization for specialty visits or certain treatments\u00a0<\/span><\/li>\n
- You don\u2019t often travel or plan on moving, so a smaller choice of <\/span>network providers<\/span> won\u2019t be an issue<\/span><\/li>\n
- You want an <\/span>out-of-pocket maximum<\/span><\/li>\n<\/ul>\n
Pros and cons of Medicare Advantages plans vs. <\/span>Original Medicare<\/span><\/h2>\nOnly you can decide the best way in which to receive your <\/span>Medicare benefit<\/span>.\u00a0<\/span><\/p>\nSimply put, those who frequently visit the doctor and have pre-existing health conditions requiring frequent treatment will likely want to choose <\/span>Original Medicare<\/span>.\u00a0<\/span><\/p>\nThe\u00a0advantages<\/strong> of Original Medicare are that it has an extensive network of healthcare providers across the United States, and it covers a wide range of services that don\u2019t typically need prior authorization.\u00a0You can get additional coverage through <\/span>Medigap<\/span> plans (Medicare <\/span>supplemental insurance<\/span>) that help pay uncovered costs like <\/span>co-pays<\/span> and <\/span>coinsurance<\/span>.\u00a0<\/span><\/p>\nThe <\/span>disadvantages<\/b> of <\/span>Original Medicare<\/span> are that it does not cover vision, dental, or hearing services, there isn\u2019t an <\/span>out-of-pocket limit<\/span>, and there are <\/span>monthly premiums<\/span> you\u2019ll have to pay with Medicare Part B<\/span> (unless you qualify for a Medicare Savings Program)<\/span>.<\/span><\/p>\nYou may want to choose <\/span>
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